Eur radiol:评估心肌梗死新技术!碘剂延迟强化CT结合图像剪影评估心肌梗死的价值!

2017-10-01 shaosai MedSci原创

心肌梗死又叫心肌梗塞,心肌梗塞(myocardialinfarction)是冠状动脉闭塞,血流中断,使部分心肌因严重的持久性缺血而发生局部坏死。临床上有剧烈而较持久的胸骨后疼痛,发热、白细胞增多、红细胞沉降率加快,血清心肌酶活力增高及进行性心电图变化,可发生心律失常、休克或心力衰竭。本研究旨在评价碘剂延迟强化CT(LIE-CT)结合图像剪影评估心肌梗死(MI)的价值,并将结果发表在Eur radi

心肌梗死又叫心肌梗塞,心肌梗塞(myocardialinfarction)是冠状动脉闭塞,血流中断,使部分心肌因严重的持久性缺血而发生局部坏死。临床上有剧烈而较持久的胸骨后疼痛,发热、白细胞增多、红细胞沉降率加快,血清心肌酶活力增高及进行性心电图变化,可发生心律失常、休克或心力衰竭。本研究旨在评价碘剂延迟强化CT(LIE-CT)结合图像剪影评估心肌梗死(MI)的价值,并将结果发表在Eur radiol上。

本研究共纳入了27例患者,并行心脏CT和钆剂延迟强化MRI(LGE-MRI)。在行CT灌注(CTP)和CT血管成像后进行LIE-CT检查。通过对CTP得到的原始LIE-CT中左心室(LV)腔的蒙片得到剪影LIE-CT。有LIE比整个LV体积得到%MI体积,LIE的透壁梗死程度(TME)被分为0%、1-24%、25-49%、50-74%和 75-100%。利用Spearman等级测验、Bland-Altman方法和卡方检验比较上述结果和LGE-MRI的结果。

结果为,共有125/432段(29%)在LGE-MRI上为阳性。原始图像和LIE-CT与LGE-MRI的%MI体积相关系数分别为0.79、0.85。原始图像和LIE-CT与LGE-MRI的%MI体积经5分等级量表测算的TME一致性分别为75%、84%。通过剪影技术的使用,一致性明显改善(p <0.05)。

本研究表明,与原始LIE-CT相比,利用LIE-CT剪影技术更加准确地评估MI程度。

原始出处:

Tanabe Y, Kido T, Kurata A, et al,Late iodine enhancement computed tomography with image subtraction for assessment of myocardial infarction.Eur Radiol. 2017.DOI: 10.1007/s00330-017-5048-9

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    2017-10-08 Y—xianghai

    学习了新知识

    0

  3. 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    2017-10-04 大爰

    学习了谢谢分享!!

    0

  4. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249585, encodeId=50e724958501, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Mon Oct 02 07:26:27 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249583, encodeId=80fd24958302, content=临床上有剧烈而较持久的胸骨后疼痛.发热.白细胞增多.红细胞沉降率加快.血清心肌酶活力增高及进行性心电图变化.可发生心律失常.休克或心力衰竭, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Mon Oct 02 07:26:19 CST 2017, time=2017-10-02, status=1, ipAttribution=)]
    2017-10-03 飘飘爱

    很好

    0

  5. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249585, encodeId=50e724958501, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Mon Oct 02 07:26:27 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249583, encodeId=80fd24958302, content=临床上有剧烈而较持久的胸骨后疼痛.发热.白细胞增多.红细胞沉降率加快.血清心肌酶活力增高及进行性心电图变化.可发生心律失常.休克或心力衰竭, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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    2017-10-03 Drhzm308

    谢谢.学习了

    0

  6. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249585, encodeId=50e724958501, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Mon Oct 02 07:26:27 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249583, encodeId=80fd24958302, content=临床上有剧烈而较持久的胸骨后疼痛.发热.白细胞增多.红细胞沉降率加快.血清心肌酶活力增高及进行性心电图变化.可发生心律失常.休克或心力衰竭, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Mon Oct 02 07:26:19 CST 2017, time=2017-10-02, status=1, ipAttribution=)]
    2017-10-02 Y—xianghai

    学习了新知识

    0

  7. 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08:41:09 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249627, encodeId=63ee24962ea0, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Mon Oct 02 08:39:18 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249597, encodeId=985e24959e96, content=内容新颖.好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon Oct 02 07:42:30 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249585, encodeId=50e724958501, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Mon Oct 02 07:26:27 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249583, encodeId=80fd24958302, content=临床上有剧烈而较持久的胸骨后疼痛.发热.白细胞增多.红细胞沉降率加快.血清心肌酶活力增高及进行性心电图变化.可发生心律失常.休克或心力衰竭, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Mon Oct 02 07:26:19 CST 2017, time=2017-10-02, status=1, ipAttribution=)]
    2017-10-02 龙胆草

    学习谢谢分享

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1903776, encodeId=9ee51903e762b, content=<a href='/topic/show?id=be285836438' target=_blank style='color:#2F92EE;'>#新技术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58364, encryptionId=be285836438, topicName=新技术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d39f177, createdName=lixiao3326, createdTime=Thu May 24 02:12:00 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=251274, encodeId=3b662512e46d, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Sun 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createdBy=e8d51649330, createdName=飘飘爱, createdTime=Tue Oct 03 11:42:36 CST 2017, time=2017-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249833, encodeId=b1f9249833ff, content=谢谢.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4c106013, createdName=Drhzm308, createdTime=Tue Oct 03 03:38:56 CST 2017, time=2017-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249634, encodeId=29dd249634a2, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Mon Oct 02 08:41:09 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249627, encodeId=63ee24962ea0, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Mon Oct 02 08:39:18 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249597, encodeId=985e24959e96, content=内容新颖.好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon Oct 02 07:42:30 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249585, encodeId=50e724958501, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Mon Oct 02 07:26:27 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249583, encodeId=80fd24958302, content=临床上有剧烈而较持久的胸骨后疼痛.发热.白细胞增多.红细胞沉降率加快.血清心肌酶活力增高及进行性心电图变化.可发生心律失常.休克或心力衰竭, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Mon Oct 02 07:26:19 CST 2017, time=2017-10-02, status=1, ipAttribution=)]
    2017-10-02 忠诚向上

    内容新颖.好好看下

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1903776, encodeId=9ee51903e762b, content=<a href='/topic/show?id=be285836438' target=_blank style='color:#2F92EE;'>#新技术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58364, encryptionId=be285836438, topicName=新技术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d39f177, createdName=lixiao3326, createdTime=Thu May 24 02:12:00 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=251274, encodeId=3b662512e46d, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Sun 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08:41:09 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249627, encodeId=63ee24962ea0, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Mon Oct 02 08:39:18 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249597, encodeId=985e24959e96, content=内容新颖.好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon Oct 02 07:42:30 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249585, encodeId=50e724958501, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Mon Oct 02 07:26:27 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249583, encodeId=80fd24958302, content=临床上有剧烈而较持久的胸骨后疼痛.发热.白细胞增多.红细胞沉降率加快.血清心肌酶活力增高及进行性心电图变化.可发生心律失常.休克或心力衰竭, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Mon Oct 02 07:26:19 CST 2017, time=2017-10-02, status=1, ipAttribution=)]
    2017-10-02 榄枷檬

    谢谢分享

    0

  10. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249585, encodeId=50e724958501, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Mon Oct 02 07:26:27 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249583, encodeId=80fd24958302, content=临床上有剧烈而较持久的胸骨后疼痛.发热.白细胞增多.红细胞沉降率加快.血清心肌酶活力增高及进行性心电图变化.可发生心律失常.休克或心力衰竭, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Mon Oct 02 07:26:19 CST 2017, time=2017-10-02, status=1, ipAttribution=)]
    2017-10-02 榄枷檬

    临床上有剧烈而较持久的胸骨后疼痛.发热.白细胞增多.红细胞沉降率加快.血清心肌酶活力增高及进行性心电图变化.可发生心律失常.休克或心力衰竭

    0

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研究发现,过去10年间高风险血管手术后心肌梗死风险未发生实质性降低,与不良预后显著相关。围手术后期护理与心脏并发症降低的医疗负担仍十分沉重

或许,你只需要一次听诊……

人们常用侦探来形容医生,因为医生常常从细微处着手找到正确的诊断;前辈们经常教导我们,做医生要认真,因为一个小小的线索就能成为诊断和鉴别诊断的关键;我们也常常告诫自己,要从问病史、查体这些细节做起,避免误诊、漏诊,为患者提供最佳的医疗。

Heart:IL-6抑制剂不影响心肌梗死患者冠脉血流储备

2017年10月,发表在《Heart》上的一项由挪威科学家进行的双中心、双盲、随机、安慰剂对照试验,考察了白细胞介素-6(IL-6)抑制剂对心肌梗死患者冠状动脉微血管和血管内皮功能的影响。

Eur Radiol:基于T1 mapping图计算准确预测钆剂延迟强化的价值。

评估腺苷负荷心肌灌注磁共振成像(CMR)后T1mapping图增强后早期合成钆剂增强(ESGE)成像与传统延迟钆剂增强(LGE)成像在评价心肌梗死的价值,并将结果发表在Eur Radiol上。

JAHA:急性心梗伴房颤患者的支架类型选择

与BMS相比,符合抗凝指征的AF患者更有可能使用DES,即使是在中风和出血预测风险高的患者中。

NEJM:疑似心肌梗死患者的氧疗收益研究

研究认为,对于未出现血氧不足的疑似心肌梗死患者进行持续氧疗不会降低患者1年内的心梗复发风险