一站式心脏MRI对心肌病的评价

心肌病的一站式心脏MRI扫描包括梯度回波序列、自旋回波序列及反转恢复快速自旋回波序列平扫,梯度回波序列电影扫描,梯度回波序列首过灌注及延迟增强扫描和冠状动脉扫描等,可综合评价心脏解剖结构、心肌病理特点、心脏功能及冠状动脉状态等,从而达到使多种影像学检查综合起来的共同目的。心肌延迟强化的特点还可对部分心肌病进行危险度分级、病因分析、治疗指导、穿刺定位等,在临床中对心肌病的诊治具有举足轻重的作用。     

心脏生理的电影MRI

本综述了心脏电影ＭＲＩ的基本原理；在电影ＭＲＩ上正常心脏信号表现及心功能测定；并简要评价其临床地地位。     

利用心脏MRI探索围产期心肌病的特征性影像表现

围产期心肌病（PPCM）是导致心力衰竭的一种罕见病因．只有半数病人能够恢复到正常心功能。利用MRI及延时增强成像检测心肌纤维化,以预测围产期心肌病病人心脏功能恢复的可能。1999年——2006年,涉及心力衰竭治疗或预后评估的连续1037例病人中,有8例女性被证实为PPCM。     

利用心脏MRI探索围产期心肌病的特征性影像表现

围产期心肌病（PPCM）是导致心力衰竭的一种罕见病因．只有半数病人能够恢复到正常心功能。利用MRI及延时增强成像检测心肌纤维化,以预测围产期心肌病病人心脏功能恢复的可能。1999年——2006年,涉及心力衰竭治疗或预后评估的连续1037例病人中,有8例女性被证实为PPCM。     

心脏MRI定量评价心肌梗死患者微循环阻塞

目的：微循环阻塞（MO）及心肌梗死程度是急性心肌梗死患者的重要预后因子。本研究旨在探讨对比剂注射与图像采集之间的时间间隔（扫描延迟时间）对定量评价微循环阻塞和心肌梗死的影响。方法：50例急性心肌梗死患者[男40例,女10例,年龄（58．1±11．7）岁]均行经皮冠状动脉血管重建术,根据心肌梗死溶栓术后血流分级标准血流评级为3级。     

心脏磁共振在尿毒症性心肌病中的应用进展

【摘要】心脏磁共振（CMR）能提供心脏形态功能、心肌灌注、心肌组织特征等信息,在临床得到了越来越广泛的应用。本文主要阐述CMR在尿毒症性心肌病中的应用进展。     

第九部分心脏MRI

今年的RSNA大会上,涉及心脏MRI的报道有51篇,新技术和新进展不多,乏善可陈.重点主要集中在心脏灌注成像和延迟增强在心脏疾病中的应用.     

心脏大血疾病 MRI 诊断的初步经验

本文分析41例作过心电图门控磁共振成像(ECG—G—MRI)的心脏大血管疾病的MRI表现,并与心血管造影、心导管检查、彩色多普勒超声显像及手术所见相比较。MRI 没有放射幅射,不需使用造影剂即可清楚刻画出心脏大血管腔、心肌和心包,随着设备和技术的进步,MRI 诊断许多获得性和先天性心赃大血管的能力增强,堪与损伤性的心脏大血管造影和心导管检查媲美。     

CMR对扩张性心肌病的应用价值

扩张性心肌病（DCM）的早期诊断及病情监测对其预后非常重要。心脏磁共振（CMR）可以无创性评估心肌的形态、功能及组织特性,有利于DCM的诊断和管理。就延迟钆增强、T₁ mapping、T₂ mapping及CMR特征追踪等CMR技术在DCM的早期诊断、病情监测与评估、预后预测以及鉴别诊断方面的应用价值进行综述。     

梗死心肌的MRI评价及病理对照实验研究

目的　通过MR影像与病理对照的方法明确心肌梗死后 7～ 10dMRI延迟强化区与梗死心肌的关系 ,以期为MRI评价心肌活性提供病理依据。方法　利用 6只猪无再灌注和再灌注的心肌梗死模型 ,行短轴面MR心肌延迟强化扫描。扫描结束后将心脏离体 ,沿短轴面将心脏切成断面行氯化三苯基四氮唑 (TTC)染色。比较心肌梗死区和正常对照区的延迟强化信号强度的差异 ;比较相应层面的MRI延迟强化区和TTC染色所示梗死区的关系。结果　在心肌梗死的 7～ 10d ,无论有无再灌注 ,MR延迟强化扫描均可见心肌梗死区信号较正常对照区明显升高 ,无再灌注组梗死区信号( 2 0 81± 6 49)是正常对照区 ( 2 68± 1 10 )的 7 76倍 (t =11 68,P <0 0 1) ,再灌注组梗死区信号( 14 2 8± 1 64)是正常对照区 ( 1 44± 0 52 )的 9 92倍 (t =3 1 69,P <0 0 1) ;无再灌注组的延迟强化区[占同层面左室面积的百分率为 ( 15 49± 6 0 7) % ]与梗死心肌 [( 14 95± 7 3 6) % ]一致 (t =-0 78,P>0 0 5) ,再灌注组的延迟强化区 [( 12 52± 5 93 ) % ]包括梗死区 [( 11 13± 5 81) % ]和梗死周围区 ,过度估计梗死心肌范围约 12 47% (t =-14 48,P <0 0 1)。结论　在心肌梗死的 7～ 10d ,MR延迟强化扫描可较准确地反映梗死心肌的范围     

心脏一站式MR检查方法的进展

随着MRI设备软硬件高新成像技术的产生,使MRI在心脏形态及功能代谢研究方面得到了广泛的应用.如快速黑血及电影白血成像技术;心肌标记技术:快速多层心肌灌注技术;实时导航技术;2D、3D增强及非增强冠状动脉成像技术;冠状动脉粥样斑块、冠状动脉血流量测定技术;各种心功能测量分析及快速在体定域心脏波谱分析;心肌纤维弥散张量成...     

一站式MRI对复杂先天性心脏病的诊断价值

目的 评价一站式MRI对复杂先天性心脏病的诊断价值.资料与方法 对33例复杂先天性心脏病患儿进行MRI扫描,包括梯度回波序列及自旋回波序列平扫,梯度回波序列电影扫描及三维增强磁共振血管成像(3D-CE MRA)扫描.将患儿MRI影像资料分为平扫+电影(A组)及平扫+电影+3D-CE MRA(B组)两组图像分别进行分析诊断,以手术作为参考标准,评估其诊断价值,并与B超结果进行对照.结果 22例成功完成一站式MRI扫描并经手术证实,共计109处心脏大血管异常,包括心内结构异常46处,心外结构异常63处.A组整体正确诊断率为84.4%,其中心内结构异常及心外结构异常的正确诊断率分别为82.6%、85.7%.B组整体正确诊断率为90.8%,其中心内结构异常及心外结构异常的正确诊断率分别为82.6%、96.8%.B超整体正确诊断率为82.6%,其中心内结构异常及心外结构异常的正确诊断率分别为87.0%、79.4%.结论 一站式MRl扫描能明显提高心外大血管异常的正确诊断率,对心内结构异常诊断无明显帮助.与B超比较,MRI平扫+电影及一站式.MRI平扫对心内结构异常的诊断均不如B超,对心外结构异常的诊断均比B超更具优势.     

心脏MRI在诊断肥厚型心肌病中的应用价值

目的：分析肥厚型心肌病的MRI与超声心动图征象，探讨MRI对肥厚型心肌病的诊断价值。方法：对31例拟诊为肥厚型心肌病患者行心脏MRI、超声心动图检查，对比2种检查方法对心肌肥厚程度的测量结果。结果：31例中，均发现心室壁不同程度肥厚。其中，非对称性室间隔肥厚17例（54.8%），左心室普遍肥厚3例（9.7%），室间隔增厚并累及右心室心尖部2例（6.5%），左心室游离壁局限性肥厚3例（9.7%），心尖肥厚型6例（19.4%），可见典型"黑桃尖"表现。梗阻型肥厚型心肌病2例，收缩期二尖瓣前叶向前运动；伴感染性心内膜炎1例；伴左心室心尖部室壁瘤1例。全部患者均行心肌对比增强扫描，20例（64.5%）肥厚心肌内可见点状、片状心肌中层延迟强化，5例非肥厚心肌内亦可见延迟强化。1例累及右心室心尖部及3例心尖肥厚型心肌病超声心动图诊断为阴性，室壁厚度测量结果低于MRI（P<0.05）。结论：MRI诊断肥厚型心肌病具有很高的准确性，超声心动图诊断心尖肥厚型心肌病敏感性低；对于临床怀疑肥厚型心肌病，特别是心尖肥厚型心肌病的患者可采用心脏MRI明确诊断。     

MRI of hypertrophic cardiomyopathy: part 2, Differential diagnosis, risk stratification, and posttreatment MRI appearances

OBJECTIVE: We present a two-part review about the use of MRI in patients with hypertrophic cardiomyopathy (HCM). This article, Part 2, covers the differential diagnosis, risk stratification, and posttreatment MRI follow-up appearances in these patients. CONCLUSION: Cardiovascular MRI is a useful imaging tool for the diagnosis of HCM and follow-up of patients after either surgical myomectomy or septal ablation therapy. In addition, MRI can help to discriminate HCM from the differential diagnoses of other cardiomyopathies and cardiac disorders, and it can potentially identify the subset of patients at risk of sudden cardiac death.     

MRI of hypertrophic cardiomyopathy: part I, MRI appearances

OBJECTIVE: We present a two-part review about the use of MRI in patients with hypertrophic cardiomyopathy (HCM). This article, Part 1, focuses on the MRI appearances of HCM. CONCLUSION: MRI has proven to be an important tool for the evaluation of patients suspected of having HCM because it can readily diagnose those with phenotypic expression of the disorder and can potentially identify the subset of patients at risk of sudden cardiac death.     

MRI在限制性心肌病中的诊断价值

论 MRI是诊断限制性心肌病较理想的方法.     

Cardiac MRI in restrictive cardiomyopathy

Restrictive cardiomyopathy (RCM) is a specific group of heart muscle disorders characterized by inadequate ventricular relaxation during diastole. This leads to diastolic dysfunction with relative preservation of systolic function. Although short axis systolic function is usually preserved in RCM, the long axis systolic function may be severely impaired. Confirmation of diagnosis and information regarding aetiology, extent of myocardial damage, and response to treatment requires imaging. Importantly, differentiation from constrictive pericarditis (CCP) is needed, as only the latter is managed surgically. Echocardiography is the initial cardiac imaging technique but cannot reliably suggest a tissue diagnosis; although recent advances, especially tissue Doppler imaging and spectral tracking, have improved its ability to differentiate RCM from CCP. Cardiac catheterization is the reference standard, but is invasive, two-dimensional, and does not aid myocardial characterization. Cardiac magnetic resonance (CMR) is a versatile technique providing anatomical, morphological and functional information. In recent years, it has been shown to provide important information regarding disease mechanisms, and also been found useful to guide treatment, assess its outcome and predict patient prognosis. This review describes the CMR features of RCM, appearances in various diseases, its overall role in patient management, and how it compares with other imaging techniques.     

Vesicouterine fistula: MRI diagnosis

A case of vesicouterine fistula in a young woman following caesarean section is presented. The diagnosis was established successfully using heavily T2-weighted MRI which clearly demonstrated fluid within the fistula, obviating the need for conventional radiographic contrast examination. Received: 21 October 1998; Revised: 27 January 1999; Accepted: 1 March 1999     

Brucellar spondylodiscitis: MRI diagnosis

Early diagnosis of brucellar spondylodiscitis is often difficult because of the long latent period. Radiographs of the spine, bone scan, and computed tomography (CT) scan provide insufficient data. Among 25 patients with brucellar spondylodiscitis studied by magnetic resonance imaging (MRI), 9 were in the acute stage and 16 were in the chronic stage. MRI is the investigation method of choice in diagnosing brucellar spondylodiscitis.