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心脏磁共振成像在急性ST段抬高型心肌梗死中的应用新进展
李东*,任雯
0
(天津医科大学总医院放射科, 天津 300052
*通信作者)
摘要:
再灌注治疗明显降低了急性ST段抬高型心肌梗死(STEMI)患者的死亡率,但是STEMI导致的心力衰竭死亡率仍呈增高趋势,因此探寻改善STEIM患者预后的新的治疗方法仍是重要任务。心脏磁共振(CMR)检查是评估STEMI新治疗方法疗效和患者预后的重要工具。纵向弛豫时间定量成像(T1 mapping)和横向弛豫时间定量成像(T2 mapping)等新技术有助于从更深层次探究STEMI再灌注后心肌水肿、微血管梗阻、心肌内出血、对侧心肌间质间隙等病理生理学改变。本文就近几年CMR在STEMI再灌注后的应用新进展进行探讨。
关键词:  心肌梗死  急性ST段抬高  经皮冠状动脉介入术  磁共振成像  微血管梗阻  心肌内出血
DOI:10.16781/j.0258-879x.2019.03.0233
投稿时间:2019-02-10修订日期:2019-02-28
基金项目:国家自然科学基金青年科学基金(81301217),科技部“十三五”国家重点研发计划(2016YFC1300402),天津市应用基础与前沿技术研究计划(14JCZDJC57000,18JCYBJC25100).
Application of cardiac magnetic resonance imaging in acute ST-segment elevation myocardial infarction: recent advances
LI Dong*,REN Wen
(Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China
*Corresponding author)
Abstract:
Reperfusion therapy has significantly reduced the mortality of patients with acute ST-segment elevation myocardial infarction (STEMI), but the associated heart failure mortality is on a rise. It is important to seek novel cardioprotective therapies to improve clinical outcomes. Cardiac magnetic resonance (CMR) is an important imaging modality for assessing the efficacy of the novel therapies and the prognosis of the patients. T1 mapping and T2 mapping have provided new insights into the pathophysiology underlying myocardial edema, microvascular obstruction, intramyocardial hemorrhage, and the remote myocardial interstitial space after reperfused STEMI. This review sums up the recent advances on the application of the CMR in reperfused STEMI.
Key words:  myocardial infarction  acute ST-segment elevation  percutaneous coronary intervention  magnetic resonance imaging  microvascular obstruction  intramyocardial hemorrhage