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微血管阻塞或无复流现象是急性心肌梗死行冠状动脉再灌注治疗中常见的并发症。这种现象是不良预后的征象,亦是导致不良左心室重构的原因。尽管微血管病变可以通过心电图、心肌声学造影、核素扫描及冠状动脉造影等检查,但远没有心脏磁共振有效、全面。微血管病变的评估已经成为了心肌梗死行再灌注治疗后效果评价及指导药物治疗的重要辅助手段。本文就微血管的病理生理,心脏磁共振用于该病变的诊断、临床意义及将来发展方向作一综述。
Microvascular occlusion or no-reflow phenomenon is a common complication of coronary reperfusion in patients with acute myocardial infarction. This phenomenon is a sign of poor prognosis and is responsible for poor left ventricular remodeling. Although microvascular lesions can be checked by electrocardiogram, myocardial contrast echocardiography, radionuclide scanning and coronary angiography, but far less effective and comprehensive cardiac MRI. Microvascular disease assessment has become a myocardial infarction after reperfusion effect evaluation and guidance of drug treatment is an important adjunct. In this paper, we reviewed the pathophysiology of microvascular and the clinical application of cardiac magnetic resonance imaging in the diagnosis of the disease, its clinical significance and future development.