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急性心肌梗死患者直接经皮冠状动脉介入(PCI)治疗的成功依赖于冠状动脉(冠脉)微循环功能和结构的完整性。冠脉微血管阻塞是急性心肌梗死患者再灌注治疗后常见的病理现象,其特征是在梗死区内由于心肌微血管的损伤和功能不全导致的“无复流”现象。微血管阻塞可以通过不同的影像技术评价,心脏磁共振影像不仅能够准确识别微血管阻塞现象,还能够进一步评估梗死程度及整个左心室功能。本文就微血管阻塞在心脏磁共振影像上的特征表现及通过对急性心肌梗死患者应用该影像技术辅助诊断和治疗的重要性作一综述。
The success of direct percutaneous coronary intervention (PCI) in patients with acute myocardial infarction depends on the coronary microcirculation function and structural integrity. Coronary microvascular occlusion is a common pathological phenomenon after reperfusion in patients with acute myocardial infarction and is characterized by a “no-reflow” phenomenon due to myocardial microvascular damage and dysfunction in the infarct zone. Microvascular obstruction can be assessed by different imaging techniques. Cardiac magnetic resonance imaging can not only accurately identify the microvascular occlusion, but also further evaluate the degree of infarction and the entire left ventricular function. This article reviews the characterization of microvascular occlusion on magnetic resonance imaging of the heart and its importance in the diagnosis and treatment of patients with acute myocardial infarction using this imaging technique.