Magnetic resonance first-pass myocardial perfusion imaging.
Magnetic resonance first-pass myocardial perfusion imaging.
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DOI：
10.1097/00002142-200012000-00007
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发表时间：
2000-12-01
期刊：
影响因子：
--
通讯作者：
Arai, A E
中科院分区：
文献类型：
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作者：
Arai, A E
磁共振首过灌注成像在过去的十年中有了很大的发展。使用高性能梯度和混合回波平面方法，可以在休息时的每次心跳和压力期间的两次心跳中采集7-8个成像平面。T1加权可以通过体积饱和脉冲或选择性“陷波”脉冲来实现。首过研究可以量化，但也可以直接将心肌灌注异常可视化为内膜下缺损，其对比增强程度低于周围心肌。在冠状动脉疾病患者中检测应激诱导的灌注异常是可行的。与心肌梗死相关的磁共振成像（MRI）灌注异常具有与核方法（如铊）显著不同的特征，其中图像的最终外观代表灌注、活力和壁厚的组合。除非有微血管或心外膜阻塞，否则在首过MRI研究中，闭塞的心肌会增强。心肌梗死后的微血管阻塞很容易被发现，并具有不良预后意义。压力引起的灌注异常并不等同于冠状动脉疾病，因为它们可以在肥厚型心肌病中检测到。只要医生根据图像中描绘的生理学解释结果，MRI灌注方法似乎很有前途。
Magnetic resonance first-pass perfusion imaging has developed considerably over the past decade. It is possible to acquire 7-8 imaging planes every heartbeat at rest and in two heartbeats during stress using high-performance gradients and hybrid echoplanar methods. T1 weighting can be achieved with volumetric saturation pulses or selective "notch" pulses. First-pass studies can be quantified, but it also is possible to directly visualize myocardial perfusion abnormalities as subendocardial defects with less contrast enhancement than surrounding myocardium. It is feasible to detect stress-induced perfusion abnormalities in patients with coronary artery disease. Magnetic resonance imaging (MRI) perfusion abnormalities associated with myocardial infarction have significantly different characteristics from those seen on nuclear methods such as thallium, where the final appearance of images represents a combination of perfusion, viability, and wall thickness. Infarcted myocardium enhances during the first-pass MRI study unless there is microvascular or epicardial obstruction. Microvascular obstruction after myocardial infarction is easily detected and has adverse prognostic significance. Stress-induced perfusion abnormalities are not synonymous with coronary artery disease, as they can be detected in hypertrophic cardiomyopathy. MRI perfusion methods appear promising as long as physicians interpret the results in accordance of the physiology portrayed in the images.