心脏磁共振在缺血性心肌病中的临床应用

目的 评价心脏磁共振（MRI）成像在缺血性心肌病诊断中的临床价值。方法 使用荷兰 Philips 公司的3.0T MRI 仪对96 例临床诊断为缺血性心肌病的患者行心脏MRI 检查，并行心脏超声和冠状 动脉CT 血管造影（CTA）检查。使用Philips Cardiac MR Analysis 工作站进行后处理分析，以计算心脏功能 参数，如左心室射血分数、每搏输出量及心输出量，并与超声心动图结果进行比较；同时分析心脏形态学、 灌注及延迟强化等特点，与冠状动脉CTA 犯罪血管相比较，评价其临床应用价值。结果 心脏MRI 与超 声心动图测量的射血分数、每搏输出量及心输出量比较，差异无统计学意义（P >0.05）。96 例患者中，心肌 首过灌注信号减低56 例，心肌延迟强化36 例，其中8 例合并室壁瘤、6 例合并慢性心力衰竭。结论 心脏 MRI 在缺血性心肌病的诊断中具有独特的优势。

Clinical application of cardiac magnetic resonance in ischemic cardiomyopath

Objective To evaluate the clinical value of cardiac magnetic resonance imaging in the diagnosis of ischemic cardiomyopathy. Methods Cardiac magnetic resonance imaging was performed on 96 patients with clinically diagnosed ischemic cardiomyopathy by Dutch Philips 3.0T magnetic resonance spectroscopy, along with echocardiography and coronary CTA. Post-processing analysis was performed using a Philips Cardiac MR Analysis workstation to calculate cardiac function parameters such as left ventricular ejection fraction, stroke volume, and cardiac output, and compared with echocardiographic results; at the same time, the characteristics of cardiac morphology, perfusion and delayed enhancement were analyzed, and the clinical application value was compared with that of coronary CTA. Results Ejection fraction (55.98%±14.2%) VS (56.34%±10.8%), stroke volume (56.66±13.84) VS (57.148±9.96), and cardiac output (3.74±0.99) VS (3.73±0.79) measured by cardiac MRI and echocardiography were not statistically significant (P > 0.05). Among the 96 patients, the reduced myocardial firstpass perfusion signal was by 56 cases; the myocardial delayed enhancement was 36 cases, of which 8 cases had ventricular aneurysm and 6 cases had chronic heart failure. Conclusions Cardiac magnetic resonance has unique advantages in the diagnosis of ischemic cardiomyopathy.