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冠状动脉疾病中使用延迟强化磁共振成像评估心肌存活性:与数字减影血管造影术测量的冠状动脉狭窄的相关性研究

Assessment of myocardial viability with delayed-enhancement MRI in coronary artery disease: A correlative study with coronary artery stenosis using digital subtraction angiography.

作者信息

Zhao Xinxiang, Zhang Yanglin, Sun Yong, Sun Lin, Cai Renhui

机构信息

Department of Radiology, The Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan 650101, P.R. China.

Department of Cardiology, The Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan 650101, P.R. China.

出版信息

Exp Ther Med. 2016 Oct;12(4):2285-2289. doi: 10.3892/etm.2016.3590. Epub 2016 Aug 12.

Abstract

The aim of the present study was to investigate the correlation between the degree of coronary artery stenosis determined by digital subtraction angiography (DSA) and infarcted segments detected by delayed enhancement magnetic resonance imaging (DE-MRI). DE-MRI and DSA were performed in 40 patients with coronary artery disease. The number of myocardial segments with infarction, the transmural extent of myocardial infarction, score of myocardial infarction by MRI, degree of coronary artery stenosis and Gensini score of the coronary artery were assessed. The correlation was analyzed using Spearman's rank correlation test. Among the 40 patients, 126 infarcted myocardial segments with a total score of 307 were found by DE-MRI; the total Gensini score for coronary artery stenosis was 587. It was observed that 81.74% of the infarcted segments were at sites with >50% coronary artery stenosis. The correlation coefficient between the Gensini score and myocardial infarction score was 0.786 (P<0.001), indicating a good correlation. However, 18.26% of myocardial infarction segments were found in patients with slight coronary artery stenosis (≤25%). A correlation was identified between DSA detected coronary artery stenosis and infarcted segments detected by DE-MRI; a higher transmural extent of myocardial infarction correlated with more severe stenosis of the coronary artery. The combined use of the two tools may facilitate accurate diagnosis.

摘要

本研究的目的是探讨数字减影血管造影(DSA)所确定的冠状动脉狭窄程度与延迟增强磁共振成像(DE-MRI)所检测到的梗死节段之间的相关性。对40例冠心病患者进行了DE-MRI和DSA检查。评估了心肌梗死节段数量、心肌梗死的透壁范围、MRI心肌梗死评分、冠状动脉狭窄程度以及冠状动脉的Gensini评分。采用Spearman等级相关检验分析相关性。在40例患者中,DE-MRI发现126个梗死心肌节段,总评分为307分;冠状动脉狭窄的总Gensini评分为587分。观察到81.74%的梗死节段位于冠状动脉狭窄>50%的部位。Gensini评分与心肌梗死评分之间的相关系数为0.786(P<0.001),表明相关性良好。然而,18.26%的心肌梗死节段出现在冠状动脉轻度狭窄(≤25%)的患者中。DSA检测到的冠状动脉狭窄与DE-MRI检测到的梗死节段之间存在相关性;心肌梗死透壁范围越大,冠状动脉狭窄越严重。两种检查手段联合使用可能有助于准确诊断。

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