Utilization of magnetic resonance imaging in the treatment of patients with acute myocardial infarction and intramyocardial hemorrhage.

Abstract

Background: We assessed the diagnostic efficacy of magnetic resonance imaging (MRI) in patients with acute myocardial infarction (AMI).

Methods: In this study, 116 patients with acute myocardial infarction (AMI) underwent direct PCI intervention, admitted to our hospital between January 2018 and January 2021 were selected. Based on the presence of intramyocardial hemorrhage (IMH), they were divided into the IMH group and the non-IMH group. There were 46 cases in the IMH group and 70 cases in the non-IMH group. All patients underwent cardiac magnetic resonance imaging (CMR) for detection. CMR was used to detect IMH and non-IMH infarction sites. Cardiac indicators of IMH and non-IMH were compared using CMR and echocardiography (ECHO). The diagnostic efficacy of MRI in patients with AMI who had myocardial hemorrhage was compared by generating receiver operating characteristic (ROC) curves.

Results: The incidence of infarction sites was significantly higher in the IMH group than in the non-IMH group (all P < 0.05); myocardial detection results revealed a significantly higher incidence of ventricular aneurysm and pericardial fluid inclusion in the IMH group than in the non-IMH group (all P < 0.05); CMR evaluation revealed that the infarction size/left ventricular (IS/LV) volume percentage, patients with microvascular obstruction (MVO), and MVO/LV volume percentage were significantly higher in the IMH group than in the non-IMH group (all P < 0.05); global circumferential strain (GCS), global radial strain (GRS), and global longitudinal strain (GLS) in the IMH group were significantly lower than those in the non-IMH group (all P < 0.05); was both groups underwent echocardiography after percutaneous coronary intervention (PCI). The results indicated a significant decrease in left ventricular ejection fraction (LVEF) and a significant increase in left ventricular end-diastolic dimension (LVEDd) and IS/LV volume percentage in the IMH group compared to the non-IMH group (all P < 0.05); the area under the ROC curve of MRI for patients with AMI who had intramyocardial hemorrhage was 0.869, with high specificity and sensitivity; the sensitivity was 87.00, and the specificity was 85.00.

Conclusion: MRI can detect myocardial hemorrhage in patients with AMI after PCI, which suggests significant clinical diagnostic value and is worthy of utilization in clinical practice.