3.0 T MR对比增强全心冠状动脉成像与CTA的对照研究

Diagnostic Value of 3 Tesla Contrast Enhanced Whole Heart Coronary MR Angiography in Coronary Artery Disease:A Comparative Analysis with Coronary Computer Tomography Angiography

目的评价3.0TMR对比增强全心冠状动脉成像(CE-CMRA)对冠状动脉病变的诊断价值。资料与方法搜集21例已行冠状动脉CTA(CCTA)检查病例,行3.0TMRCE-CMRA,以CCTA为对照,按照AHA9段法评价冠状动脉显示情况。结果 21例患者顺利完成MRI检查,平均扫描时间为(10.6±2.3)min,CE-CMRA可评价冠状动脉节段164个。冠状动脉近段及中段显示良好,与CCTA比较差异无统计学意义(P>0.05)。12例有意义狭窄(狭窄程度(50%),CE-CMRA显示10例。在狭窄段长度比较中两者差异无统计学意义(P>0.05)。狭窄程度比较,CE-CMRA较CCTA偏高。结论 CE-CMRA对冠状动脉近、中段显示良好,对狭窄的评估可靠,可作为冠状动脉近、中段有意义狭窄的一种筛选手段。对不适于CCTA检查的病例,CE-CMAR可作为一种好的替代方法。但对冠状动脉远段及小分支狭窄的评估有一定限度。

Objective To investigate the clinical value of 3 tesla contrast enhanced whole heart coronary MR angiography（CE CMRA）in coronary artery disease.Materials and Methods Twenty-one patients with coronary artery disease underwent 3T CE CMRA and coronary computer tomography angiography（CCTA）examination.Compared with the CCTA results,the principal branches were evaluated based on the 9 segments of coronary artery.Results The mean scanning time of CE CMRA was 10.6±2.3 minutes.CE CMRA displayed 164 segments of coronary artery with good or excellent quality.There was no significant difference in presenting prior and middle segments of coronary artery principal branches between CE CMRA and CCTA（P0.05）.There were 12 cases with significant stenosis（50%） of the principal branches examined by CCTA,CE-CMRA,however,found only 10 cases.There was no significant difference in detecting stenosis length between CE CMRA and CCTA.The extent of stenosis was higher in CE-CMRA compared with CCTA.Conclusion 3T CE CMRA is a non-invasive imaging modality which is reliable on detcting significant stenosis in prior and middle segments of coronary artery principal branches,and it can be used as a screening methods in coronary artery disease.And CE CMRA also can be utilizd as an alter imaging modality in patients who were not suitable in CCTA examing.However,it is still limited in assessing stenosis of distal segment and small branches of coronary artery.