| 王屹,杜湘珂.冠状动脉病变与供血心肌损伤程度的对照分析[J].中国医学影像技术,2005,21(3):422~424 |
| 冠状动脉病变与供血心肌损伤程度的对照分析 |
| Analysis of acute ischemic myocardial injury induced by different coronary artery disease using cardiac MR imaging |
| 投稿时间：2004-05-22 修订日期：2004-12-27 |
| DOI： |
| 中文关键词: 心肌梗死 磁共振成像 冠状动脉 狭窄 |
| 英文关键词:Myocardial infarction Magnetic resonance imaging Coronary artery Stenosis |
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| 中文摘要: |
| 目的 探讨心肌灌注MRI所示梗死心肌体积及分型与供血冠状动脉狭窄程度和位置的关系。方法 47例急性心肌梗死患者急诊接受冠状动脉造影及介入治疗，其后6~8周行心肌延迟灌注MR扫描，测定梗死心肌相对体积并分型。结果 22例患者单支冠状动脉完全闭塞，25例患者多支冠状动脉多处狭窄；MRI示前者延迟强化灶体积显著大于后者，以透壁型为主，后者以非透壁型为主。结论 单支冠状动脉近端闭塞较多支冠状动脉多处狭窄更易造成大范围透壁心肌梗死。 |
| 英文摘要: |
| Objective To compare the infarction induced by occlusion of single coronary artery (OSCA) with stenosis of multi coronary arteries (SMCA) using delayed enhanced cardiac MRI. Methods A total of 47 patients who had acute myocardial infarction and received emergency coronary angiography and angioplasty were included in this study. Coronary angiogram confirmed that 22 patients had single coronary artery complete occlusion and 25 patients had multi coronary artery stenosis without occlusion. Cardiac MRI (CMRI) exam was performed 6-8 weeks after diagnosis. The infarct size (hyper enhanced volume) was presented as a percentage of LV mass (%LV), i.e. the total number of hyperenhanced pixels divided by the total number of pixels of the LV myocardium and multiplied by 100. Results CMRI revealed that the mean infarct size (28%) in the patients with OSCA was significantly larger than the mean infarct size (11%) in the patients with SMCA. Out of the 22 patients with single coronary artery occlusion, 14 patients had transmural hyper enhancement and the remaining 8 patients had non transmural and discrete hyper enhancement. However, out of the 25 patients with multi coronary artery stenosis, only 6 patients showed transmural hyper enhancement and 19 patients had non transmural and discrete hyper enhancement. Conclusion CMRI demonstrated that the size of infarction induced by OSCA was much bigger than that induced by SMCA, which suggests that the occlusion of single coronary artery may induce severer irreversible myocardium damage than the stenosis of multiple coronary arteries. |
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