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目的:探讨超声和MR评价冬眠心肌及其存活性的价值。材料和方法:通过Ameroid环套扎猪冠脉的左回旋支完成6个冬眠心肌模型,分别于术前、术后2、5周进行超声和MR检查。结果:超声显示左室侧后壁运动异常区,在5、10μg/(kg.min)多巴酚丁胺刺激下,室壁运动改善,在20μg/(kg.min)多巴酚丁胺刺激下,有2头猪室壁运动恶化。MR显示2头猪有心内膜下梗死,与病理结果一致,判断的坏死心肌范围术后5周较2周时缩小;有1头猪病理显示缺血而MR灌注成像未见缺血节段。结论:多巴酚丁胺负荷超声及MR灌注成像可以识别冬眠心肌,MRI延迟显像高信号可能高估坏死心肌。
Objective: To investigate the value of ultrasound and MR in evaluating hibernating myocardium and its survival. MATERIALS AND METHODS: Six hibernating myocardium models were made by ligating the left circumflex artery of the porcine coronary artery with a loop of Ameroid. Ultrasound and MR imaging were performed at preoperative and postoperative weeks, respectively. Results: The left ventricular posterior wall motion anomalies were detected by ultrasound. After 5, 10μg / (kg · min) dobutamine stimulation, the wall motion was improved. After dobutamine stimulation at 20μg / (kg · min) Under, there are 2 pigs wall motion deterioration. MR showed that 2 pigs had subendocardial infarction, which was consistent with the pathological findings. The extent of necrotic myocardium in the 2 pigs was reduced 5 weeks after surgery compared with 2 weeks after surgery. One pig showed ischemia but no ischemic segment in MR perfusion imaging. Conclusions: Dobutamine stress ultrasound and MR perfusion imaging can identify hibernating myocardium. MRI delayed imaging with high signal intensity may overestimate necrotic myocardium.