| 何东,王莉,田建明,陈兴灿,潘永清,朱妙平.磁共振多技术扫描评价冠状动脉经皮腔内血管成形术及支架植入术存活心肌疗效[J].中国医学影像技术,2009,25(4):609~612 |
| 磁共振多技术扫描评价冠状动脉经皮腔内血管成形术及支架植入术存活心肌疗效 |
| Multimodality MR imaging in assessment of viable myocardium after PTCA-stenting |
| 投稿时间：2008-07-23 修订日期：2008-12-07 |
| DOI： |
| 中文关键词: 冠状动脉疾病 磁共振成像 存活心肌 冠状动脉造影术 |
| 英文关键词:Coronary disease Magnetic resonance imaging Viable myocardium Coronary angiography |
| 基金项目:国家自然科学基金(30270419)。 |
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| 中文摘要: |
| 目的 探讨心脏磁共振多技术扫描在存活心肌经皮腔内血管成形术(PTCA)及支架植入术后近期疗效的价值。 方法 利用磁共振心脏多技术扫描,判断冠状动脉成形及支架术后1~2周心肌缺血区的大小、部位、整体心功能及局部室壁运动较术前的改善情况。 结果 冠状动脉造影证实12例患者共16支血管有不同程度中、重度狭窄(≥70％),放置支架18枚。术后磁共振复查,未出现新的异常灌注及延迟强化区,术前25个异常灌注区均有改善,肉眼观察无明显灌注缺损区。舒张末期容积较术前下降,但两者差异无统计学意义(P＞0.05);收缩末期容积、射血分数较术前有改善(P＜0.05)。除乳头肌水平左心室下壁、心尖水平室间隔运动无改变外,其余心肌节段运动均有不同程度改善。 结论 存活心肌对PTCA及支架植入术后血运改善及心功能的恢复有重要意义;磁共振多技术扫描可从心脏形态、运动、心肌灌注等方面对血运重建术后短期疗效随访起指导作用。 |
| 英文摘要: |
| Objective To discuss the recent therapeutic effect of viable myocardium after PTCA-stenting with cardiac multimodality MR scanning. Methods The improvement of the size and location of myocardial ischemia and necrosis, the cardiac function and left ventricular motion in one to two weeks after PTCA-stenting were observed with multimodality MR scanning. Results Sixteen coronary arteries of 12 patients had varying degrees stenosis confirmed by CAG, and 18 stents were implanted in severe stenosis coronary arteries after PTCA. There was no new area of abnormal perfusion and delayed enhancement in reviewed imagings of MR myocardial perfusion after stenting. Twenty-five original abnormal perfusion segments were improved. There was no perfusion defect area with visual observation. EDV descended more than pre-stenting, but the difference was not statistically significant (P＞0.05). EF and ESV were improved significantly (P＜0.05). Except inferior wall of mid-cavity and intervenetricular septum of apical slice, the movements of the remaining myocardial segments improved. Conclusion Viable myocardium has important effect on restoring blood supply and improving cardiac function after PTCA-stenting. Cardiac multimodality MR scanning is a useful non-invasive method for assessing short-term therapeutic effect from cardiac morphous, motion and myocardial perfusion after revascularization. |
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