急性心肌梗塞磁共振心肌灌注成像的临床应用研究-影像医学与核医学专业论文.docxVIP

鬻781941急性心肌梗塞磁共振心肌灌注成像的临床应用研究 鬻781941 急性心肌梗塞磁共振心肌灌注成像的临床应用研究 中 文提要 目鹩：探讨MR心肌灌注成像结合心功能分析在评价急性心肌梗塞诊峨 及治疗效果方瑟麴价值，初步评判心肌活力。 耪辩和方法：对18铡急性心腿梗塞患者，8铡正鬻志愿者进行MR蓄过、 延迟灌注成像及cine-MR成像检蠢。其牵8辅心梗患者按受了游栓治疗 且均再通成功。绘蒂l溶栓、未溶栓及燕常对照维的时间信号强度精线，意 量测定溶栓于来溶栓组的酾线参数，分析是否有差异。吃较3组的心功能 参数，用方差分析法预测其与心肌活力的关系。 结果：心梗溶栓再通者梗塞区表现为首过轻度强化与延迟强化，时间。信 号强度曲线上升时间延长，曲线上升斜率及对比增强攀与正常心肌相比无 明显差异。心梗未溶栓者首过灌注缺损，延迟信号强度明显高于正常心肌， 基线上井时间峰值时闯上升斜率和对比增强攀与正常心肌间均有显著性 差别。心梗溶栓组及寒溶捻组峰馕信号强度分别必正常心肌的85±13％、 53±7。l％。心梗酶射斑分数及左室最大兖盈率降低，与正常对照组存在 显著差异。舒张束期室壁浮度及室壁增零率不同程度下降。 结论：心胍首过及延遴灌注成像可准确定位梗塞灶，了解盘流供应情况， 心功能分祈可了解整体及蔺部心功能改交。结合心肌首过及延迟灌注和心 功能分析可初步预计心肌活力。 关键词：心肌梗塞 磁共振成像首过灌注心功能分析 作 嚣：侯 刚 指导教嬲：郭 亮胡春洪 Clinical Clinical study of the myocardial perfusion MRI on Acute Myocardial Infarction ABSTRACT PURPOSE：To discuss the value ofmyocardial perfusion MRl with functional analysis about evaluating the diagnosis and therapeutic effection on the acute myocardial infarction。And to assess the viability ofmyocardium。 MATERIAL AND METHOD：Turbofiash，cine—MR were performed on 1 8 AMI patients and 8 volunteers to study fiest-pass myocardial perfusion,delay perfusion and function．8／1 8 receiveed thrombolysis therapy and were revascularised successfully．To determine the parameters of thrombolysis and non-thrombolysis quantitatively by drawing the time-signal intensity curves and then analysis the variances between them．One-way ANOVO was analysed on prognosing the relationship between myocardium viability and the heart functional parameter of the thrombolysis，non-thrombolysis and volunteers。 RESULT：Slight hyperenhancement and hyperenhancement appeared on first-pass and delay-phase in revascularizative patients’infarction。The time of upslope prelonger．These was no significant diference between the upslope of the time—signal intensity curves and the contrast enhancement ratio of these patients and mormal。Hypoenhancement on first-pass and hyperenhancement on delay phase appeared in patients who didn’t receive thrombolysis therapy．There were significant d