| 梁红琴,王健,朱立强,金立新,Renate Jerecic.3.0T MR全心对比增强冠状动脉成像检测冠心病的可行性[J].中国医学影像技术,2011,27(9):1813~1816 |
| 3.0T MR全心对比增强冠状动脉成像检测冠心病的可行性 |
| Feasibility of 3.0T contrast enhanced coronary magnetic resonance angiography on detecting coronary heart disease |
| 投稿时间：2011-01-26 修订日期：2011-05-18 |
| DOI： |
| 中文关键词: 冠状动脉血管造影术 磁共振成像 冠状血管 |
| 英文关键词:Coronary angiography Magnetic resonance imaging Coronary vessels |
| 基金项目: |
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| 中文摘要: |
| 目的 比较3.0T磁共振全心对比增强冠状动脉成像(CE-CMRA)与传统冠状动脉造影(CAG)对可疑冠心病(CAD)检出的能力,探讨临床应用3.0T CE-CMRA的可行性。 方法 对30例可疑CAD患者在1周内先后行CAG和CE-CMRA检查。CE-CMRA检查应用心电门控、呼吸门控、反转回复序列、分段梯度回波序列,以0.3 ml/s速率注入钆贝酸二葡甲胺(0.2 ml/kg)和15 ml生理盐水,延迟60 s开始采集数据。以传统CAG为金标准,计算CE-CMRA的诊断敏感度、特异度和准确率。应用Kappa一致性检验评价两种检查方法的一致性。 结果 成功完成26例CE-CMRA检查, CE-CMRA诊断CAD患者、段落、各支血管的准确率分别为84.62%(22/26)、78.30%(285/364)、87.50%(56/64),阳性预测值分别为81.82%(9/11)、81.05%(124/153)、91.67%(22/24),阴性预测值分别为89.47%(17/19)、80.62%(208/258)、90.32%(56/62)。CE-CMRA对右冠状动脉的显示率为86.15%(112/130);左主干100%(26/26);前降支98.46%(128/130);回旋支83.33%(65/78)。26例CE-CMRA中,17例图像为Ⅳ级,8例为Ⅲ级图像,1例为Ⅱ级图像,无0级和Ⅰ级图像。 结论 3.0T CE-CMRA的图像质量符合诊断要求,可作为检出CAD的一种方法。 |
| 英文摘要: |
| Objective To compare the detective ability of 3.0T whole heart contrast enhanced coronary magnetic resonance angiography (CE-CMRA) and conventional coronary angiography (CAG) for coronary artery diseases (CAD), and to explore the clinical application feasibility of 3.0T CE-CMRA. Methods CE-CMRA and CAG were performed within one week in 30 patients with suspected CAD. Successful CE-CMRA was obtained in 26 patients, ECG-gated, respiratory gating, inversion recovery sequences and segmented gradient echo sequence techniques were used. MultiHance (0.2 ml/kg) and 15 ml saline were injected in sequence with speed of 0.3 ml/s. After 60 s' delay, the images were collected. The diagnostic sensitivity, specificity and accuracy of CE-CMRA in detecting stenosis were evaluated using X-ray angiography as the reference. Kappa consistency test was used to evaluate the consistency of two methods. Results The accuracy of CE-CMRA for the patients, segments and blood vessels was 84.62% (22/26), 78.30% (285/364) and 87.50% (56/64), respectively; while the positive predictive value was 81.82% (9/11), 81.05% (124/153) and 91.67% (22/24), respectively, the negative predictive value was 89.47% (17/19), 80.62% (208/258) and 90.32% (56/62), respectively. CE-CMRA could display 86.15% (112/130) of the right coronary artery, 100% of the left main artery (26/26), 98.46% (128/130) of the anterior descending artery and 83.33% (65/78) of the circumflex artery. Ⅳ quality grading images were obtained in 17 patients, while Ⅲ in 8 and Ⅱ in 1 patient. Conclusion 3.0T CE-CMRA can provide qualified images, and can be used as a method for detecting CAD. |
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