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目的:探讨缺血性心脏病ATP负荷前、后MR心肌灌注成像的影像学特点,分析应用该方法评估心肌血流储备的效果。方法:采用1．5T MR成像设备对20例健康志愿者和30例临床按ISFC／WHO标准确诊为冠心病并经冠脉造影证实有心肌缺血的患者进行ATP负荷MR心肌灌注成像,对心肌灌注储备的相关参数进行定量分析,并与冠状动脉造影(CAG)进行比较。结果:ATP负荷后时间-信号强度曲线的最大上升斜率 (slope)明显增加,负荷后与负荷前slope的比值(slope+／-)正常组明显高于病例组(P<0．05);slope+／- 的正常参考值范围为2．040±0．395;与CAG的对比分析表明,ATP负荷MR心肌灌注成像诊断心肌缺血的符合率为89％。结论:ATP负荷MR心肌灌注成像能够准确地评估心肌血流储备的异常。
Objective: To investigate the imaging characteristics of MR myocardial perfusion imaging before and after ATP load of ischemic heart disease, and to evaluate the effect of this method in assessing myocardial blood flow reserve. Methods: Twenty patients with healthy volunteers and 30 patients with coronary heart disease confirmed by ISFC / WHO standard and with myocardial ischemia confirmed by coronary angiography were subjected to MR myocardial perfusion imaging with 1.5T MR imaging equipment. The relevant parameters of perfusion reserve were quantitatively analyzed and compared with coronary angiography (CAG). Results: The maximum slope of the time-signal intensity curve after ATP stress increased significantly, and the ratio of slope +/- to normal group was significantly higher than that of the normal group (P <0.05) - normal reference range of 2.040 ± 0.395; comparative analysis with CAG, myocardial ATP perfusion MR myocardial perfusion imaging diagnostic accuracy of myocardial ischemia was 89%. Conclusion: ATP-loaded MR myocardial perfusion imaging can accurately assess myocardial flow reserve abnormalities.