快速心脏磁共振成像的临床应用可行性分析  

Clinical Feasibility Analysis of the Fast Cardiac Magnetic Resonance Imaging

作　　者：王可颜 张文博[1] 李舒曼[1] 靳雅楠[1] 金红瑞[1] 安靖 程敬亮[1] WANG Keyan;ZHANG Wenbo;LI Shuman(Department of MRI,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450000,P.R.China)

机构地区：[1]郑州大学第一附属医院磁共振科,450000 [2]西门子磁共振深圳公司,深圳518000

出　　处：《临床放射学杂志》2021年第8期1599-1605,共7页Journal of Clinical Radiology

摘　　要：目的探讨快速心脏磁共振成像(fCMR)的临床应用可行性。方法前瞻性纳入123例具有心脏病指征的患者,每例患者检查过程中先后接受标准心脏磁共振成像(sCMR)检查和fCMR检查两种成像方案,仅给予每例患者一次对比剂。sCMR主要包括屏气电影成像技术(BH-cine)和屏气延迟增强扫描技术(BH-LGE)。fCMR主要包括压缩感知电影成像(CS-cine)技术以及运动矫正相位敏感反转恢复延迟增强扫描技术(MOCO-LGE)。回顾性比较两种方法在成像时间、图像质量(IQ)评分、左心室心功能分析[包括射血分数(EF)、MyoMass、舒张末期容积(EDV)、收缩末期容积(ESV)、射血量(SV)]、左心室组织特征追踪(TT)及左心室心肌瘢痕检测中的一致性。IQ评分采用基于Likert评分标准进行评估。结果fCMR成像总时长(9.85±0.61)min显著小于sCMR(33.48±2.88)min(P<0.001)。对于所有入组患者而言,sCMR和fCMR的IQ无显著差异[4分(3~5分)vs.4分(3~5分),P=0.702]。但有12例患者在sCMR检查过程中因心功能欠佳而出现了屏气困难,对于这12例患者,sCMR的IQ显著低于fCMR[1分(1~2分)vs.4分(3~5分),P<0.001]。fCMR优质图像(IQ>3分)获取率显著大于sCMR(100%vs.90.2%,P<0.001)。当判断MOCO-LGE与BH-LGE图像LGE存在/不存在时,两位医师在MOCO-LGE图像对LGE的判断更为一致MOCO-LGE[Kappa:0.80(95%CI:0.70~0.92)],而BH-LGE[Kappa:0.75(95%CI:0.61~0.89)]。对于LGE分布模式的判断上,MOCO-LGE图像对LGE模式判断同样更为一致[Kappa:0.90(95%CI:0.82~0.97)],而BH-LGE[Kappa:0.85(95%CI:0.81~0.94)]。对于111例同时成功获得了两种扫描方案的优质图像患者而言,sCMR在EF、MyoMass、EDV、ESV、SV、TT定量分析及瘢痕检测方面与fCMR具有极高的一致性(R2:0.85~0.99)。结论当sCMR获得良好时,sCMR和fCMR在左心室功能、组织追踪和瘢痕检测方面相似,但sCMR的图像质量易受患者配合程度的影响。fCMR在采集时间、图像质量和检查成功率方面均优于sCMR。fCMObjective To investigate the clinical feasibility of fast cardiac magnetic resonance(fCMR)imaging.Methods 123 patients with suspicious heart disease were enrolled prospectively on a 3 T scanner(MAGNETOM Skyra).The fCMR protocols were performed during the time between the contrast administration and late gadolinium enhancement(LGE)scans in the sCMR protocols,the contrast agent was given only once during the examination.SCMR included breath-holding cine sequence(BH-cine)and late gadolinium enhancement(BH-LGE).fCMR included real-time compressed sensing(CS)cine and prototype motion-corrected(MOCO)LGE.Image quality(IQ)of both protocols was evaluated based on a five-point Likert scaling.Acquisition time,image quality(IQ),left ventricular function(including EF、MyoMass、EDV、ESV、SV),tissue tracking(TT)and scar presence were compared between the two protocols.Results The total time of fCMR examination was shorter than that of sCMR,with statistical difference[(9.85±0.61)min vs.(33.48±2.88)min,P<0.001].There was no significant difference in IQ between sCMR and fCMR[4(3-5)vs.4(3-5),P=0.702].However,12 patients had difficulty in breath holding due to poor cardiac function during sCMR examination.In these 12 patients,the IQ of sCMR was significantly lower than that of fCMR[1(1-2)vs.4(3-5),P<0.001].The percent of success(IQ>3)of fCMR was significantly higher than that of sCMR(100%vs.90.2%,P<0.001).When judging the presence/absence of LGE in MOCO-LGE and BH-LGE images,two doctors’judgment consistence of LGE in MOCO-LGE images was[Kappa:0.80(95%CI:0.70-0.92)],while BH-LGE was[Kappa:0.75(95%CI:0.61-0.89)].For the judgment of LGE distribution pattern,MOCO-LGE image was also more consistent with BH-LGE mode,MOCO-LGE[Kappa:0.90(95%CI:0.82-0.97)],while BH-LGE was[Kappa:0.85(95%CI:0.81-0.94)].The EF、Myomass、EDV、ESV、SV and TT measure correlated highly(R2:0.85-0.99)without bias between sCMR and fCMR for 111 patients who successfully obtained both sCMR and fCMR protocols without obvious artifacts.Conclusion Left ventricu

关 键 词：标准心脏磁共振成像 快速心脏磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]