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心脏磁共振在房颤患者左心房/左心耳血栓检测中的应用进展

何钗 杨英

何钗, 杨英. 心脏磁共振在房颤患者左心房/左心耳血栓检测中的应用进展[J]. 分子影像学杂志, 2019, 42(1): 27-30. doi: 10.12122/j.issn.1674-4500.2019.01.07
引用本文: 何钗, 杨英. 心脏磁共振在房颤患者左心房/左心耳血栓检测中的应用进展[J]. 分子影像学杂志, 2019, 42(1): 27-30. doi: 10.12122/j.issn.1674-4500.2019.01.07
Chai HE, Ying YANG. Application and progress of cardiac magnetic resonance imaging in the detection of left atrial/left atrial appendage thrombosis in patients with atrial fibrillation[J]. Journal of Molecular Imaging, 2019, 42(1): 27-30. doi: 10.12122/j.issn.1674-4500.2019.01.07
Citation: Chai HE, Ying YANG. Application and progress of cardiac magnetic resonance imaging in the detection of left atrial/left atrial appendage thrombosis in patients with atrial fibrillation[J]. Journal of Molecular Imaging, 2019, 42(1): 27-30. doi: 10.12122/j.issn.1674-4500.2019.01.07

心脏磁共振在房颤患者左心房/左心耳血栓检测中的应用进展

doi: 10.12122/j.issn.1674-4500.2019.01.07
详细信息
    作者简介:

    何钗:何 钗,医师,E-mail: 226879299@qq.com

    通讯作者:

    杨 英,医师,E-mail: 1959382844@qq.com

Application and progress of cardiac magnetic resonance imaging in the detection of left atrial/left atrial appendage thrombosis in patients with atrial fibrillation

  • 摘要: 左心房/左心耳血栓是心房颤动最严重的并发症,不但影响心脏输出功能,而且栓子脱落后随血液循环至全身各处可致重要动脉栓塞,尤其是脑动脉栓塞可致急性脑卒中。心脏磁共振成像作为一种新的非侵入性检查已受业界广泛关注,能动态观察心房、心耳运动功能及血流动力学情况,且有较高的左心房/左心耳血栓检出率,有望替代经食道超声在诊断左心房/左心耳血栓在临床中的应用。

     

  • 表  1  CMR与其它检查技术的比较

    比较项目 TEE 多层螺旋CT CMR
    适应症 急诊手术麻醉需要排除心脏和大血管的并发症;心律失常;肺动脉高压;肺栓塞;心脏瓣膜性疾病;感染性心内膜炎;心肌病;血流动力学指标;围术期监测等 血管性疾病及血管造影;心肌灌注成像;心脏瓣膜性疾病;先天性心脏病;肺栓塞;心肌病;心脏占位;心脏容积测量;心功能评价等 先天性心脏病;心肌病;心力衰竭及心功能评价;血管性疾病;心脏瓣膜性疾病;心脏占位;心包病变;心脏电影;心肌灌注成像;心肌活性成像等
    禁忌症 先天性或获得性上消化道疾病;凝血功能障碍;咽部占位;纵隔放疗史;颈椎疾病严重心血管疾病;麻醉剂过敏等 造影剂过敏;严重肝、肾功能不全;重症甲状腺疾患(甲亢)等 抗磁性金属植入者;对比剂过敏;早期妊娠(3月内)等
    操作前准备 相关查血准备;禁食4~6 h,口咽部麻醉等 相关查血准备;心率准备(建议低于70次/min);注射造影剂(必要时)等 去除身体上金属、磁性以及电子物件,注射对比剂(必要时)等
    是否需要术中监测
    并发症 咽部黏膜出血;食管损伤;心律失常;一过性血压异常;感染;麻醉剂过敏;下颌关节脱位等 造影剂过敏,肾功能损伤等 射频场(RF)的致热效应;对比剂过敏或致肾源性系统性纤维化(罕见)
    优点 更接近左心房,能清楚观察左房结构;快速等 无创;时间、空间分辨率高;可重复性强;方便快捷等 无创;无放射性;时间、空间分辨率更高;成像速度快;可重复性;组织对比度高;3D成像等
    不足 半有创侵入式检查,时间短,不能充分观察,有一定误诊率,对检查医师依赖性强等 运动伪影、射线硬化伪影;辐射剂量大;造影剂过敏;对于较多钙化斑块和支架内管腔的观察受限;评估管腔内血流动力学状况受限等 价格高;检测时间长;噪声大;MR扫描室内金属物体飞射;体内金属植入患者禁行此项检查等
    下载: 导出CSV
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  • 收稿日期:  2018-10-11
  • 刊出日期:  2019-01-01

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