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目的:评价心脏腺苷负荷磁共振成像在冠心病早期诊断中的作用。方法:选择临床无急性冠脉综合征,选择性冠状动脉造影(CAG)证实冠脉有不同程度狭窄的患者34例,根据CAG结果将患者分为3组,第1组管腔狭窄>75%、第2组狭窄50%~75%以及第3组狭窄<50%。在3.0T磁共振成像仪上分别行静息和腺苷负荷磁共振心脏灌注扫描和延迟增强成像,对比分析不同状态下磁共振(MR)成像心肌灌注变化。结果:在未发生急性冠脉综合征患者,静息磁共振心肌灌注成像显示心肌缺血主要表现为心肌灌注减少,总阳性率38%(13/34),不同冠状动脉狭窄组间无显著性差异。磁共振腺苷负荷试验可增加患者心肌灌注降低检测的阳性率[62%(21/34)]。统计结果显示,对于心肌缺血的检测,心脏磁共振腺苷负荷试验与静息心脏磁共振心肌灌注之间有显著性差异(P<0.01)。延迟扫描成像在34例患者中无延迟增强改变。结论:腺苷负荷MR灌注成像可以显著提高心肌缺血诊断的阳性率,有助于冠心病的早期诊断。
Objective: To evaluate the role of cardiac adenosine stress magnetic resonance imaging in the early diagnosis of coronary heart disease. Methods: Thirty-four patients with clinically no acute coronary syndrome and selective coronary angiography (CAG) were selected. The patients were divided into three groups according to CAG results. The first group had lumen stenosis> 75% 50% to 75% in group 2 and <50% in group 3. Resting and adenosine stress-loaded cardiac perfusion scanning and delayed enhancement imaging were performed on 3.0T magnetic resonance imaging system respectively. Changes of myocardial perfusion under different MR imaging were compared. Results: In patients without acute coronary syndrome, resting myocardial perfusion imaging showed myocardial ischemia reduced myocardial perfusion, the total positive rate was 38% (13/34), there was no significant difference between different groups of coronary artery stenosis difference. Magnetic resonance adenosine stress test increased the positive rate of myocardial perfusion in patients [62% (21/34)]. The statistical results showed that there was a significant difference (P <0.01) between the cardiac magnetic resonance adenosine stress test and resting cardiac magnetic resonance myocardial perfusion in the detection of myocardial ischemia. Delayed scan imaging showed no delay enhancement in 34 patients. Conclusion: Adenosine load MR perfusion imaging can significantly improve the positive rate of myocardial ischemia diagnosis, contribute to the early diagnosis of coronary heart disease.