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定量心肌血流和 perfusion 储备与运动心血管磁共振

Alexander Schulz¹, Tess E Wallace², Kelvin Chow³

¹Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.

Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance

|November 15, 2025

概括

定量运动压力心血管磁共振 (Ex-CMR) 是可行的评估心肌血流 (MBF) 和心肌 perfusion 储备 (MPR). 这项试点研究发现,高性心肌病 (HCM) 患者的输液模式与心力衰竭与保存喷射小部分 (HFpEF) 和非心脏呼吸障碍 (NCD) 组相比不同.

科学领域:

心血管成像 - 心血管成像
心脏生理学心脏生理学
磁共振成像是一种磁共振成像技术.

背景情况:

心肌血流 (MBF) 和心肌 perfusion 储备 (MPR) 是关键的心脏功能参数.
血管扩张应激心血管磁共振 (CMR) 量化了MBF和MPR,而运动应激CMR (Ex-CMR) 提供了更生理的评估.
量化Ex-CMR输液成像的可行性以前没有被证明.

研究的目的:

评估量化Ex-CMR输液成像的可行性.
通过使用定量Ex-CMR来表征运动诱导的输液反应.
进行一项试点研究,比较MBF和MPR在患有多变性心肌病 (HCM),心力衰竭与保留射出分数 (HFpEF) 和非心脏性呼吸障碍 (NCD) 的患者中.

主要方法:

一项前性研究,涉及患有HCM,HFpEF或NCD的患者,他们在3T接受Ex-CMR.
在扫描仪外进行运动,随后进行压力和休息输液成像.
一个双序列协议与内联像素智能定量化被用来计算MBF和MPR.

主要成果:

量化Ex-CMR在90%的病例中是成功的,常见的质量问题包括门/心律失常和切片 misalignment.
最终的队列包括89名患者 (34名HCM,34名HFpEF,21名NCD).
与HFpEF和NCD组相比,患有HCM的患者表现出明显较低的MBF和MPR (p <0.05). 运动心率峰值是MBF和MPR最强的预测因素.

结论:

在图像质量控制后,大多数患者可以对MBF和MPR进行定量Ex-CMR评估.
虽然MBF的增加在低至中等强度的运动时是有限的,但Ex-CMR在研究的队列中显示出明显的 perfusion 反应模式.
这种技术显示出基于 perfusion 特性区分心脏病的潜力.

关键词:

进行CMR练习.心力衰竭与保存的喷射分数的心脏衰竭过度缩性心肌病变性是一种心脏病变.心肌动脉的血液流动定量性心肌 perfusion 的使用方法.

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