评价导航波门控法冠状动脉MRA诊断冠状动脉狭窄的价值

Evaluating the Value of Navigator-gated 3D FIESTA Coronary MRA in Diagnosing Coronary Stenoses

目的:评价导航波门控法三维冠状动脉MRA诊断冠状动脉狭窄的价值。材料和方法:34例临床怀疑冠心病的患者用导航波门控法三维FIESTA MRA序列定向扫描冠状动脉,与DSA冠状动脉造影结果相比,评价其显示冠状动脉狭窄的价值。结果:MRA显示冠状动脉248个节段的质量平均为2.8±4.5,与DSA相比,对于>50%的冠状动脉狭窄,MRA敏感性、特异性、阳性预测值及阴性预测值分别为83.0%、98.0%、93.2%、97.5%。而对于<50%的节段性狭窄的敏感性、特异性、阳性预测值、阴性预测值分别为86.0%、96.0%、72.0%及98.8%。结论:导航波门控法三维冠状动脉成像判断>50%的冠状动脉狭窄有较高的价值,对于判断<50%的节段性冠状动脉狭窄亦有一定的价值,后者需要更多的病例证实。

Purpose： To investigate the value of navigator-gated 3 D FIESTA MRA in the detection of coronary artery stenoses. Materials and Methods： Thirty-four patients with clinically suspect coronary stenoses underwent navigator-gated 3 D MRA and then conventional coronary angiography was taken as the standard of reference. Targeted coronary MR images were evaluated the presence of stenoses and image quality were scaled by two observers independently. Results： The mean image quality score of 248 segments of coronary arteries was 2.8 ± 4.5. For the stenoses 〉 50% reduction in diameter on DSA, the sensitivity, specificity, positive predictive value and negative predictive value were 83.0%, 98.0%, 93.2%, and 97.5% respectively. For those segmental stenoses 〈 50% on DSA, the sensitivity, specificity, positive predictive value and negative predictive value were 86.0%, 96.0%, 72.0% and 98.8% respectively. Conclusion： The navigatorgated 3D FIESTA coronary MRA is of value in detecting coronary artery stenoses 〉 50% and also may be helpful for those segmental stenoses 〈 50%, and the latter needs more investigating.