Saeed Maythem, Hetts Steve, Wilson Mark
Maythem Saeed, Steve Hetts, Mark Wilson, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107-5705, United States.
World J Radiol. 2010 Jan 28;2(1):1-14. doi: 10.4329/wjr.v2.i1.1.
Advances in magnetic resonance (MR) and computed tomography (CT) imaging have improved visualization of acute and scar infarct. Over the past decade, there have been and continues to be many significant technical advancements in cardiac MR and multi-detector computed tomography (MDCT) technologies. The strength of MR imaging relies on a variety of pulse sequences and the ability to noninvasively provide information on myocardial structure, function and perfusion in a single imaging session. The recent technical developments may also allow CT technologies to rise to the forefront for evaluating clinical ischemic heart disease. Components of reperfusion injury including myocardial edema, hemorrhage, calcium deposition and microvascular obstruction (MO) have been demonstrated using MR and CT technologies. MR imaging can be used serially and noninvasively in assessing acute and chronic consequences of reperfusion injury because there is no radiation exposure or administration of radioactive materials. MDCT is better suited for assessing coronary artery stenosis and as an alternative technique for assessing viability in patients where MR imaging is contraindicated. Changes in left ventricular (LV) volumes and function measured on cine MR are directly related to infarct size measured on delayed contrast enhanced images. Recent MR studies found that transmural infarct, MO and peri-infarct zone are excellent predictors of poor post-infarct recovery and mortality. Recent MR studies provided ample evidence that growth factor genes and stem cells delivered locally have beneficial effects on myocardial viability, perfusion and function. The significance of deposited calcium in acute infarct detected on MDCT requires further studies. Cardiac MR and MDCT imaging have the potential for assessing reperfusion injury components and manifestations.
磁共振（MR）和计算机断层扫描（CT）成像技术的进步提高了对急性梗死和梗死瘢痕的可视化。在过去十年中，心脏磁共振成像（CMR）和多排螺旋计算机断层扫描（MDCT）技术取得了许多重大技术进展，并且这些进展仍在持续。MR成像的优势在于多种脉冲序列以及能够在一次成像过程中无创地提供有关心肌结构、功能和灌注的信息。近期的技术发展也可能使CT技术在评估临床缺血性心脏病方面占据前沿地位。利用MR和CT技术已证实了再灌注损伤的组成部分，包括心肌水肿、出血、钙沉积和微血管阻塞（MO）。由于不存在辐射暴露或放射性物质的施用，MR成像可用于连续无创评估再灌注损伤的急性和慢性后果。MDCT更适合评估冠状动脉狭窄，并且可作为在CMR成像禁忌的患者中评估心肌存活性的替代技术。电影MR测量的左心室（LV）容积和功能变化与延迟对比增强图像测量的梗死面积直接相关。近期的MR研究发现，透壁梗死、MO和梗死周边区是梗死后期恢复不良和死亡率的极佳预测指标。近期的MR研究提供了充分证据，表明局部递送的生长因子基因和干细胞对心肌存活性、灌注和功能具有有益作用。MDCT检测到的急性梗死中沉积钙的意义需要进一步研究。心脏MR和MDCT成像有潜力评估再灌注损伤的组成部分和表现。
