Filipchuk N G, Peshock R M, Malloy C R, Corbett J R, Rehr R B, Buja L M, Jansen D E, Redish G R, Gabliani G I, Parkey R W
Am J Cardiol. 1986 Aug 1;58(3):214-9. doi: 10.1016/0002-9149(86)90049-4.
The potential of magnetic resonance imaging (MRI) to detect and localize acute myocardial infarction (AMI) in 27 patients a mean interval of 15 days after AMI was evaluated. Eighteen asymptomatic volunteers were also studied to determine the specificity of the observations. The diagnosis of AMI was established by conventional criteria; the infarct was localized by electrocardiography in all patients, technetium pyrophosphate scintigraphy in 19 and necropsy in 1 patient. MRI detected increased myocardial signal intensity in 88%, cavitary signal in 74% and regional wall thinning in 67% of the patients. At least 1 of these 3 features was seen in the area of the infarct in each patient. The sensitivity of these MRI observations was not influenced by location of the infarct or presence of Q waves. Asymptomatic volunteers also had increased myocardial signal in 83%, cavitary signal in 94% and wall thinning in 11% of cases. Some patients had these findings in myocardial segments not suspected of being involved by recent or remote AMI. It is concluded that AMI can be detected by MRI performed an average of 15 days after infarction. However, the hearts of normal volunteers and apparently normal myocardial segments of patients with AMI may have the MRI findings previously associated with AMI. Of these findings, wall thinning was the most predictive of and specific for AMI.
对27例急性心肌梗死（AMI）患者在AMI后平均15天进行磁共振成像（MRI）检测和定位急性心肌梗死的潜力进行了评估。还对18名无症状志愿者进行了研究，以确定观察结果的特异性。AMI的诊断依据传统标准确立；所有患者通过心电图定位梗死灶，19例通过焦磷酸锝闪烁扫描，1例通过尸检。MRI检测到88%的患者心肌信号强度增加，74%的患者有空洞信号，67%的患者有节段性室壁变薄。每位患者在梗死区域均可见这3种特征中的至少1种。这些MRI观察结果的敏感性不受梗死部位或Q波的影响。无症状志愿者中，83%的患者心肌信号增加，94%的患者有空洞信号，11%的患者有室壁变薄。一些患者在未怀疑近期或陈旧性AMI累及的心肌节段出现了这些表现。得出的结论是，在梗死平均15天后进行MRI检查可以检测到AMI。然而，正常志愿者的心脏以及AMI患者明显正常的心肌节段可能会出现以前与AMI相关的MRI表现。在这些表现中，室壁变薄对AMI的预测性和特异性最强。
