首页|心脏磁共振对比增强电影序列对合并微血管阻塞STEMI患者的诊断价值

心脏磁共振对比增强电影序列对合并微血管阻塞STEMI患者的诊断价值

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目的 运用磁共振对比增强平衡稳态自由进动(contrast enhancement-steady state free precession,CE-SSFP)电影序列对老年合并微循环阻塞(microvascular obstruction,MVO)的ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者进行图像质量评价,结合序列参数分析,进一步探讨其对MVO的诊断效能.材料与方法 回顾性分析2016年9月至2023年3月50例STEMI患者(STEMI组)的资料,所有患者均进行CE-SSFP电影序列的短轴位、四腔心位、两腔心位扫描.收集与患者组性别、年龄相匹配的50例志愿者为健康对照组.由两名放射诊断医师在CE-SSFP序列上对两组心肌、血池进行定性、定量图像质量评价.采用独立样本t检验分析STEMI组和对照组间的一般资料和影像资料.采用受试者工作特征(receiver operating characteristic,ROC)曲线分析CE-SSFP序列对MVO的诊断效能.结果 STEMI组48例患者(96%)和健康对照组49例(98%)的CE-SSFP图像均可满足诊断条件;STEMI组的血池与心肌对比噪声比显著优于健康对照组(222.9±15.6 vs.170.1±14.9,t=4.631,P<0.05);CE-SSFP人工识别MVO的敏感度为91.38%,特异度为91.88%,约登指数为0.833;以2倍标准差评价MVO的敏感度为90.23%,特异度为89.94%,约登指数为0.802.两种方法的曲线下面积分别为0.931和0.909.结论 CE-SSFP序列可定量评估STEMI合并MVO患者的图像质量,能提供有效量化识别MVO的指标,为临床诊断提供影像学依据.
Diagnostic value of cardiac magnetic contrast-enhanced cine sequences in STEMI patients with microvascular obstruction
Objective:Using magnetic resonance contrast enhancement-steady state free precession(CE-SSFP)cine sequence to detect ST-segment elevation myocardial infarction(STEMI)in elderly patients with microvascular obstruction(MVO).STEMI patients were evaluated for image quality and combined with sequence parameter analysis to further explore its diagnostic performance for MVO.Materials and Methods:The clinical data of 50 patients with STEMI(STEMI group)from September 2016 to March 2023 were retrospectively analyzed.All patients underwented CE-SSFP cine sequence short axis,four chamber,and two chamber scans.The STEMI patient group was included according to the 2020 European Heart Journal guideline standards and healthy controls matched for gender and age were collected.Qualitative and quantitative image quality evaluation of the myocardium and blood pool were performed on the CE-SSFP sequence by two diagnostic radiologists.The independent sample t test was used to analyze the general information and imaging data between the STEMI group and the healthy control group.The diagnostic performance of CE-SSFP sequence for MVO was analyzed using receiver operating characteristic(ROC)curve.Results:The CE-SSFP images of 48 patients(96%)in the STEMI group and 49 volunteers(98%)in the healthy control group could meet the diagnostic conditions;the contrast-to-noise ratio of the blood pool and myocardium in the STEMI group was significantly better than that in the healthy control group(222.9±15.6 vs.170.1±14.9,t=4.631,P<0.05);the sensitivity of CE-SSFP to manually identify MVO was 91.38%,the specificity was 91.88%,and the Youden index was 0.833;the sensitivity of MVO was evaluated with 2 times the standard deviation.The specificity was 90.23%,the specificity was 89.94%,and the Youden index was 0.802.The areas under the curve for the two methods were 0.931 and 0.909 respectively.Conclusions:The CE-SSFP sequence can quantitatively evaluate the image quality of patients with STEMI combined with MVO,provide effective indicators for quantitatively identifying MVO,and provide imaging basis for clinical diagnosis.

ST-segment elevation myocardial infarctionmicrovascular obstructioncardiac magnetic resonancecontrast enhancement-steady state free precessionmagnetic resonance imaging

胡莹莹、郭勇、孙峥、赵丽、刘志、陈楠、卢洁

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首都医科大学宣武医院放射与核医学科,北京 100053

北京大学国际医院放射科,北京 102206

首都医科大学宣武医院急诊科,北京 100053

ST段抬高型心肌梗死 微血管阻塞 心脏磁共振 对比增强平衡稳态自由进动 磁共振成像

国家自然科学基金

62172288

2024

磁共振成像
中国医院协会 首都医科大学附属北京天坛医院

磁共振成像

CSTPCD北大核心
影响因子:1.38
ISSN:1674-8034
年,卷(期):2024.15(2)
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