MR新技术在冠状动脉微栓塞早期检测及其延迟强化演变机制的研究

项目名称： MR新技术在冠状动脉微栓塞早期检测及其延迟强化演变机制的研究

项目编号： No.81201070

项目类型： 青年科学基金项目

立项/批准年度： 2013

项目学科： 影像医学与生物医学工程

项目作者： 金航

作者单位： 复旦大学

项目金额： 23万元

中文摘要： 冠脉微栓塞是急性冠脉综合征和冠心病介入术中常见而重要的临床事件，危害较大，但诊断冠心病的"金标准"冠脉造影术无法显示微小动脉病变，因此，冠脉微栓塞成为当前研究的热点。我们前期MR研究发现：微栓塞后6小时受累心肌可出现延迟强化，1周后其范围显著缩小甚至消失，伴随左室重构，其延迟强化及其消失的演变过程是何机理？目前尚未完全明了，仅用微梗死灶难以解释急性期较大范围延迟强化，我们推测炎症反应也起重要作用，然而延迟增强扫描（梯度回波T1WI）难以显示微栓塞所致心肌水肿。因此，本研究拟建立微栓塞动物（猪）模型，利用MR-BLADE刀锋序列能清楚显示心肌水肿的特点，结合MR心功能评价、血液及心肌相关标志物的检测，并进行抗炎及改善微循环的干预研究，为探讨微栓塞MR延迟强化的病理生理意义及机制提供科学依据，并有望为更早期显示微栓塞病变和评价药物的疗效开辟新的途径以及提供基础的研究资料。

中文关键词： 磁共振成像；刀锋技术；延迟强化；冠状动脉微栓塞；

英文摘要： Coronary microembolization (CME) is a frequent complication following acute coronary syndromes and percutaneous coronary interventions. Accurate detection of CME is important, because previous studies have shown that CME is independently associated with adverse ventricular remodeling and patient prognosis. It's difficult to detect CME through X-ray coronary angiography - the reference standard for the diagnosis of coronary artery disease and CME becomes a focus of research. Our previous study has shown that hyperenhancement was detectable at 6 hours after coronary microembolization in animal experiments using late gadolinium-enhanced cardiovascular MRI and the hyperenhanced areas were largely decreased or even disappeared and the left ventricular volume was enlarged indicating ventricular remodeling at 1 week. Based on previous study, we believe that further study need to be performed on the following issues: the early characterization of coronary microembolization and the mechanism of delayed enhancement phenomenon of CME. The latter may be attributed to the microinfarction and inflammatory response to CME. However, the sequence of late gadolinium-enhanced MRI belongs to gradient echo T1-weighted imaging and is difficult to show the myocardial edema secondary to microinfarction and inflammation due to CME dire

英文关键词： Magnetic Resonance Imaging；BLADE；Delayed Enhancement；Coronary microembolization；