心脏增强磁共振成像评价临床患者心肌活性的实验研究

摘要

Objective: The aim of this study was to investigate the feasibility and accuracy of the ceMRI to detect the viable myocardium. Methods;In 13 OMI patients analyze ceMRI, TIMI results of coronary angjog-raphy and myocardial viability score of SPECT. Determining the diagnostic accuracy of the ceMRI and TIMI by receiver operating characteristic curve(ROC) analysis. Results:The area under the curve(AUC) of transmural ratio with ceMRI was 0. 953 and AUC of TIMI was 0. 935. The sensitivity and specificity of transmural ratio 26% -50% to detect viable myocardium were 88.9% and 82. 7% respectively. The sensitivity and specificity of transmural ratio 51%-75% to detect viable myocardium were 74. 1% and 98.7% respectively. Conclusion; Contrast-enhanced MRI can clearly display the location, dimension and extention of myocardial infarction. The accuracy of the ceMRI to detect viable myocardium was very high.%目的:评价磁共振成像(MRI)对陈旧性心肌梗死(old myocardial infarction,OMI)患者心肌活性的诊断价值.方法:分析13例OMI患者的增强磁共振(contrast enhanced magnetic resonance imaging,ceMRI)延迟强化透壁率、冠状动脉造影TIMI分级结果和心肌双核素显像(single-photon emission computed tomography,SPECT)心肌存活情况.将13例OM1患者ceMRI透壁率、冠状动脉造影TIMI分级和SPECT心肌存活情况进行受试者工作曲线(ROC)分析.结果:ceMRI透壁率曲线下面积为0.953,冠状动脉造影TIMI分级曲线下面积为0.935,ceMRI透壁率与金标准心肌双核素显像相比,透壁率在26％～ 50％诊断存活心肌的灵敏度为88.9％,特异度为82.7％；透壁率在51％ ～75％诊断存活心肌的灵敏度为74.1％,特异度为98.7％,与心肌双核素显像相比其诊断的准确性较高.结论:增强MRI清晰显示心肌梗死的位置、范围和程度.ceMRI透壁率诊断存活心肌的准确性较高.