CAJ | 학술논문

目的探讨采用单次激发相位反转恢复稳态快速成像序列对心律失常患者行心肌延迟强化成像的可行性及其临床应用价值.方法前瞻性收集心电图确诊为心律失常,且行MR扫描时有心律失常的56例患者纳入研究.患者均行MR单次激发相位反转恢复稳态快速成像序列(序列1)与常规节段磁化相位敏感反转恢复快速小角度激发序列(序列2)心肌延迟强化成像.由2名高年资放射科医师采用盲法对图像质量进行独立评价(分为4级).对2种序列图像质量的比较采用等级资料x2检验和Fisher精确概率法进行比较,对2名医师评价同一序列图像质量的一致性采用加权Kappa检验.结果 56例患者均完成了2种序列的心肌延迟强化成像检查.序列1图像质量均达3级及以上,满足临床诊断要求,19例检出心肌延迟强化.序列2图像均出现了不同程度的伪影,尤其是对于有严重心律不齐、屏气配合困难的患者图像质量不佳影响临床诊断.医师1对序列1图像进行评价,4级50例、3级6例,序列2图像2级15例、1级41例;医师2对序列1图像进行评价,4级48例、3级8例,序列2图像2级13例、1级43例.2名医师序列1的图像质量均高于序列2,差异均有统计学意义(x2分别为141.329和141.177,P均＜0.01).2名医师评价序列1和序列2的图像质量一致性结果均为优(Kappa值分别为0.837和0.905,P均＜0.01).结论采用序列1对心律失常患者进行心肌延迟强化成像,图像质量较好,有较大的应用价值.
목적 탐토채용단차격발상위반전회복은태쾌속성상서렬대심률실상환자행심기연지강화성상적가행성급기림상응용개치.방법 전첨성수집심전도학진위심률실상,차행MR소묘시유심률실상적56례환자납입연구.환자균행MR단차격발상위반전회복은태쾌속성상서렬(서렬1)여상규절단자화상위민감반전회복쾌속소각도격발서렬(서렬2)심기연지강화성상.유2명고년자방사과의사채용맹법대도상질량진행독립평개(분위4급).대2충서렬도상질량적비교채용등급자료x2검험화Fisher정학개솔법진행비교,대2명의사평개동일서렬도상질량적일치성채용가권Kappa검험.결과 56례환자균완성료2충서렬적심기연지강화성상검사.서렬1도상질량균체3급급이상,만족림상진단요구,19례검출심기연지강화.서렬2도상균출현료불동정도적위영,우기시대우유엄중심률불제、병기배합곤난적환자도상질량불가영향림상진단.의사1대서렬1도상진행평개,4급50례、3급6례,서렬2도상2급15례、1급41례;의사2대서렬1도상진행평개,4급48례、3급8례,서렬2도상2급13례、1급43례.2명의사서렬1적도상질량균고우서렬2,차이균유통계학의의(x2분별위141.329화141.177,P균＜0.01).2명의사평개서렬1화서렬2적도상질량일치성결과균위우(Kappa치분별위0.837화0.905,P균＜0.01).결론 채용서렬1대심률실상환자진행심기연지강화성상,도상질량교호,유교대적응용개치.
Objective To evaluate the feasibility and its clinical application of 3.0 T MRI in the assessment of the late gadolinium enhancement in patients with cardiac arrhythmias with phase-sensitive inversion recovery (PSIR) single-shot true fast imaging with steady-state precession (True FISP) sequence.Methods Fifty-six patients with arrhythmia confirmed by electrocardiogram underwent MRI in this prospective study.Late gadolinium enhancement were performed with both PSIR single-shot True FISP (sequence 1) and conventional segmented PSIR Turbo FLASH sequences (sequence 2).The overall image quality (4 scales) was assessed and recorded independently by two experienced radiologists.Statistical analysis was performed with Chi-square test and weighted Kappa test.Results Late gadolinium enhancement of all the 56 patients were successfully examined with the sequence 1 and 2.All the image qualities of sequence 1 reached 3 scales or more and met the requirements of clinical diagnosis,and late gadolinium enhancement lesions were detection in 19 patients.All the sequence 2 images were improperly used for clinical diagnosis of the different degrees of artifacts,especially in patients with severe arrhythmia and those who breath-hold with difficulty.Sequence 1 images were classified as scale 4 in 50 cases and scale 3 in 6 cases by Doctor 1,while scale 4 in 48 cases and scale 3 in 8 cases by Doctor 2,respectively.However,sequence 2 images were classified as scale 2 in 15 cases and scale 1 in 41 cases by Doctor 1,as well as scale 2 in 13 cases and scale 1 in 43 cases by Doctor 2,respectively.Sequence 1 image qualities were significantly higher than those of the segmented sequence 2 (x2 values were 141.329 and 141.177,P＜0.01).Excellent agreements between two observers of the 2 sequences (Kappa values were 0.837 and 0.905,P＜ 0.01) were found.Conclusion PSIR single-shot True FISP sequence provides higher reliability for image quality of late gadolinium enhancement in patients with cardiac arrhythmia,which may be useful for clinical application.