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目的评价磁共振成像心肌灌注延迟显像(DE-MRI)所显示的高信号检测存活心肌的临床价值。方法 24例经彩超检查存在左室壁节段运动障碍冠心病患者,进行DE-MRI、冠状动脉造影(CAG)及介入治疗(PCI),所有狭窄病变行完全血运重建。参照美国超声心动图学会16节段划分法获得各运动异常节段心肌延迟增强,并对其进行分级,根据分级结果对心肌存活情况进行判定。术后1,3,6月时复查心脏超声,以冠脉血运重建后室壁节段收缩功能改善为判断存活心肌的金标准,根据诊断试验四格表得出DE-MRI检测存活心肌的价值。结果 24例冠心病患者共获得符合条件的室壁运动异常节段170个,根据金标准判断其中115个为存活心肌,55个为非存活心肌,DE-MRI检测存活心肌的灵敏度、特异度、准确度分别是73.3%、92.4%、86.7%。结论 DE-MRI检测冠心病患者的存活心肌有较高的临床价值。
Objective To evaluate the clinical value of magnetic resonance imaging myocardial perfusion delayed imaging (DE-MRI) to detect viable myocardium with high signal intensity. Methods Twenty-four patients with coronary artery disease of left ventricular wall motion disorder who underwent color Doppler ultrasonography were examined by DE-MRI, coronary angiography (CAG) and interventional therapy (PCI). All the stenotic lesions were completely revascularized. According to the American Society of Echocardiography 16-segment classification method, the myocardial delay of each abnormal segment was increased and graded, and the survival of the myocardium was judged according to the grading results. Cardiac echocardiography was retrospectively performed at 1, 3 and 6 months after surgery. The improvement of systolic function of the ventricular wall after coronary revascularization was evaluated as the gold standard for determining viable myocardium. According to the four tables of diagnostic tests, DE-MRI was used to detect viable myocardium value. Results A total of 170 qualified segments of wall motion were obtained in 24 patients with coronary heart disease. Among them, 115 were viable myocardium and 55 were non-viable myocardium according to the gold standard. The sensitivity, specificity, The accuracy was 73.3%, 92.4% and 86.7% respectively. Conclusion DE-MRI has a higher clinical value in detecting myocardial viability in patients with coronary heart disease.