Kramer C M, Rogers W J, Geskin G, Power T P, Theobald T M, Hu Y L, Reichek N
Department of Medicine, Allegheny Campus, Allegheny University of the Health Sciences, Pittsburgh, Pennsylvania, USA.
Am J Cardiol. 1997 Sep 15;80(6):690-5. doi: 10.1016/s0002-9149(97)00496-7.
In patients, early after acute myocardial infarction (AMI), rapid magnetic resonance imaging (MRI) techniques have been used to assess left ventricular (LV) structure, global and regional function, infarct artery patency, or contrast uptake individually. We hypothesized that MRI could be used as a comprehensive evaluation of the post-AMI patient, studying all of these parameters in < 1 hour. Twenty-seven patients were studied after first AMI. Complete examinations were performed in 23 patients, 16 with anterior and 7 with inferior wall myocardial infarction, on day 5 +/- 2 after the event. For measurement of LV structure and regional function, a breath-hold segmented k-space gradient echo tagging sequence was used. A fat-suppressed segmented k-space breath-hold sequence was used for coronary artery imaging. MRI contrast-enhanced images during bolus gadoteridol transit through the myocardium were obtained to assess first-pass contrast uptake. No adverse events were noted during the MRI scanning, which was completed in 46 +/- 5 minutes. The LV mass index, end-diastolic and end-systolic volume indexes, and ejection fraction were (mean +/- SD) 107 +/- 13 g/m2, 87 +/- 23 ml/m2, 54 +/- 20 ml/m2, and 39 +/- 12%, respectively. Intramyocardial percent circumferential shortening was 11 +/- 6% at the apex, 14 +/- 4% in the midventricle, and 15 +/- 4% at the base. Flow within all infarct arteries was visualized. Seventeen of 23 patients had regions of reduced contrast uptake on first-pass imaging with mean signal intensity of 47 +/- 24% that of remote regions. In patients with recent AMI, comprehensive assessment of LV structure and function, infarct artery patency, and regional myocardial contrast uptake was safe and feasible with MRI of < 1 hour.
在急性心肌梗死（AMI）后的早期患者中，快速磁共振成像（MRI）技术已被用于单独评估左心室（LV）结构、整体和局部功能、梗死动脉通畅情况或对比剂摄取情况。我们假设MRI可用于对AMI后患者进行全面评估，在不到1小时的时间内研究所有这些参数。对27例首次发生AMI后的患者进行了研究。在事件发生后第5±2天，对23例患者进行了完整检查，其中16例为前壁心肌梗死，7例为下壁心肌梗死。测量LV结构和局部功能时，使用屏气分段k空间梯度回波标记序列。使用脂肪抑制分段k空间屏气序列进行冠状动脉成像。在团注钆特醇通过心肌期间获得MRI对比增强图像，以评估首过对比剂摄取情况。MRI扫描过程中未观察到不良事件，扫描在46±5分钟内完成。LV质量指数、舒张末期和收缩末期容积指数以及射血分数分别为（平均值±标准差）107±13 g/m²、87±23 ml/m²、54±20 ml/m²和39±12%。心尖部心肌内圆周缩短百分比为11±6%，心室中部为14±4%，心底为15±4%。所有梗死动脉内的血流均清晰可见。23例患者中有17例在首过成像时有对比剂摄取减少区域，平均信号强度为远隔区域的47±24%。对于近期发生AMI的患者，采用不到1小时的MRI对LV结构和功能、梗死动脉通畅情况以及局部心肌对比剂摄取进行全面评估是安全可行的。
