Correspondence Between the 17-Segment Model and Coronary Arterial Anatomy Using Contrast-Enhanced Cardiac Magnetic Resonance Imaging
Correspondence Between the 17-Segment Model and Coronary Arterial Anatomy Using Contrast-Enhanced Cardiac Magnetic Resonance Imaging
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DOI：
10.1016/j.jcmg.2008.01.014
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发表时间：
2008-05-01
影响因子：
14
通讯作者：
Wu, Edwin
中科院分区：
文献类型：
--
作者：
Ortiz-Perez, Jose T.;Rodriguez, Jose;Wu, Edwin
本研究的目的是根据美国心脏协会提出的17- 2005年冠状动脉解剖与供血心肌之间的对应关系，背景：目前，将冠状动脉标准化分配到特定的心肌节段是基于经验假设的。冠状动脉介入两名观察员盲法检查所有血管造影片，以检查罪犯病变的位置和冠状动脉优势。另外两名观察员在17节段模型上对心脏磁共振增强（HE）的存在进行评分。段划分的基础上解剖标志，如室间沟和乳头muscle.RESULTS在每段分析，23%的HE段与经验分配的冠状动脉分布不一致。基底前间隔、中前壁、中前间隔或心尖前壁HE的存在对于左前降支动脉闭塞具有100%的特异性。左前降支梗死常累及前外侧壁、顶外侧壁和顶下壁。尽管基底前外侧壁的HE对LCX闭塞具有高度特异性（98%），但没有一个节段对右冠状动脉或左旋支（LCX）闭塞具有100%特异性。HE在前外侧和下外侧壁的组合是100%特异性的LCX闭塞，当扩展到下壁，也是100%特异性的主导或共同主导的LCX occlusions.CONCLUSIONS四段是完全特定的左前降支动脉闭塞。没有一个节段可以完全归因于右冠状动脉或LCX闭塞。然而，相邻节段的分析增加了特定冠状动脉闭塞的特异性。这些发现为冠状动脉灌注区域的适当分割提供了客观证据，并有助于在各种成像模式中准确分配罪犯血管。（美国科尔心脏病学杂志2008; 1：282-93）（C）美国心脏病学会基金会2008年
OBJECTIVES The purpose of this study was to investigate the correspondence between the coronary arterial anatomy and supplied myocardium based on the proposed American Heart Association 17-segment model.BACKGROUND Standardized assignment of coronary arteries to specific myocardial segments is currently based on empirical assumptions.METHODS A cardiac magnetic resonance study was performed in 93 subjects following acute myocardial infarction treated with primary percutaneous coronary intervention. Two observers blindly reviewed all angiograms to examine the location of the culprit lesion and coronary dominancy. Two additional observers scored for the presence of cardiac magnetic resonance hyperenhancement (HE) on a 17-segment model. Segments were divided based on anatomical landmarks such as the interventricular grooves and papillary muscles.RESULTS In a per-segment analysis, 23% of HE segments were discordant with the empirically assigned coronary distribution. Presence of HE in the basal anteroseptal, mid-anterior, mid-anteroseptal, or apical anterior wall was 100% specific for left anterior descending artery occlusion. The left anterior descending artery infarcts frequently involved the mid-anterolateral, apical lateral, and apical inferior walls. No segment was 100% specific for right coronary artery or left circumflex artery (LCX) occlusion, although HE in the basal anterolateral wall was highly specific (98%) for LCX occlusion. Combination of HE in the anterolateral and inferolateral walls was 100% specific for a LCX occlusion, and when extended to the inferior wall, was also 100% specific for a dominant or codominant LCX occlusion.CONCLUSIONS Four segments were completely specific for left anterior descending artery occlusion. No segment can be exclusively attributed to the right coronary artery or LCX occlusion. However, analysis of adjacent segments increased the specificity for a given coronary occlusion. These findings bring objective evidence in the appropriate segmentation of coronary arterial perfusion territories and assist accurate assignment of the culprit vessel in various imaging modalities. (J Am Coll Cardiol Img 2008; 1: 282-93) (C) 2008 by the American College of Cardiology Foundation