磁共振多技术联合应用检测存活心肌的实验研究

目的　评估磁共振多技术联合应用检测心肌存活的价值。材料与方法　选择慢性心肌缺血模型猪 2 0只 ,分别于制作模型前、后 1～ 2个月行磁共振多技术联合应用扫描 (形态、电影扫描、心肌灌注和心肌活性扫描 ) ,判断心肌缺血区和坏死区的大小 ,并与病理结果对照了解其准确性。结果　MRI检查发现 2 0只猪中有 3只形态扫描见左室侧壁变薄 ;负荷电影扫描见 11(11/2 0 )只猪左心室收缩功能正常 ,有 9(9/2 0 )只静息时左室节段不同程度运动减弱 (n =7)或丧失 (n =2 )。多巴酚丁胺负荷电影扫描检测到 7只猪左室节段功能改善 ,但有 2只猪无明显改善。心肌灌注扫描有 13只猪共 4 7.8个节段缺血 ,心肌活性扫描有 8只猪共 2 3.6个节段坏死 ,病理检查发现共有 7只猪 2 3个节段坏死。与MRI延迟强化区所显示的梗死区一致 ,差异无统计学意义 (t=0 .0 4 5 ,P >0 .0 5 )。结论　磁共振多技术联合应用可有效检出缺血、坏死心肌 ,并准确判断其程度和范围

Multimodality MR Imaging Assessment in Detecting of Myocardial Viability (A Experiment Study)

Objective To evaluate the value of multimodality MR imaging in detecting of myocardial viability.Materials and Methods 20 pig models of chronic myocardium ischemia were underwent multimodality MR imaging 1-2 months before and after making model. The multimodality MR imaging include: Morphology scanning, cine MRI, myocardial perfusion and viability scanning. The range of myocardial ischemia and necrosis in MRI was compared with pathological results. Results Morphology scanning detected thinning in lateral wall of left ventricle in 3 pigs. Stress cine MRI detected normal wall motion in 11(11/20) pigs. 9(9/20) pigs were found with hypokinetic (n=7) or akinetic (n=2) in lateral wall of left ventricle in rest. Dobutamine stress cine MRI detected increased regional motion of the lateral wall in 7 pigs, but the lateral wall remained akinetic in 2 pigs. Myocardial perfusion scanning detected 47.8 segments ischemia in 13 pigs. The total segments of necrosis was 23.6 in 8 pigs detected by viability MRI, 23 segments in 7 pigs by pathological results, which were no significant difference with MR delated scan (t= 0.045, P>0.05).Conclusion Multimodality MR imaging can detect myocardial ischemia and necrosis effectively, and judge the severity and extent accurately.