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目的探讨心脏核磁共振(CMR)在临床诊疗过程中的应用现状。方法连续纳入344例符合CMR检查指征的患者,收集患者CMR图像及诊断描述,并利用CMR图像对心脏结构、功能指标及钆延迟强化(LGE)等指标进行测量及分析。结果本组资料中,因心力衰竭和心肌病进行CMR检查的患者最多,共有164例,占患者总数的47.7%,其次是冠状动脉疾病(79例,23.0%)和室性心律失常(65例,18.9%)。进一步对图像质量清晰的319例(92.7%)患者的心肌结构及功能进行定量分析,发现208例(65.2%)患者存在左心室扩大,46例(14.4%)患者存在右心室扩大。并且197例(57.3%)患者通过CMR检查证实了最初诊断,73例(21.2%)患者通过CMR检查修正了最初诊断,另外仍有74例(21.5%)患者不能仅依靠CMR检查明确诊断。结论患者进行CMR检查的适应征为评估患者的心脏结构和功能。该检查还可辅助鉴别其他影像学检查未能识别的心脏异常表现,从而为患者明确诊断、制定治疗方案以及判断预后提供更多有价值的信息。
Objective To investigate the clinical application of cardiac magnetic resonance imaging (CMR) in the clinical diagnosis and treatment. Methods A total of 344 consecutive patients undergoing CMR examination were enrolled in this study. CMR images and their diagnostic descriptions were collected. CMR images were used to measure and analyze cardiac structure, function, and gadolinium delay enhancement (LGE). Results In this study, 164 patients (47.7%) had CMR due to heart failure and cardiomyopathy, followed by coronary artery disease (79 cases, 23.0%) and ventricular arrhythmias (65 cases, 18.9%). Quantitative analysis of myocardial structure and function in 319 patients (92.7%) with clear image quality revealed that left ventricular enlargement was found in 208 (65.2%) patients and right ventricular enlargement in 46 patients (14.4%). And initial diagnosis was confirmed by CMR in 197 patients (57.3%). Initial diagnosis was corrected by CMR in 73 patients (21.2%). Another 74 patients (21.5%) could not be diagnosed by CMR alone. Conclusions The patient is eligible for CMR to assess the patient’s cardiac structure and function. This test can also help identify abnormal cardiac manifestations that other imaging studies have failed to identify, providing more valuable information for the patient to make a definitive diagnosis, formulate a treatment plan and determine the prognosis.