Đánh giá tổn thương cơ tim trên cộng hưởng từ ở bệnh nhân nhồi máu cơ tim cấp

Evaluation of myocardium injury on cardiac magnetic resonance imaging in patients with acute myocardial infarction

SUMMARY

Objective: To access the imaging characteristic of the myocardium injury on cardiacmagnetic resonance imaging (MRI) in reperfused acutemyocardial infarction (MI) after percutanous coronary revascularization.

Materialand Methods: Cine sequence and Delayed Contrast- Enhanced MRIwere underwent in period of 9 days after percutanous coronary revascularization on 50 patients suffering from Acute Myocardial Infarction at Bach Mai Hospital. Left ventricular function was done on cine sequence and extent of infarction, infarct size was evaluated on delayed-enhancement images.

Results: A total of 50 patients with acute MI were classified 90% as STEMI and 10% as NSTEMI. The sensitivity of delay-enhancement MRI for detecting MI reaching 98%. The accuracy of MRI for identifying MI location (compared with infarct-related artery perfusion territory) were 92%, kappa=0,842 with all the patients and were 97,8%, kappa=0,952 with STEMI. The infarcted areas in 49 patients were detected by use of cardiac delayedenhancement MRI. There was an excellent correlation between quantitative planimetry and scoring method for the hyperenhancement infarct size (r=0,976, p<0,0001). Infarct size on delayed-enhancement MRI showed a good correlation with left ventricular ejection fraction (r=-0,63,p<0,0001 with planimetry method; r=-0,602, p<0,0001 with scoring method).

Conclusion: Cardiac MRI could evaluation of myocardium injury in patients with reperfused acute myocardial infarction.

Key words: Cardiac Magnetic Resonace Imaging, delayed enhancement MRI, late gadolinium, Acute myocardial infarction, infarct size.