Pflugfelder P W, Sechtem U P, White R D, Higgins C B
Department of Radiology, University of California, San Francisco 94143.
AJR Am J Roentgenol. 1988 Mar;150(3):523-9. doi: 10.2214/ajr.150.3.523.
The capability of rapid (cine) MR imaging to quantitate left ventricular function was assessed in 13 normal subjects and in 15 patients with ischemic heart disease and regional wall-motion abnormalities proved by echocardiography and/or by contrast ventriculography. Fifteen to 20 MR images/cardiac cycle were acquired by using partial flip angles, short repetition times, and gradient-refocused echoes. Regional wall motion was assessed qualitatively in the equatorial left ventricular section by using the cine display and quantitatively by measuring myocardial thickness at end-diastole and at end-systole in six left ventricular segments in this plane. In normal volunteers wall motion was normal in all segments. Heterogeneity of systolic wall thickening was observed in normal subjects, ranging from 33% +/- 17% in the posteroseptal segment to 66% +/- 29% in the posterior segment. Overall systolic wall thickening was 48% +/- 28%. From the cinematic display of MR images, abnormal wall motion was observed in 40 of 90 segments in patients with ischemic heart disease, which correlated well with results of echocardiography or contrast ventriculography. Twenty-one segments were hypokinetic, 15 were akinetic, and four were dyskinetic. In patients with ischemic heart disease, percentage systolic wall thickening was 43% +/- 31% in the segments with normal wall motion, 6% +/- 18% in hypokinetic segments, -4% +/- 24% in akinetic segments, and -13% +/- 25% in dyskinetic zones. Absolute systolic wall thickening was less than 2 mm in 31 of 40 abnormal segments and was greater than 2 mm in only three. Rapid acquisition, improved temporal resolution, and the capacity for cine display make this new MR technique potentially useful not only for qualitative assessment of cardiac wall motion, but also for quantification of regional myocardial function.
对13名正常受试者以及15名经超声心动图和/或造影心室造影证实患有缺血性心脏病且存在局部室壁运动异常的患者，评估了快速（电影）磁共振成像定量左心室功能的能力。通过使用部分翻转角、短重复时间和梯度重聚回波，在每个心动周期采集15至20幅磁共振图像。通过电影显示在左心室赤道平面定性评估局部室壁运动，并通过测量该平面六个左心室节段的舒张末期和收缩末期心肌厚度进行定量评估。在正常志愿者中，所有节段的室壁运动均正常。在正常受试者中观察到收缩期室壁增厚的异质性，范围从后间隔节段的33%±17%到后节段的66%±29%。总体收缩期室壁增厚为48%±28%。从磁共振图像的电影显示中，在缺血性心脏病患者的90个节段中有40个观察到异常室壁运动，这与超声心动图或造影心室造影的结果密切相关。21个节段运动减弱，15个节段无运动，4个节段运动障碍。在缺血性心脏病患者中，室壁运动正常的节段收缩期室壁增厚百分比为43%±31%，运动减弱节段为6%±18%，无运动节段为-4%±24%，运动障碍节段为-13%±25%。在40个异常节段中，31个节段的绝对收缩期室壁增厚小于2mm，只有3个节段大于2mm。快速采集、提高的时间分辨率以及电影显示能力使这种新的磁共振技术不仅对心脏壁运动的定性评估有潜在用途，而且对局部心肌功能的定量评估也有潜在用途。
