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基于特征追踪磁共振成像的心肌应力检测对急性心肌梗死患者的诊断价值

Diagnostic value of myocardial stress detection based on feature tracking MRI in patients with acute myocardial infarction.

作者信息

Feng Li, Yang Zhao, Chen Shiyue, Wan Jianghua

机构信息

Department of Radiology, Chengdu First People's Hospital, Chengdu, China.

Department of Imaging Medicine, First Affiliated Hospital of Naval Military Medical University, Shanghai, China.

出版信息

J Thorac Dis. 2022 Sep;14(9):3454-3461. doi: 10.21037/jtd-22-973.

Abstract

BACKGROUND

Evaluate the predictive value of myocardial stress measured by magnetic resonance imaging (MRI) on the severity of coronary artery stenosis and acute myocardial infarction (AMI). In the early stage of acute myocardial infarction, many imaging findings are negative, and MRI myocardial stress detection is controversial in the diagnosis of this aspect. Therefore, it is necessary to determine whether MRI myocardial stress can diagnose acute myocardial infarction.

METHODS

A total of 120 patients were divided into an AMI group and non-AMI group. The AMI group was further divided into a mild group, moderate group, and severe group. The myocardial stress was measured by MRI, compared in each group, the correlation between myocardial stress and coronary artery stenosis rate was analyzed, and coronary artery disease (CAD) compared between patients with AMI, and the relationship between myocardial stress and AMI was observed.

RESULTS

Among the 120 patients, there were 77 cases in the AMI group, including 21 cases in the mild group, 40 cases in the moderate group, and 16 cases in the severe group. There were a total of 43 cases in the non-AMI group. Myocardial stress in the AMI group was significantly higher than that in the non-AMI group (P<0.05). The myocardial stress increased gradually in the mild, moderate, and severe AMI groups (P<0.001). Myocardial stress was positively correlated with coronary artery stenosis rate (P<0.001) and CAD (P<0.05). Logistic regression analysis showed that myocardial stress was an independent risk factor for AMI (P<0.05). The sensitivity and specificity of myocardial stress >5.15 mm in the diagnosis of AMI were 83.5%, 68.6% (AUC =0.834), respectively. Acute myocardial infarction is often caused by risk factors such as hyperlipidemia, hypertension and hyperglycemia, as well as vascular stenosis caused by arterial wall malformation, vascular wall inflammation or vasospasm.

CONCLUSIONS

The MRI measurement of myocardial stress is simple, reliable, and practical to evaluate the degree of coronary artery lesions. Myocardial stress is closely related to AMI and can assist in the diagnosis of AMI.

摘要

背景

评估磁共振成像(MRI)测量的心肌应力对冠状动脉狭窄严重程度及急性心肌梗死(AMI)的预测价值。在急性心肌梗死早期,许多影像学表现为阴性,MRI心肌应力检测在这方面的诊断存在争议。因此,有必要确定MRI心肌应力能否诊断急性心肌梗死。

方法

将120例患者分为AMI组和非AMI组。AMI组进一步分为轻度组、中度组和重度组。采用MRI测量心肌应力,比较各组情况,分析心肌应力与冠状动脉狭窄率的相关性,比较AMI患者之间的冠状动脉疾病(CAD)情况,并观察心肌应力与AMI的关系。

结果

120例患者中,AMI组77例,其中轻度组21例,中度组40例,重度组16例。非AMI组共43例。AMI组心肌应力显著高于非AMI组(P<0.05)。轻度、中度和重度AMI组心肌应力逐渐升高(P<0.001)。心肌应力与冠状动脉狭窄率(P<0.001)及CAD(P<0.05)呈正相关。Logistic回归分析显示心肌应力是AMI的独立危险因素(P<0.05)。心肌应力>5.15 mm诊断AMI的敏感性和特异性分别为83.5%、68.6%(AUC =0.834)。急性心肌梗死常由高脂血症、高血压和高血糖等危险因素以及动脉壁畸形、血管壁炎症或血管痉挛导致的血管狭窄引起。

结论

MRI测量心肌应力评估冠状动脉病变程度简单、可靠且实用。心肌应力与AMI密切相关,可辅助诊断AMI。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d10/9562525/8cd85457958f/jtd-14-09-3454-f1.jpg

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