MR心肌灌注成像与DSA冠状动脉造影结果的对比分析

Comparison of image results between MR myocardial perfusion imaging and DSA coronary arteriography

目的 :研究 MR心肌灌注成像与 DSA冠状动脉造影检查结果的一致性。方法 :将 5 1例临床诊断为冠心病患者同期进行 MR心肌灌注成像和 DSA冠脉造影 ;应用 GE AW4 .0工作站 (DCEMI)心肌灌注图像分析软件 ,对左心室短轴心肌灌注首过时相图像进行分析 ,得到心肌灌注时间 -信号强度曲线 ,观察曲线的上升斜率和信号强度的峰值。根据左心室短轴位与冠状动脉血管分布的对应关系 ,确定存在狭窄的冠状动脉血管。冠脉造影采用 Seldinger′s法经皮股动脉穿刺插管的 Judkin法 ,以冠状动脉管径≤ 5 0 %作为有临床意义狭窄的诊断标准。结果 :4 3例两种检查方法结果一致 ,8例结果不一致 ,符合率为 84 .3%。结论 :MR心肌灌注成像与 DSA冠脉造影检查结果具有高度一致性 ,MR心肌灌注成像是一种无创性的测定心肌血流的检查方法 ,可为临床诊断及恰当治疗提供可靠的依据。

Objective To study the consistency of the results between of MR myocardial perfusion imaging and DSA coronary arteriography. Methods MR myocardial perfusion imaging and DSA cornary artery imaging were perfromed to 51 patients with coronary heart disease with typical clinical symptoms and typical cardiogram. Dynamic contrast enhanced myocardial imaging (DCEMI) myocardial perfusion imaging analysis software for GE AW4.0 working station was employed to analyze the first pass phase images of the myocardial perfusion of the left ventricle short axle. A curve of the time-intensity of the cardiac muscle perfusion was obtained and the rising slope and the peak value of signal intensity were observed. According to the description of the relation between the position of the short axle of left ventricle and the distribution of the coronary artery blood vessels, the existence of narrowed coronary artery was determined. DSA machine of DAR 1 200 double C arm was employed in the coronary artery imaging. Judkin method employing Seldinger′s method of femoral centesis was carried out and the value ≤50% of the diameter of the coronary artery was determined as the diagnostic standard of narrowness of clinical significance. Results The results of the two methods in 43 cases were consistent and 8 not, the rate of consistency was 84.3%. Conclusion High consistency of the results was found between MR myocardial perfusion imaging and DSA coronary arteriography. MR myocardial perfusion imaging is a non-traumatic method to determine the blood flow of myocardium and it can supply valuable information and guidance for the diagnosis and treatment for the patients.