摘要:
目的:应用3T心脏磁共振成像探讨心肌梗死择期PCI治疗前后心肌相对梗死量、左室心功能、梗死远端节段、梗死邻近节段、梗死节段的局部室壁增厚率的变化及其相关性。方法:收集本院2014年8月至2016年3月22例急性心肌梗死的患者,在术前、术后1周内、术后6个月行磁共振检查。观察并比较三组病例心肌相对梗死量、左室心功能、梗死远端节段、梗死邻近节段和梗死节段的局部室壁增厚率的差异。结果:心肌相对梗死量的比较,术前术后1周内、术后6个月分别为(13.1±7.6)%、(9.4±6.6)%,(8.9±6.4)%,重复检验P<0.05,差异有统计学意义。左室心功能的比较,左室心功能指标随着时间的延长渐进增强。左室射血分数分别为(43.9±10.9)%,(46.7±10.8)%,(52.3±12.5)%。左室舒张末期容积(LVEDV)分别为(161.4±54.0) mL、(168.6±53.0) mL、(168.5±52.6) mL。左室收缩末期容积(LVSDV)分别为(91.62±43.5) mL、(91.3±43.7) mL、(82.5±43.4) mL,差异有统计学意义。室壁增厚率的变化,远端节段、近端节段及梗死透壁程度为1%~25%、26%~50%、51%~75%的心肌节段在术后1个月及半年室壁增厚率增加。梗死透壁程度在75%~100%的室壁增厚率在各时间点均未见明显改变。术前磁共振检查所见心肌梗死区域透壁程度越大,室壁增厚率越低,P<0.05。结论:择期PCI治疗可能缩小梗死心肌范围,改善总体心功能及局部心功能。3T心脏磁共振能够准确评价冠心病PCI疗效。
关键词:
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磁共振成像
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心肌梗死
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重构
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再灌注
Abstract:
Objective: Myocardial remodeling and time course and magnitude of infact involution after acute myocardial infarction undergoing selective percutaneous coronary intervention(PCI) opterations are not completely knowed in humans. This subject is to explore the changes and correlations of relative amount of hyperenhancement, global left ventricular function and regional wall thickening by using 3T cardiac magnetic resonance. Method: To collect patients with acute myocardial infarction in our hospital from August 2014 to March 2016. They were examination by MRI before PCI operation and reexamine at one week and half year after PCI operation. To observe and compare the changes of relative amount of hyperenhancement, global left ventricular function and regional wall thickening in three groups. Result: Comparison of relative amount of hyperenhancement: relative amount of hyperenhancement was reduced by about 30% during the first week after operation, which were respectively(13.1 ±7.6)%,(9.4 ±6.6)%,(8.9 ±6.4)% at the time before PCI operation, one week after PCI operation and half year after operation, the difference was statistically significant(P<0.05). Comparison of global left ventricular function: the global left ventricular function increase gradually by time. LVEF were respectively(43.9 ±10.9)%,(46.7 ±10.8)%,(52.3 ±12.5)% at the time before PCI operation, one week after PCI operation and half year after operation. LVEDV were respectively(161.4 ±54.0)mL,(1.686 ±53.0)mL,(168.5 ±52.6)mL. LVSDV were respectively(91.62 ±43.5)mL,(91.3 ±43.7)mL,(82.5 ±43.4) mL. he difference was statistically significant(P<0.05). The changes of regional wall thickening: Regional wall thickening was increased by remote segments,adjacent segment and which transmural extent of hyperenhancement is 1%~25%, 26%~50%, 51%~75% and no significant change by which transmural extent of hyperenhancement is 75%~100%.Regional wall thickening decreased progressively with increasing transmural extent of hyperenhancement(P<0.05). Conclusion: The efficacy of PCI operation may reduce the relative amount of hyperenhancement, improve regional left ventricular function and regional wall thickening. 3T magnetic resonance can accurately evaluate the efficacy of PCI in patients with coronary heart disease.
百度学术
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