3.0T磁共振全心冠状动脉成像对冠心病的诊断价值  

The diagnostic value of 3.0T whole heart coronary magnetic resonance imaging for coronary artery disease

作　　者：张丽君[1] 窦瑞雨[1] 赵轶轲[1] 刘一[1] 徐磊[1] ZHANG Lijun;DOU Ruiyu;ZHAO Yike;LIU Yi;XU Lei(Radiology Department, Beijing Anzhen Hospital, Capital Medical University,Beijing 100029, P.R.China)

机构地区：[1]首都医科大学附属北京安贞医院放射科,北京100029

出　　处：《医学影像学杂志》2021年第5期758-761,共4页Journal of Medical Imaging

基　　金：国家重点研发计划课题项目(编号:2016YFC1300301);国家自然科学基金资助项目(编号:U1908211)。

摘　　要：目的探讨3.0T磁共振对比剂增强的全心冠状动脉成像在冠心病诊断中的价值。方法对51例冠心病患者行心脏磁共振检查,包括自由呼吸门控下的全心增强冠状动脉成像、静息心肌灌注和心肌延迟强化成像。结果本组51例患者中46例成功完成了全心增强冠状动脉成像。在以患者为基础的分析中,全心磁共振血管造影(MRCA)诊断冠状动脉显著狭窄的敏感性为97.1%,特异性为91.7%,准确性为95.7%,阳性预测值94.3%,阴性预测值91.7%。基于患者为基础的ROC分析中显示,MRCA诊断冠心病的曲线下面积为0.94。结论3.0T磁共振自由呼吸门控下的增强全心冠状动脉成像是筛查冠状动脉显著狭窄的有效手段,其在冠心病的诊断中具有较高的准确度。Objective The purpose of the work was to evaluate the diagnostic value of 3.0T free-breathing 3D contrast-enhanced whole-heart magnetic resonance coronary angiography(CE-MRCA)for detecting coronary artery disease(CAD).Methods Fifty-one patients with suspected CAD underwent a comprehensive cardiac magnetic resonance(CMR)examination(MRCA,MPI,and LGE).The diagnostic value of MRCA was evaluated using invasive x-ray coronary angiography(XA)as the standard for defining functionally significant CAD(≥50%stenosis in vessels>2 mm in diameter).Results 90.2%(46/51)patients(54.0±11.5 years;71.7%men)completed MRCA successfully.In patient-based analysis,the accuracy,sensitivity,specificity,positive and negative predictive values were 95.7%,97.1%,91.7%,94.3%,and 91.7%,for CE-MRCA.The AUC for MRCA was 0.94(95%CI,0.85-1.0)in patient-based analysis.Conclusion For patients with suspected coronary artery disease,3.0T free-breathing 3D contrast enhanced whole-heart MRCA is the optimal method of anatomically screening for significant coronary stenosis.

关 键 词：心脏 冠心病 磁共振成像 

分 类 号：R541[医药卫生—心血管疾病] R445.2[医药卫生—内科学]