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磁共振成像评估主动脉冠状动脉搭桥移植血管的通畅性。

Magnetic resonance imaging to evaluate patency of aortocoronary bypass grafts.

作者信息

Rubinstein R I, Askenase A D, Thickman D, Feldman M S, Agarwal J B, Helfant R H

机构信息

Philadelphia Heart Institute, Division of Cardiology, Presbyterian-University of Pennsylvania Medical Center 19104.

出版信息

Circulation. 1987 Oct;76(4):786-91. doi: 10.1161/01.cir.76.4.786.

Abstract

To assess the efficacy of magnetic resonance (MR) imaging in evaluating graft patency after coronary bypass surgery, 20 patients who had prior surgery (average 5.5 years, range 1.5 to 14) and recent cardiac catheterization because of chest pain were studied. No patient had surgical intervention or change in symptoms in the time interval between catheterization and MR imaging. These 20 patients had a total of 47 grafts, defined as proximal anastomoses: 20 to the left anterior descending or diagonal artery (LAD), 13 to the left circumflex artery marginal branches (LCX), and 14 to the right coronary artery or posterior descending artery (RCA). The patients underwent cardiac and respiratory gated MR scans in a 0.5 tesla magnet with an echo time of 22 msec and two repetitions in a 128 X 256 matrix. In-plane resolution was 2.7 mm. Every patient had a scan in the transaxial plane and some underwent scanning in the sagittal and coronal planes as well. A graft was considered patent by MR when a signal-free lumen was visualized in an anatomic position consistent with that of a bypass graft, had a lumen larger than the native vessels, was seen on more than one slice, and was seen at a level higher than that of the native vessels. If a known graft was not seen it was considered occluded. The scans were interpreted by consensus of two physicians aware of the operative but not the cardiac catheterization data.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为评估磁共振(MR)成像在评价冠状动脉搭桥术后移植血管通畅性方面的疗效,对20例曾接受过手术(平均5.5年,范围1.5至14年)且因胸痛近期接受过心脏导管检查的患者进行了研究。在导管检查和MR成像的时间间隔内,没有患者接受手术干预或症状发生变化。这20例患者共有47条移植血管,定义为近端吻合口:20条至左前降支或对角支动脉(LAD),13条至左旋支动脉边缘分支(LCX),14条至右冠状动脉或后降支动脉(RCA)。患者在0.5特斯拉磁体中接受心脏和呼吸门控MR扫描,回波时间为22毫秒,在128×256矩阵中进行两次重复扫描。平面分辨率为2.7毫米。每位患者均进行了横断面扫描,部分患者还进行了矢状面和冠状面扫描。当在与旁路移植血管一致的解剖位置上可见无信号的管腔,管腔大于天然血管,在多个层面上可见,且在高于天然血管的层面上可见时,MR认为移植血管通畅。如果未见到已知的移植血管,则认为其闭塞。扫描结果由两位知晓手术情况但不知晓心脏导管检查数据的医生共同解读。(摘要截断于250字)

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