呼吸导航3D BTFE序列评价冠状动脉狭窄的初步研究

Preliminary study of respiratory navigator 3D Balanced Turbo Field Echo Sequence in the detection of coronary stenosis

目的以选择性冠状动脉造影(coronary angiography,CAG)为参照标准,评价呼吸导航三维超快平衡场回波(Balanced Turbo FieldEcho:BTFE)序列诊断冠状动脉狭窄的效能,并初步分析冠状动脉狭窄的CMRA(Coronary magneticresonance angiograpyg,MRA)影像学表现。方法11例受检者进行了CAG检查和呼吸导航3D BTFE序列MRA联合检查,按冠状动脉解剖节段进行配比对照,用双盲法比较呼吸导航3D BTFE CMRA对冠状动脉狭窄的诊断效能;同时初步分析状动脉狭窄的呼吸导航三维BTFE MRA影像学表现。结果以冠状动脉狭窄50%为统计截断点,将冠状动脉狭窄分为无明显狭窄和明显狭窄;3DBTFE CMRA诊断冠状动脉明显狭窄的敏感性、特异性和准确性分别为67%、94%和84%;CMRA和CAG两种检查结果的一致率为0.8409,kappa值为0.4914;冠状动脉狭窄在呼吸导航3D BTFE CMRA上的表现包括:血管节段性显示、血管壁增厚、血管走行僵硬、管腔狭窄或闭塞、管腔内血流信号减低、不均匀。结论呼吸导航3D BTFE MRA可以定性评价冠状动脉明显狭窄,并用于冠状动脉明显狭窄的排除性诊断,但尚不能对冠状动脉狭窄进行定量评价。

Objective To evaluate the efficiency of respiratory navigator 3D Balanced Turbo Field Echo（BTFE） MRA Sequence in the detection of coronary stenosis with the reference of conventional coronary angiography（CAG）. Methods 11 patients with suspected coronary aretry diseases were evaluated with respiratory navigator three dimensional BTFE CMRA examination within two weeks before the CAG. Coronary stenosis were graded in two levels as 〈50% and ;〉 50%, and the results of CMRA and CAG were compared segment by segment. Respiratory navigator three dimensional BTFE CMRA were performed in 11 patients with suspected coronary aretry diseases within two weeks before CAG and its valuation in the diagnosis of coronary stenosis were studied by way of double blind as well as its characteristics on MRI. Results Setting 50 percent as the differentiation point, coronary stenosis could be divided into remarkable and unremarkable stenosis. The sensitivity, specificity and accuracy of CMRA in the diagnosis of coronary stenosis was 67%, 94% and 84% respectively. The concordance rate and kappa value between CMRA and CAG were 0.8409 and 0.4914. Conclusion The respiratory navigator three dimensional BTFE sequence MRA is useful for the exclusion diagnosis of remarkable coronary stenosis and qualitative evaluation of coronary atenosis, but does not work in quantitative grade.