Coronary Embolization and Myocardial Microinfarction: MR Imaging and Histopathologic CharacterizationReportar como inadecuado




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Magnetic resonance imaging MRI has been proven to reliably assess regional perfusion and left ventricular LV function of microembolized myocardium. The visibility of microinfarct on delayed enhancement MRI DE-MRI is limited and dependent on technical and biological issues. Furthermore, MRI underestimates total microinfarct size compared with microscopy. MRI studies revealed that the presence of microemboli in pre-existing acute infarct delays infarct healing and magnifies LV remodeling. Discrimination of acute from chronic microinfarct is based on presence of inflammatory cells, edema and scar tissue, respectively. These noninvasive findings highlight the importance of prognostic utility of MRI and warrant larger clinical studies or registries to evaluate the significance of presence of focal microinfarct. Serial microscopic studies revealed that intravascular microemboli migrate into the extravascular space and this migration process is a function of time. This phenomenon may limit the use of microemboli therapy in occluding hemorrhagic blood vessels or treating tumors. Despite current standard of care, existing methods and therapies do not prevent coronary embolization nor reverse their deleterious effects.

KEYWORDS

Percutaneous Coronary Revascularization, Coronary Microembolization, Myocardial Microinfarct, Magnetic Resonance Imaging, Microscopy

Cite this paper

Saeed, M. , W. Hetts, S. , Liang, A. and Wilson, M. 2016 Coronary Embolization and Myocardial Microinfarction: MR Imaging and Histopathologic Characterization. International Journal of Clinical Medicine, 7, 399-418. doi: 10.4236-ijcm.2016.76043.





Autor: Maythem Saeed*, Steven W. Hetts, Anqi Liang, Mark W. Wilson

Fuente: http://www.scirp.org/



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