共查询到20条相似文献,搜索用时 15 毫秒
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Stensaeth KH Hoffmann P Fossum E Mangschau A Sandvik L Klow NE 《The international journal of cardiovascular imaging》2012,28(2):327-335
Our objective was to evaluate the ability of CMR to visualize myocardial injuries over the course of myocarditis. We studied
42 patients (39 males, 3 females; age 37 ± 14 years) with myocarditis during the acute phase and after 12 ± 9 months. CMR
included function analyses, T2-weighted imaging (T2 ratio), T1-weighted imaging before and after i.v. gadolinium injection
(global relative enhancement; gRE), and late gadolinium enhancement (LGE). In the acute phase, the T2 ratio was elevated in
57%, gRE in 31%, and LGE was present in 64% of the patients. In 32 patients (76%) were any two (or more) out of three sequences
abnormal. At follow-up, there was an increase in ejection fraction (57.4 ± 11.9% vs. 61.4 ± 7.6; P < 0.05) while both T2 ratio (2.04 ± 0.32 vs. 1.70 ± 0.28; P < 0.001) and gRE (4.07 ± 1.63 vs. 3.11 ± 1.22; P < 0.05) significantly decreased. The LGE persisted in 10 patients. Dilated cardiomyopathy was present in 3 patients and 4
patients received a defibrillator or a pacemaker. A comprehensive CMR approach is a useful tool to visualize myocardial tissue
injuries over the course of myocarditis. CMR may help to differentiate acute from healed myocarditis, and add information
for the differential diagnoses. 相似文献
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Matteo Perfetti Gelsomina Malatesta Irene Alvarez Riccardo Liga Andrea Barison Giancarlo Todiere Nicoletta Eletto Raffaele De Caterina Massimo Lombardi Giovanni Donato Aquaro 《The international journal of cardiovascular imaging》2014,30(3):629-637
Current cardiac magnetic resonance (CMR) quantitative signs for the diagnosis of myocarditis include myocardial edema, fibrosis and myocardial hyperemia (Hyp). Methods for the assessment of Hyp are actually complex and time-consuming. To test a simple and fast method to assess Hyp, using contrast enhancement steady state free precession (ceSSFP) technique. CMR imaging at 1.5T was performed on 39 patients with diagnosis of acute myocarditis and in 20 healthy controls. Hyp was evaluated in systolic and diastolic frames (Hyp-SYS and Hyp-DIA) as areas of myocardial hyperintensity in ceSSFP images early after gadolinium injection. Myocardial edema was evaluated using T2-STIR images. Myocardial fibrosis was assessed in conventional late gadolinium enhancement (LGE) images. A value of ≤12.1 g of Hyp-DIA was obtained as cut-off of normality in healthy controls. Using this threshold, Hyp was detected in 30 patients (77 %) with myocarditis. LGE was detected in 36 patients (92 %), and myocardial edema in 38 (97 %) patients with myocarditis A linear relation was found between Hyp-DIA and the extent of myocardial edema (R2 0.48, 95 % CI 0.47–0.85, p < 0.001) and the extent of LGE (R2 0.41, 95 % CI 0.31–0.61, p < 0.001). Patients with hyperemia had higher levels of C-reactive protein (p < 0.001), a higher extent of LGE (p < 0.05) and a larger left atrial area (p < 0.05). ceSSFP sequence at CMR is a novel and fast method to assess myocardial hyperemia in patient with acute myocarditis. Compared with non-Hyp subjects, patients with Hyp had more signs of inflammation and myocardial damage. 相似文献
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目的 探讨多模态心脏磁共振成像(CMR)在急性病毒性心肌炎(AVM)中的临床价值.方法 选择60例AVM患者为观察组,另选取40例健康志愿者为对照组.2组受检者均接受多模态CMR检查,并检测白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平.采用受试者工作特征(ROC)曲线分析多模态CMR参数在AVM诊断中... 相似文献
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Desch S Engelhardt H Meissner J Eitel I Sareban M Fuernau G de Waha S Grothoff M Gutberlet M Schuler G Thiele H 《The international journal of cardiovascular imaging》2012,28(2):263-272
Myocardial salvage assessed by cardiac magnetic resonance imaging (CMRI) holds promise as a surrogate endpoint in studies comparing different treatment strategies for ST-elevation myocardial infarction (STEMI). The aim of this study was to evaluate the reliability of salvaged myocardium measurements by CMRI. Twenty patients underwent CMRI on 2 consecutive days early after reperfused STEMI to assess the area at risk (AAR) on T2-weighted and final infarct size (IS) on delayed enhancement images. Myocardial salvage index (MSI) was calculated (AAR minus IS). Agreement between scans 1 and 2 for the AAR, IS and MSI were analyzed using Bland?CAltman analyses. Inter- and intraobserver reliability were assessed. Paired t testing revealed a trend for a significant difference for MSI between scans 1 and 2 (scan 1: 43.8?±?22.5; scan 2: 45.5?±?22.0; P?=?0.052). The average difference for AAR and IS between scan 1 and scan 2 was ?0.5 (upper limit of agreement 5.4% of left ventricular [LV] volume; lower limit of agreement ?6.4%LV) and 0.1%LV (upper limit of agreement 2.3%LV; lower limit of agreement ?2.1%LV). The corresponding calculated MSI measurements showed a mean bias of ?1.7 (upper limit of agreement 5.5; lower limit of agreement ?8.9). Coefficients of repeatability for interobserver variability were 3.6%LV for AAR, 2.4%LV for IS and 5.4 for MSI. Likewise, for intraobserver variability, coefficients of repeatability were 5.0%LV (AAR), 2.4%LV (IS) and 4.8 (MSI). Assessment of myocardial salvage by CMRI shows acceptable reliability. Further validation studies and trials showing the prognostic value of myocardial salvage by CMRI are needed before routine implementation as a surrogate endpoint in STEMI trials. 相似文献
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Teresa Arcadi Massimo Bolognesi Erica Maffei Filippo Cademartiri 《The international journal of cardiovascular imaging》2014,30(4):769-771
A 54-year-old male with history of cocaine abuse underwent trans-thoracic echocardiography that showed hyper-echogenicity of the basal segments of the septum and infero-lateral wall of the left ventricle. The patient underwent cardiac CT that reported diffuse non-obstructive CAD. Cardiac MR showed LGE patterns consistent with non-ischemic myocardial damage associated with cocaine abuse. 相似文献
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目的探讨心脏磁共振特征追踪技术在射血分数(EF)保留急性心肌炎心功能受损中的评估价值。方法回顾性收集49例心肌炎病例,并招募了50例正常志愿者作为对照,利用心脏磁共振特征追踪技术,分析心肌炎、EF值保留心肌炎与对照组的心脏磁共振参数与心肌应变的变化特征。结果结果显示心肌炎组较对照组的EF(55.39%±17.55%比66.28%±5.36%)、心肌径向应变(PSR)(25.97%±11.77%比40.80%±9.68%)、圆周应变(PSC)(-16.47%±6.27%比-22.19%±2.76%)、纵向应变(PSL)(-10.49%±4.40%比-14.50%±2.56%)是下降的。EF保留心肌炎组较对照组的PSR(31.30%±7.16%比40.80%±9.68%)、PSC(-19.64%±2.44%比-22.19%±2.76%)、PSL(-12.14%±3.75%比-14.50%±2.56%)也是下降的。ROC曲线分析结果显示PSR,PSC鉴别心肌炎与正常病例的AUC最大(为0.84),其中PSR的临界值取33.61%时,敏感度为76%,特异度为80%,而PSC的临界值为-20.14%时,敏感度为73%,特异度为84%。而在区分EF保留心肌炎与正常者的能力方面,PSR的AUC值最大(为0.79),当PSR的临界值为35.82%时,敏感度为70%,特异度为75%。结论利用心脏磁共振特征特征追踪技术能发现EF保留心肌炎患者的心肌应变受损,有助于对早期心功能受损的识别与评估。 相似文献
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Florian André Florian T. Stock Johannes Riffel Evangelos Giannitsis Henning Steen Jürgen Scharhag Hugo A. Katus Sebastian J. Buss 《The international journal of cardiovascular imaging》2016,32(7):1093-1101
The aim of this study was to assess cardiac deformation patterns in myocarditis applying feature tracking imaging (FTI) to cardiovascular magnetic resonance (CMR) images. Thirty-six patients (31 males) with acute myocarditis and 36 age- and gender-matched healthy volunteers were studied. CMR examinations were performed in a 1.5 T MR-scanner including late gadolinium enhancement (LGE). FTI was applied to standard cine images of long and short axis views. Global peak circumferential, longitudinal and radial systolic strains as well as long axis strain (LAS) were measured. Patients showed significantly impaired global peak circumferential (?24.4?±?4.2?% vs. ?28.8?±?3.8?%, p?<?0.0001), longitudinal (?17.6?±?4.4?% vs. ?23.8?±?3.1?%, p?<?0.0001) and radial (26.1?±?5.4?% vs. 37.9?±?7.6?%, p?<?0.0001) systolic strains. Even patients with a preserved ejection fraction (pEF, ≥55?%) had significantly reduced longitudinal (?20.0?±?4.8?% vs. ?23.8?±?3.1?%, p?<?0.01) and radial (27.7?±?5.5?% vs. 37.9?±?7.6?%, p?<?0.0001) strains. The extent of LGE in patients did not correlate to their respective strains. Regarding the differentiation between patients and controls, the addition of global peak systolic strains to ejection fraction led to a significant improvement of the logistic regression model (χ2 48.7 vs. 71.5; p?<?0.001) resulting in a high AUC of 0.98. Applying previously published reference values, 75?% or 31?% of patients with pEF showed at least one strain value or a LAS, which fell below the limit of 1 or respectively 2 standard deviations from the reference mean value. Cardiac strains measured by CMR–FTI are significantly impaired in patients with acute myocarditis even in those with pEF. Therefore, strain assessment may improve the diagnostic accuracy of CMR for myocarditis. 相似文献
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目的探讨心脏磁共振(cardiac magnetic resonance imaging,CMR)及实验室检查指标在评估心肌缺血中的临床价值。材料与方法 7只巴马小型猪成功构建心肌缺血模型,分别于术前、术后2 h、12 h、24 h、48 h、72 h、1周、2周、3周、4周检测心肌酶谱、肌钙蛋白、肌红蛋白等实验室检查指标,并于上述各时段行CMR检查,最终行病理检查。结果巴马猪术后2 h肌钙蛋白及肌红蛋白即明显升高,分别为[(0.005±0.002)、(0.338±0.768) ng/ml,P<0.05],72 h内诸心肌损伤标志物变化显著(均P<0.05),提示心肌损伤,1周后趋于平稳;CMR示缺血早期T2WI黑血序列显示心肌水肿,即危险心肌,电影(cine)序列出现局部室壁运动异常,首过灌注术后2 h即出现灌注减低或缺损,术后24 h部分心肌节段出现延迟强化,透壁程度随着缺血时间的延长,不断增加,最终经病理证实心肌坏死、纤维化。4周CMR所测心功能指标较术前显著降低(左室射血分数%:分别为62.71±8.33、45.97±6.37,P<0.05)。结论心肌酶谱及肌钙蛋白、肌红蛋白对心肌损伤有提示意义,CMR可确切地显示心肌缺血微观组织学变化,联合评估可为急性冠脉综合症提供详细的诊断信息并指导治疗。 相似文献
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Michael Jeserich Eva Brunner Reinhard Kandolf Manfred Olschewski Simone Kimmel Matthias G. Friedrich Daniela Föll Christoph Bode Annette Geibel 《The international journal of cardiovascular imaging》2013,29(1):121-129
In patients with acute myocarditis, viral genome can be detected in plasma and peripheral leukocytes. Its relationship with active myocardial inflammation, however, is not well understood. Myocardial edema as a feature of inflammation and myocardial necrosis or fibrosis can be frequently observed in patients with acute myocarditis by cardiovascular magnetic resonance (CMR). We assessed the association of viral genome presence in peripheral blood samples with myocardial edema and irreversible injury. We examined consecutive patients with clinically suspected myocarditis after an episode of viral illness. State-of-the-art methods were used for detecting myocardial edema and irreversible injury using CMR and viral genome applying reverse transcribed, nested polymerase chain reaction in peripheral blood samples. The specificity of viral amplification products was confirmed by automatic DNA sequencing. Of a total of 55 patients (53.5 ± 15.6 years), 21 were positive for viral genome in peripheral leukocytes. Interestingly, 18 (86 %) of these patients also showed global myocardial edema, as compared to only 7/34 (21 %) without PCR evidence for viral genome. The overall agreement between CMR criteria for edema and viral PCR was 84 %. In contrast, there was no significant relationship of viral genome presence with myocardial necrosis or scars. In patients with clinically suspected myocarditis, myocardial edema but not irreversible myocardial injury is associated with the presence of viral genome in peripheral blood. 相似文献
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Shapiro MD Guarraia DL Moloo J Cury RC 《Topics in magnetic resonance imaging : TMRI》2008,19(1):25-32
The use of cardiovascular magnetic resonance (CMR) imaging for the evaluation of patients with acute chest pain and acute coronary syndromes has great potential. The strength of CMR relies on its ability to provide information on anatomy, physiology, and function in a single scanning session in a noninvasive manner without the need for iodinated contrast, radiation, or the need to undergo invasive procedures. Specifically, with regard to imaging patients with acute chest pain and/or myocardial infarction (MI), CMR has the ability to qualitatively and quantitatively evaluate global and regional right and left ventricular systolic functions, myocardial edema, myocardial perfusion, and myocardial infarct size and transmurality/viability. This review will focus on CMR imaging for the following applications: (1) imaging for the evaluation of ventricular function and infarct size in patients with acute chest pain and/or acute MI, (2) for triage and prognosis of patients presenting to the emergency department with acute chest pain, (3) for evaluating patients after sustaining an acute MI, and (4) for stem cell research. 相似文献
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Sinn Martin R. Lund Gunnar K. Muellerleile Kai Freiwald Eric Saeed Maythem Avanesov Maxim Lenz Alexander Starekova Jitka von Kodolitsch Yskert Blankenberg Stefan Adam Gerhard Tahir Enver 《The international journal of cardiovascular imaging》2021,37(5):1711-1720
The International Journal of Cardiovascular Imaging - To study the long-term prognosis of early pre-discharge and late left ventricular (LV) dilatation in patients with first ST-elevation... 相似文献
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Mayr A Pedarnig K Klug G Schocke M Pachinger O Jaschke W Metzler B 《The international journal of cardiovascular imaging》2012,28(6):1445-1453
We sought to analyze the trend of functional recovery after successful reperfused ST-elevation myocardial infarction (STEMI) in an optimally treated patient group over a 14?month follow-up in relation to ischemia-time and the presence of microvascular obstruction (MVO). First-pass perfusion-, cine- and late enhancement (LE)- cardiac MR were performed in 40 patients (33 male and 7 female, 54.8?±?12.3?years) within 6?days as well as 4 and 14?months after successful primary percutaneous coronary intervention for STEMI. Significant recovery of segmental wall thickening (SWT %) occurred exclusively in infarcted segments reperfused within 4?h after symptom onset (group 1 with pain-to-balloon time <2?h: 59?±?4 to 70?±?4%; P?0.02) (group 2 with pain-to-balloon-time 2-4?h: 51?±?4 to 59?±?3%, P?0.05) during the first 4?months, whereas changes thereafter were not significant (P?=?NS). Infarcted segments with MVO showed lowest regional myocardial function at any time of assessment (all P?0.001) and a lack of significant recovery during the study period. Significant recovery of regional myocardial function is related to rapid revascularization of the infarct-related artery and the absence of MVO. Improvement of SWT occurred exclusively within the first 4?months after acute myocardial infarction and remained unchanged thereafter. 相似文献
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Yurumez Y Yavuz Y Saglam H Durukan P Ozkan S Akdur O Yucel M 《The Journal of emergency medicine》2009,36(1):39-42
In this study, we evaluated 85 patients who presented to our Emergency Department with organophosphate (OP) poisoning and discuss their associated electrocardiographic (ECG) abnormalities. Over a period of 3 years, 85 patients with OP poisoning were included in this retrospective study. ECG analysis included the rate, rhythm, ST-T abnormalities, conduction defects, and measurement of PR and QT intervals. The mean age was 32.2 +/- 14.9 years. Sixty percent of the patients were female. The mean corrected QT interval (QTc interval) was 0.435 +/- 0.052 s. Prolongation of the QTc interval (55.5%) was the most common ECG abnormality, followed by sinus tachycardia (31.8%). Elevation of the ST segment and low amplitude T waves were seen in 15 cases (17.6%). Patients with OP poisoning might reveal ECG abnormalities such as QTc interval prolongation or non-specific ST-T changes. QTc interval prolongation cannot be used as a unique predictive factor in determining short-term prognosis in OP poisoning. We found no clear relation between OP poisoning-related malignant ventricular dysrhythmia and QTc interval. 相似文献
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Francesca Sanguineti Philippe Garot Melina Mana Darach O’h-Ici Thomas Hovasse Thierry Unterseeh Yves Louvard Xavier Troussier Marie-Claude Morice Jér?me Garot 《Journal of cardiovascular magnetic resonance》2015,17(1)