3.0T MR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

作　　者：贺毅[1] 戴沁怡[1] 安靖[1] 李德彪 

机构地区：[1]首都医科大学附属北京安贞医院医学影像科,北京100029 [2]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

出　　处：《中国医学影像技术》2016年第4期504-508,共5页Chinese Journal of Medical Imaging Technology

基　　金：首都医科大学基础-临床科研合作基金(15JL58)

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。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 1case with poor quality（grade 1）.Among 286 coronary segments detected by CAG,238segments（238/286,83.22%）were deceted and 48segments（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.

关 键 词：磁共振血管造影术 冠状血管 狭窄 

分 类 号：R735[医药卫生—肿瘤] R445.2[医药卫生—临床医学]