Assessment of intramyocardial hemorrhage by T1-weighted cardiovascular magnetic resonance in reperfused acute myocardial infarction.
Assessment of intramyocardial hemorrhage by T1-weighted cardiovascular magnetic resonance in reperfused acute myocardial infarction.
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DOI：
10.1186/1532-429x-14-59
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发表时间：
2012-08-30
期刊：
影响因子：
--
通讯作者：
Kim WY
中科院分区：
文献类型：
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作者：
Pedersen SF;Thrysøe SA;Robich MP;Paaske WP;Ringgaard S;Bøtker HE;Hansen ES;Kim WY
心肌内出血（IMH）反映了急性心肌梗死严重的再灌注损伤。心血管磁共振（CMR）的IMH的非侵入性检测可以作为一个替代指标，以评估预防措施，以减少再灌注损伤的效果，从而提供额外的预后信息。我们试图研究IMH是否可以通过CMR利用高铁血红蛋白在急性心肌梗死实验模型中的T1缩短效应来检测。将结果与T2加权短tau反转恢复（T2-STIR）和T2* 加权（T2*W）序列进行比较。在10头40 kg猪中，通过球囊闭塞LAD中段50 min，然后再灌注来诱导IMH。伤后4-9天（平均4.8天），采用T1加权反转恢复（T1 W-IR）、T2-STIR和T2* W序列对左室心肌进行评价。所有的巨磁共振图像均与组织病理学相匹配，并与IMH区域进行比较。在T1 W-IR图像上检测到的IMH区域大小与病理结果之间的差异为-1.6 ± 11.3%（一致性限值，-24%-21%），对于T2*W图像，差异为-0.1 ± 18.3% T2-STIR的差异为8.0 ± 15.5%（一致性范围为-23%-39%）。T1 WI诊断IMH的敏感性为90%，特异性为70%，T2 WI诊断IMH的敏感性为70%，特异性为50%，T2-STIR诊断IMH的敏感性为50%，特异性为60%。T1加权非增强CMR检测IMH具有较高的敏感性和特异性，可能成为心肌梗死患者IMH的诊断工具。
Intramyocardialhemorrhage (IMH) reflects severe reperfusion injury in acute myocardial infarction. Non-invasive detection of IMH by cardiovascular magnetic resonance (CMR) may serve as a surrogate marker to evaluate the effect of preventive measures to reduce reperfusion injury and hence provide additional prognostic information. We sought to investigate whether IMH could be detected by CMR exploiting the T1 shortening effect of methemoglobin in an experimental model of acute myocardial infarction. The results were compared to T2-weighthed short tau inversion recovery (T2-STIR), and T2*-weighted(T2*W) sequences. IMH was induced in ten 40 kg pigs by 50-min balloon occlusion of the mid LAD followed by reperfusion. Between 4–9 days (average 4.8) post-injury, the left ventricular myocardium was assessed by T1-weigthed Inversion Recovery(T1W-IR), T2-STIR, and T2*Wsequences. All CMR images were matched to histopathology and compared with the area of IMH. The difference between the size of the IMH area detected on T1W-IR images and pathology was −1.6 ± 11.3% (limits of agreement, -24%–21%), for the T2*W images the difference was −0.1 ± 18.3% (limitsof agreement, -36.8%–36.6%), and for T2-STIR the difference was 8.0 ± 15.5% (limits of agreement, -23%–39%). By T1W IR the diagnostic sensitivity of IMH was 90% and specificity 70%, for T2*W imaging the sensitivity was 70% and specificity 50%, and for T2-STIR sensitivity for imaging IMH was 50% and specificity 60%. T1-weigthednon-contrast enhanced CMR detects IMH with high sensitivity and specificity and may become a diagnostic tool for detection of IMH in patients with myocardial infarction.