Stork Alexander, Lund Gunnar K, Muellerleile Kai, Bansmann Paul M, Nolte-Ernsting Claus, Kemper Joern, Begemann Philipp G C, Adam Gerhard
Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Eur Radiol. 2006 Oct;16(10):2350-7. doi: 10.1007/s00330-006-0232-3. Epub 2006 Apr 20.
To characterize the peri-infarction zone using T2-weighted (T2w) magnetic resonance imaging (MRI) and infarct size on delayed enhancement (DE) MRI in patients with acute myocardial infarction (AMI). In 65 patients, short-axis T2w and DE MRI images were acquired 5 +/- 3 d after AMI. The MRI was analyzed using a threshold method defining infarct size on DE MRI and edema on T2w MRI as areas with signal intensity larger than +2 SD above remote normal myocardium. The peri-infarction zone was calculated as the difference between the size of edema and the infarct size. The size of edema on T2w MRI (31.3 +/- 13.4% of LV area) was larger than the infarct size on DE MRI (20.3 +/- 10.4% of LV area, p< 0.0001). The size of the peri-infarction zone was 11.0 +/- 10.0% of the LV area. Good correlation was found between infarct size on DE MRI and peak creatine kinase (CK) isoenzyme MB (r = 0.65, p< 0.0001), but there was no correlation between the size of the peri-infarction zone and CK MB (r = 0.05, p = 0.67). The peri-infarction zone was larger in patients with an infarct size <28% of the LV area (12.6 +/- 10.0% LV area) compared with patients with an infarct size > or =28% of the LV area (6.7 +/- 9.0% of the LV area, p< 0.05). The peri-infarction zone does not correlate with enzymatic parameters of infarct size and is substantially larger in small infarcts, indicating viable myocardium.
利用T2加权（T2w）磁共振成像（MRI）对急性心肌梗死（AMI）患者梗死周边区进行特征性分析，并通过延迟强化（DE）MRI评估梗死面积。对65例患者在AMI后5±3天采集短轴T2w和DE MRI图像。采用阈值法分析MRI，将DE MRI上的梗死面积和T2w MRI上的水肿定义为信号强度高于远隔正常心肌+2标准差的区域。梗死周边区通过水肿面积与梗死面积之差计算得出。T2w MRI上的水肿面积（占左心室面积的31.3±13.4%）大于DE MRI上的梗死面积（占左心室面积的20.3±10.4%，p<0.0001）。梗死周边区面积为左心室面积的11.0±10.0%。DE MRI上的梗死面积与肌酸激酶（CK）同工酶MB峰值之间存在良好相关性（r = 0.65，p<0.0001），但梗死周边区面积与CK MB之间无相关性（r = 0.05，p = 0.67）。梗死面积<左心室面积28%的患者梗死周边区（占左心室面积12.6±10.0%）大于梗死面积≥左心室面积28%的患者（占左心室面积6.7±9.0%，p<0.05）。梗死周边区与梗死面积的酶学参数无关，在小梗死中明显更大，提示存在存活心肌。
