Keijer J T, van Rossum A C, Wilke N, van Eenige M J, Jerosch-Herold M, Bronzwaer J G, Visser C A
Department of Cardiology, Free University Hospital, Amsterdam, The Netherlands.
J Cardiovasc Magn Reson. 2000;2(3):189-200. doi: 10.3109/10976640009146567.
The purpose of the study was to investigate the potential of magnetic resonance imaging (MRI) to assess transmural differences in myocardial perfusion. Contrast-enhanced MRI was performed at rest and during hyperemia in a dog model and in 22 patients with single-vessel coronary artery disease. From MR signal intensity-versus-time curves, three perfusion parameters were derived: maximum myocardial contrast enhancement (MCE), slope, and inverse mean transit time (1/MTT). In dogs, MCE correlated well (r = 0.87, p < 0.00001) with microsphere-assessed myocardial blood flow. In the patients, the subendocardial MCE decreased during hyperemia (0.89 +/- 0.18 vs. 0.74 +/- 0.15, p < 0.003) and was lower in subendocardium than in subepicardium (0.74 +/- 0.15 vs. 0.84 +/- 0.21, p < 0.02). Parameters slope and 1/MTT paralleled MCE. Contrast-enhanced MRI reflects the transmural redistribution of myocardial perfusion during hyperemia. Perfusion abnormalities can be identified most distinctly in subendocardial myocardium.
该研究的目的是调查磁共振成像（MRI）评估心肌灌注透壁差异的潜力。在犬模型和22名单支冠状动脉疾病患者中，于静息状态和充血状态下进行了对比增强MRI检查。从磁共振信号强度-时间曲线中得出了三个灌注参数：最大心肌对比增强（MCE）、斜率和平均通过时间倒数（1/MTT）。在犬类中，MCE与微球评估的心肌血流量具有良好的相关性（r = 0.87，p < 0.00001）。在患者中，充血期间心内膜下MCE降低（0.89±0.18对0.74±0.15，p < 0.003），且心内膜下低于心外膜下（0.74±0.15对0.84±0.21，p < 0.02）。斜率和1/MTT参数与MCE情况相似。对比增强MRI反映了充血期间心肌灌注的透壁再分布。灌注异常在心内膜下心肌中最为明显。
