屏气三维快速平衡稳态进动序列对冠状动脉狭窄的诊断效能

Efficiency of breath-hold three-dimensional fast imaging employing steady state acquisition sequence for coronary stenoses detection

目的以普通冠状动脉导管造影为参照,评价屏气三维快速平衡稳态进动(FIESTA)序列对冠状动脉狭窄的显示效能。方法连续33例患者在冠状动脉导管造影检查的3周内接受冠状动脉MR血管成像(CMRA)检查,将冠状动脉狭窄划分成0%、0%~25%、25%~50%、50%~75%,75%~100%共5个级别,对两者判断的结果逐段进行比较。结果CMRA对区分>50%和<50%狭窄的准确度、敏感度和特异度分别为843%、848%和841%,阴性预测值为923%;对区分50%~75%与75%~100%狭窄的准确度、敏感度和特异度均为615%。结论屏气三维FIESTA冠状动脉成像序列对具有血流动力学意义狭窄的排除具有一定的实用价值,但是更细致的分级受限。

Objective To evaluate the efficiency of coronary magnetic resonance angiography (CMRA) for stenoses detection by using breath-hold three-dimensional fast imaging employing steady state acquisition (FIESTA) sequence with the reference of conventional coronary catheter angiography. Methods^Consecutive 33 patients accepted CMRA examination within 3 weeks after the catheter angiography. Coronary stenoses was graded in 5 levels as 0%, 0%-25%, 25%-50%, 50%-75%, and 75%-100%, respectively, and CMRA and catheter angiogram were compared segment by segment. Results For the differentiation of the stenoses <50% and >50%, the accuracy, sensitivity, and specificity of CMRA was 84.3%, 84.8%, and 84.1%, respectively, and the negative prediction value was 92.3%. The accuracy, sensitivity, and specificity for the differentiation of stenoses between 50%-75% and 75%-100% were all 61.5%. Conclusion The breath-holding three-dimensional FIESTA sequence for CMRA was practical to exclude hemodynamic significant coronary stenoses but limited in detail grading.