【摘要】 目的 :探讨MRI心肌灌注成像(MRMPI)对冠状动脉粥样硬化性心脏病(冠心病)心肌缺血的诊断价值。方法 :选取行MRMPI及冠脉造影(CAG)的冠心病患者30例,分析MRI特征,测量MRMPI中病变心肌与正常心肌首过灌注时间、首过最大上升斜率及延迟强化信号强度。结果:30例中,以CAG为参照,MRMPI发现左前降支(LAD)病变20例,诊断符合率、灵敏度、特异度分别为93.8%、95.5%、90.0%;左旋支(LCX)病变12例,诊断符合率、灵敏度、特异度分别为90.9%、92.9%、89.5%;右冠状动脉(RCA)病变15例,诊断符合率、灵敏度、特异度分别为85.7%、89.5%、81.3%。54个室壁节段出现心肌首过灌注降低及最大上升斜率降低;49个心肌节段出现延迟强化,其中22个节段呈透壁性强化,27个节段呈非透壁强化,主要表现为中层心肌、心内膜、心外膜下的异常强化。结论:MRMPI有利于显示心肌病理生理学方面的改变,对冠心病综合诊断有很高的临床应用价值。更多还原

【Abstract】 Objective:To discuss the diagnostic value of MR myocardial perfusion imaging(MRMPI) in myocardial ischemia of coronary heart disease. Methods:30 patients with conformed coronary heart disease who completed MRMPI and coronary angiography(CAG) were selected,the imaging features of MRMPI were analyzed,the first-pass perfusion time,the first maximal increase slope and the delayed enhancement feature of myocardium and normal myocardium were measured. Results:In 30 patients,taking CAG as a reference,20 cases of LAD lesion,12 cases of LCX lesion and 15 cases of RCA lesion were found by MRMPI,the diagnostic accuracy,sensitivity,specificity were 93.8%,95.5%,90.0%;90.9%,92.9%,89.5%;and 85.7%,89.5%,81.3%respectively. 54 ventricular wall segments showed a decrease in myocardial first-pass perfusion and a decrease in the maximum ascending slope. 49 myocardial segments appeared delayed enhancement,22 segments showed transmural enhancement;27 segments showed non-transmural enhancement,mainly manifested as abnormal enhancement of mid myocardium,endocardium and epicardium. Conclusion:MRMPI can show the pathophysiological changes in the myocardium,and it has high clinical value in the comprehensive diagnosis of coronary artery disease.更多还原