Breuckmann Frank, Nassenstein Kai, Bruder Oliver, Buhr Christiane, Sievers Burkhard, Barkhausen Jörg, Erbel Raimund, Hunold Peter
Westdeutsches Herzzentrum Essen, Klinik für Kardiologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen.
Herz. 2008 Mar;33(2):129-35. doi: 10.1007/s00059-008-3110-8.
In contrast to chronic myocardial infarction, data concerning the value of cardiac magnetic resonance imaging in patients with acute onset of chest pain are still rare. Even in the presence of characteristic clinical parameters, cardiac magnetic resonance imaging might provide independent evidence especially in the absence of typical ECG alterations and prior to biomarker elevation. Besides the ability to demonstrate wall motion abnormalities cardiac magnetic resonance imaging gains additional potential as to the detection of myocardial edema, microvascular obstruction (no-reflow) and myocardial necrosis. However, cardiac magnetic resonance imaging is expensive and time-consuming, and therefore may not be cost-effective. At present, a lack of sufficient diagnostic and prognostic data would make cardiac magnetic resonance imaging unsuitable for routine stratification of chest pain patients in an emergency department.
与慢性心肌梗死不同,关于心脏磁共振成像在急性胸痛患者中的价值的数据仍然很少。即使存在特征性临床参数,心脏磁共振成像也可能提供独立证据,尤其是在没有典型心电图改变且生物标志物升高之前。除了能够显示室壁运动异常外,心脏磁共振成像在检测心肌水肿、微血管阻塞(无复流)和心肌坏死方面还有额外的潜力。然而,心脏磁共振成像昂贵且耗时,因此可能不具有成本效益。目前,缺乏足够的诊断和预后数据会使心脏磁共振成像不适用于急诊科胸痛患者的常规分层。