中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2011年
4期
329-333
,共5页
曹桢斌%孔祥泉%常丹丹%刘定西
曹楨斌%孔祥泉%常丹丹%劉定西
조정빈%공상천%상단단%류정서
冠状动脉疾病%冠状血管造影术%磁共振血管造影术
冠狀動脈疾病%冠狀血管造影術%磁共振血管造影術
관상동맥질병%관상혈관조영술%자공진혈관조영술
Coronary disease%Coronary arteriography%Magnetic resonance angiography
目的 探讨自由呼吸导航门控3 T磁共振增强全心冠状动脉三维成像技术临床应用可行性及其价值.方法应用自由呼吸导航3 T磁共振增强全心冠状动脉三维成像方法对临床疑似冠心病患者行全心冠状动脉成像,增强采用钆贝葡胺注射液(0.2 mmol/kg)静脉缓慢注射,流率0.3ml/s.数据经后处理获得冠状动脉主要分支图像,评价图像质量,并以选择性冠状动脉造影检查结果为参照标准,采用9段划分法评价冠状动脉主要分支的有意义狭窄(＞50%),判断磁共振增强冠状动脉成像对冠心病的诊断准确性及其价值.结果26例病例中23例顺利完成磁共振检查,平均扫描时间为(10.4±2.1)min.选择性冠状动脉造影显示的202个节段中,磁共振增强冠状动脉成像显示可评价节段178个(88.1%),以近、中段图像质量较好.与选择性冠状动脉造影比较,磁共振增强冠状动脉成像在显示近段及中段可评价节段上差异无统计学意义(P＞0.05).磁共振冠状动脉成像显示阳性9例,阴性14例.选择性冠状动脉造影显示11例阳性,12例阴性.磁共振冠状动脉成像有意义的狭窄总体诊断符合率91.3%(21/23),灵敏度81.8%(9/11),特异度88.5%(169/191),阴性预测值98.8%(9/31).结论自由呼吸导航门控3 T磁共振增强全心冠状动脉三维成像技术能够对冠状动脉近中段有意义的狭窄进行初步评估,一致性较好.但对冠状动脉远段及小分支狭窄的评估有一定限度.
目的 探討自由呼吸導航門控3 T磁共振增彊全心冠狀動脈三維成像技術臨床應用可行性及其價值.方法應用自由呼吸導航3 T磁共振增彊全心冠狀動脈三維成像方法對臨床疑似冠心病患者行全心冠狀動脈成像,增彊採用釓貝葡胺註射液(0.2 mmol/kg)靜脈緩慢註射,流率0.3ml/s.數據經後處理穫得冠狀動脈主要分支圖像,評價圖像質量,併以選擇性冠狀動脈造影檢查結果為參照標準,採用9段劃分法評價冠狀動脈主要分支的有意義狹窄(＞50%),判斷磁共振增彊冠狀動脈成像對冠心病的診斷準確性及其價值.結果26例病例中23例順利完成磁共振檢查,平均掃描時間為(10.4±2.1)min.選擇性冠狀動脈造影顯示的202箇節段中,磁共振增彊冠狀動脈成像顯示可評價節段178箇(88.1%),以近、中段圖像質量較好.與選擇性冠狀動脈造影比較,磁共振增彊冠狀動脈成像在顯示近段及中段可評價節段上差異無統計學意義(P＞0.05).磁共振冠狀動脈成像顯示暘性9例,陰性14例.選擇性冠狀動脈造影顯示11例暘性,12例陰性.磁共振冠狀動脈成像有意義的狹窄總體診斷符閤率91.3%(21/23),靈敏度81.8%(9/11),特異度88.5%(169/191),陰性預測值98.8%(9/31).結論自由呼吸導航門控3 T磁共振增彊全心冠狀動脈三維成像技術能夠對冠狀動脈近中段有意義的狹窄進行初步評估,一緻性較好.但對冠狀動脈遠段及小分支狹窄的評估有一定限度.
목적 탐토자유호흡도항문공3 T자공진증강전심관상동맥삼유성상기술림상응용가행성급기개치.방법응용자유호흡도항3 T자공진증강전심관상동맥삼유성상방법대림상의사관심병환자행전심관상동맥성상,증강채용구패포알주사액(0.2 mmol/kg)정맥완만주사,류솔0.3ml/s.수거경후처리획득관상동맥주요분지도상,평개도상질량,병이선택성관상동맥조영검사결과위삼조표준,채용9단화분법평개관상동맥주요분지적유의의협착(＞50%),판단자공진증강관상동맥성상대관심병적진단준학성급기개치.결과26례병례중23례순리완성자공진검사,평균소묘시간위(10.4±2.1)min.선택성관상동맥조영현시적202개절단중,자공진증강관상동맥성상현시가평개절단178개(88.1%),이근、중단도상질량교호.여선택성관상동맥조영비교,자공진증강관상동맥성상재현시근단급중단가평개절단상차이무통계학의의(P＞0.05).자공진관상동맥성상현시양성9례,음성14례.선택성관상동맥조영현시11례양성,12례음성.자공진관상동맥성상유의의적협착총체진단부합솔91.3%(21/23),령민도81.8%(9/11),특이도88.5%(169/191),음성예측치98.8%(9/31).결론자유호흡도항문공3 T자공진증강전심관상동맥삼유성상기술능구대관상동맥근중단유의의적협착진행초보평고,일치성교호.단대관상동맥원단급소분지협착적평고유일정한도.
Objective To investigate the clinical application, feasibility and value of 3 T wholeheart contrast enhanced free-breathing navigator-gated three-dimensional coronary magnetic resonance angiography (CE-CMRA). Methods 3 T CE-CMRA was used to examine patients with suspected coronary heart disease (CAD). Gd-BOPTA(0. 2 mmol/kg) was injected intravenously with slow infusion rate(0. 3ml/s) to perform enhancement. Data were post-processed to obtain principal branches of coronary artery and picture quality was evaluated. According to results of selective coronary arteriography ( SCAG ), the diagnostic accuracy of CE-CMRA for diagnosing CAD was judged by means of detecting significant stenosis ( ＞50% ) of the principal branches based on the 9 segments of coronary artery. Results Twenty-three out of 26 patients successfully completed the examination. The mean scanning time was ( 10. 4 ± 2. 1 ) minutes,178 out of 202 (88. 1% ) SCAG demonstrated segments could be evaluated by CE-CMRA. The imaging quality was superior in proximal and middle segments of coronary artery principal branches than in distal segments. Based on patient-level, there were 9 positive cases and 14 negative cases examined by CE-CMRA compared with 11 positive cases and 12 negative cases examined by SCAG, respectively. The whole diagnose accordance rate of CE-CMRA was 91.3% (21/23)compared with SCAG. The sensitivity, specificity and negative predictive values were 81.8% (9/11), 88.5% (169/191) and 98.8% (9/31)respectively. Conclusions 3 T CE-CMRA is a feasible non-invasive imaging modality for diagnosing CAD,especially to detect significant stenosis in proximal and middle segments of coronary artery principal branches. However, the detecting efficacy is limited in assessing stenosis of distal segment and small branches of coronary artery.
