Konermann M, Grötz J, Altmann C, Laschewski F, Josephs W, Hötzinger H
Medizinische Klinik, Ruhr-Universität Bochum, Marienhospital Herne.
Z Kardiol. 1992 Nov;81(11):610-8.
To study left ventricular morphological and functional changes in the first six months after acute myocardial infarction, 37 patients (28 male, 9 female, age 42-78 years) underwent cardiac Cine-MRT 1 week, 4 weeks and 6 months after their first myocardial infarction. MR-tomograms were oriented to left ventricular true long and short axis. For comparison, contrast angiocardiographic, radionuclide and echocardiographic left ventricular studies were performed. LV-volume was calculated with the Simpson method for long axis images and by summation of slices for short axis images. Cine MRT results showed the following correlation to angiocardiography: in long axis r = 0.945 for LVEDVI, r = 0.958 for LVESVI, r = 0.869 for LVEF and r = 0.885 for cardiac index; in short axis r = 0.956 for LVEDVI, r = 0.965 for LVESVI, r = 0.917 for LVEF and r = 0.844 for cardiac index. For LVEF correlation to technetium radionuclide ventriculography was r = 0.760 in long and r = 0.861 in short axis. Correlation between Cine-MRT and echocardiography was poor as a consequence of the great variance of echogenity in the study patients. We conclude that Cine-MRT is an excellent method for morphological and functional left ventricular investigation, still limited in clinical praxis by costs and duration. As known from earlier investigations the development of left ventricular dilatation and functional disturbance was influenced by the size and location of the infarction with infarct size being the primary factor in the early and infarct location in the late post-infarction period. Outcome was worst following large anterior infarction.
为研究急性心肌梗死后最初六个月内左心室的形态和功能变化,37例患者(28例男性,9例女性,年龄42 - 78岁)在首次心肌梗死后1周、4周和6个月接受了心脏电影磁共振成像(Cine - MRT)检查。磁共振断层图像以左心室真正的长轴和短轴为方向。为作比较,还进行了对比血管造影、放射性核素和超声心动图左心室检查。左心室容积通过辛普森法计算长轴图像,短轴图像则通过切片求和计算。心脏电影磁共振成像结果与血管造影显示出以下相关性:长轴上,左心室舒张末期容积指数(LVEDVI)的r值为0.945,左心室收缩末期容积指数(LVESVI)的r值为0.958,左心室射血分数(LVEF)的r值为0.869,心脏指数的r值为0.885;短轴上,LVEDVI的r值为0.956,LVESVI的r值为0.965,LVEF的r值为0.917,心脏指数的r值为0.844。对于LVEF,与锝放射性核素心室造影的相关性在长轴上为r = 0.760,短轴上为r = 0.861。由于研究患者中回声性差异很大,心脏电影磁共振成像与超声心动图之间的相关性较差。我们得出结论,心脏电影磁共振成像是左心室形态和功能研究的一种优秀方法,但在临床实践中仍受成本和检查时间的限制。如早期研究所知,左心室扩张和功能障碍的发展受梗死面积和部位的影响,梗死面积是梗死早期的主要因素,梗死部位是梗死后期的主要因素。大面积前壁梗死的预后最差。