PET和SPECT结合延迟增强MRI评价存活心肌的进展

冠状动脉硬化性心脏病可造成不同程度的心肌损害,而只有存活心肌经血运重建后心功能得到改善,患者才能从中获益。因此,选择一种有效、准确的评价存活心肌的方法对选择治疗方案,决定是否进行血运重建治疗具有重要的临床指导意义。PET和SPECT是评价心肌存活的常用方法,近年来,随着MRI技术的迅速发展,临床应用也不断扩展,特别是心肌灌注延迟增强扫描显像的应用可从坏死组织中区分周围的存活心肌。

The progress of assessment of myocardial viability by delayed-enhanced magnetic resonance imaging and positron emission tomography and single-photon emission computed tomography

Coronary artery disease (CAD)is one of the most common diseases that results in the different degree of myocardial damage. Thus, only viable myocardium in patients can get benefit from the myocardial revascularization. The accurate differentiation of viable and nonviable myocardium is crucial for therapy planning in patients with coronary artery disease and left ventricular dysfunction. Clinically, traditional techniques such as echocardiography, positron emission tomography, and single photon emission computed tomography have established roles. With the recent MRI technical developments allowing for a combined assessment of perfusion and irreversible damage with late enhancement imaging, MRI will now play a major role in the assessment of myocardial viability. Through the technique of delayed-enhancement MRI (DE-MRI), viable and infarcted myocardium can be simultaneously identified in a manner that closely correlates with histopathology findings.