贺毅,戴沁怡,安靖,李德彪.3.0TMR自动呼吸导航对比增强全心冠状动脉磁共振血管成像的临床应用[J].中国医学影像技术,2016,32(4):504~508
3.0TMR自动呼吸导航对比增强全心冠状动脉磁共振血管成像的临床应用
Clinical application of self-navigated whole heart contrast-enhanced coronary magnetic resonance angiography with 3.0T MR scanner
投稿时间:2015-08-10  修订日期:2016-03-08
DOI:10.13929/j.1003-3289.2016.04.006
中文关键词:  磁共振血管造影术  冠状血管  狭窄
英文关键词:Magnetic resonance angiography  Coronary vessels  Stenosis
基金项目:首都医科大学基础-临床科研合作基金(15JL58).
作者单位E-mail
贺毅 首都医科大学附属北京安贞医院医学影像科, 北京 100029  
戴沁怡 首都医科大学附属北京安贞医院医学影像科, 北京 100029 qy627@aliyun.com 
安靖 首都医科大学附属北京安贞医院医学影像科, 北京 100029  
李德彪 美国洛杉矶雪松西奈山医院生物医学影像研究中心, 加利福尼亚州 洛杉矶 90001  
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中文摘要:
      目的 评价3.0T MR自动呼吸导航全心冠状动脉磁共振血管成像(CMRA)诊断冠状动脉狭窄的临床应用价值.方法 对50例临床疑诊或确诊冠心病或心肌病的患者行自动呼吸导航对比增强CMRA,其中33例经冠状动脉造影(CAG)证实.评价CMRA图像质量,并与CAG相对照,评价CMRA诊断冠状动脉狭窄的效能.结果 1例CMRA图像质量较差,为1级;余49例CMRA图像质量均满足诊断要求,为2~4级.33例经CAG证实的患者共286段血管中,CRMA可显示238段(238/286,83.22%),未显示48段(48/286,16.78%).以患者数、血管支和血管段为单位,CMRA诊断冠状动脉狭窄的敏感度分别为80.95%(17/21)、79.31%(23/29)、84.62%(33/39),特异度分别为75.00%(9/12)、91.09%(92/101)、75.00%(33/44),阳性预测值(PPV)分别为85.00%(17/20)、71.88%(23/32)、75.00%(33/44),阴性预测值(NPV)分别为69.23%(9/13)、93.88%(92/98)、96.91%(188/194),准确率分别为78.79%(26/33)、88.46%(115/130)、92.86%(221/238).结论 3.0T MR自动呼吸导航对比增强全心CMRA有助于诊断冠状动脉狭窄.
英文摘要:
      Objective To evaluate the application value of self-navigated whole-heart coronary magnetic resonance angiography (CMRA) with 3.0T MR scanner for the diagnosis of coronary artery etenosis. Methods A total of 50 patients underwent self-navigated whole-heart CMRA. And 33 of them underwent coronary angiography (CAG). The image quality of CMRA was evaluated. And the diagnostic efficiency of CMRA for coronary artery etenosis was studied taking CAG result as gold standard. Results CMRA scans were performed successfully on all of 50 cases. There were 49 cases with preferable image quality (grades 2-4) and another 1 case with poor quality (grade 1). Among 286 coronary segments detected by CAG, 238 segments (238/286, 83.22%)were deceted and 48 segments (48/286, 16.78%) undetected by CMRA. With per-patient, per-vessel and per-segment basis for stenosis detection, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were 80.95% (17/21), 79.31% (23/29), 84.62% (33/39); 75.00% (9/12), 91.09% (92/101), 75.00% (33/44); 85.00% (17/20), 71.88% (23/32), 75.00% (33/44); 69.23% (9/13),93.88% (92/98), 96.91% (188/194); 78.79% (26/33), 88.46% (115/130), 92.86% (221/238); respectively. Conclusion Contrast-enhanced self-navigated whole-heart CMRA with 3.0T MR scanner is a promising method for the noninvasive detection of significant coronary stenosis.
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