摘要
目的比较3.0T磁共振全心对比增强冠状动脉成像(CE-CMRA)与传统冠状动脉造影(CAG)对可疑冠心病(CAD)检出的能力,探讨临床应用3.0T CE-CMRA的可行性。方法对30例可疑CAD患者在1周内先后行CAG和CE-CMRA检查。CE-CMRA检查应用心电门控、呼吸门控、反转回复序列、分段梯度回波序列,以0.3 ml/s速率注入钆贝酸二葡甲胺(0.2 ml/kg)和15 ml生理盐水,延迟60 s开始采集数据。以传统CAG为金标准,计算CE-CMRA的诊断敏感度、特异度和准确率。应用Kappa一致性检验评价两种检查方法的一致性。结果成功完成26例CE-CMRA检查,CE-CMRA诊断CAD患者、段落、各支血管的准确率分别为84.62%(22/26)、78.30%(285/364)、87.50%(56/64),阳性预测值分别为81.82%(9/11)、81.05%(124/153)、91.67%(22/24),阴性预测值分别为89.47%(17/19)、80.62%(208/258)、90.32%(56/62)。CE-CMRA对右冠状动脉的显示率为86.15%(112/130);左主干100%(26/26);前降支98.46%(128/130);回旋支83.33%(65/78)。26例CE-CMRA中,17例图像为Ⅳ级,8例为Ⅲ级图像,1例为Ⅱ级图像,无0级和Ⅰ级图像。结论 3.0T CE-CMRA的图像质量符合诊断要求,可作为检出CAD的一种方法。
Objective To compare the detective ability of 3.0T whole heart contrast enhanced coronary magnetic resonance angiography（CE-CMRA） and conventional coronary angiography（CAG） for coronary artery diseases（CAD）,and to explore the clinical application feasibility of 3.0T CE-CMRA.Methods CE-CMRA and CAG were performed within one week in 30 patients with suspected CAD.Successful CE-CMRA was obtained in 26 patients,ECG-gated,respiratory gating,inversion recovery sequences and segmented gradient echo sequence techniques were used.MultiHance（0.2 ml/kg） and 15 ml saline were injected in sequence with speed of 0.3 ml/s.After 60 s＇ delay,the images were collected.The diagnostic sensitivity,specificity and accuracy of CE-CMRA in detecting stenosis were evaluated using X-ray angiography as the reference.Kappa consistency test was used to evaluate the consistency of two methods.Results The accuracy of CE-CMRA for the patients,segments and blood vessels was 84.62%（22/26）,78.30%（285/364） and 87.50%（56/64）,respectively;while the positive predictive value was 81.82%（9/11）,81.05%（124/153） and 91.67%（22/24）,respectively,the negative predictive value was 89.47%（17/19）,80.62%（208/258） and 90.32%（56/62）,respectively.CE-CMRA could display 86.15%（112/130） of the right coronary artery,100% of the left main artery（26/26）,98.46%（128/130） of the anterior descending artery and 83.33%（65/78） of the circumflex artery.Ⅳ quality grading images were obtained in 17 patients,while Ⅲ in 8 and Ⅱ in 1 patient.Conclusion 3.0T CE-CMRA can provide qualified images,and can be used as a method for detecting CAD.
出处
《中国医学影像技术》
CSCD
北大核心
2011年第9期1813-1816,共4页
Chinese Journal of Medical Imaging Technology
