Detection of coronary artery stenosis with whole-heart coronary magnetic resonance angiography
Detection of coronary artery stenosis with whole-heart coronary magnetic resonance angiography
复制标题
DOI：
10.1016/j.jacc.2006.07.055
复制
发表时间：
2006-11-21
影响因子：
24
通讯作者：
Takeda, Kan
中科院分区：
文献类型：
--
作者：
Sakuma, Hajime;Ichikawa, Yasutaka;Takeda, Kan
我们试图确定全心脏冠状动脉磁共振（MR）血管造影检测显着coronary artery diseases.Background的准确性全心脏冠状动脉MR血管造影的诊断性能尚未确定在大量patients.METHODS三维冠状动脉MR血管造影覆盖整个心脏期间获得自由呼吸131例患者。在心动周期中的患者特定时间窗内采集图像，冠状动脉运动最小。在X线冠状动脉造影上，显著冠状动脉疾病被定义为冠状动脉直径减少≥ 50%，参考直径≥ 2 mm。结果131例患者中有113例（86%）完成了MR血管造影，平均成像时间为12.9 ± 4.3 min。MR血管造影的阳性和阴性预测值及准确性均为82%（95%置信区间[CI] 69%至91%），90%（95% CI 79%至96%）、88%（95% CI 74%至95%）、86%（95% CI 75%至93%）和87%（95% CI 79%至92%）。这些值在单个节段中为78%（95% CI 68%至85%），96%（95% CI 95%至97%），69%（95% CI 60%至77%），98%（95% CI 96%至98%），94%（95% CI 96%至96%）。心脏冠状动脉MR血管造影允许无创检测直径为2 min的冠状动脉段中的显著狭窄，具有中等灵敏度和高特异性。
OBJECTIVES We sought to determine the diagnostic performance of whole-heart coronary magnetic resonance (MR) angiography for detecting significant coronary artery disease.BACKGROUND The accuracy of whole-heart coronary MR angiography has not been determined in a large number of patients.METHODS Three-dimensional coronary MR angiograms covering the entire heart were obtained during free breathing in 131 patients. Images were acquired during a patient-specific time window in the cardiac cycle with minimal motion of the coronary artery. Significant coronary artery disease was defined on X-ray coronary angiography as a diameter reduction of >= 50% in coronary arteries with a reference diameter of >= 2 mm.RESULTS The acquisition of MR angiography was completed in 113 (86%) of 131 patients, with an imaging time averaged at 12.9 +/- 4.3 min. On a patient-based analysis, the sensitivity, specificity, positive and negative predictive value, and accuracy of MR angiography were 82% (95% confidence interval [CI] 69% to 91%), 90% (95% CI 79% to 96%), 88% (95% CI 74% to 95%), 86% (95% CI 75% to 93%), and 87% (95% CI 79% to 92%), respectively. These values in the individual segments were 78% (95% CI 68% to 85%), 96% (95% Cl 95% to 97%), 69% (95% CI 60% to 77%), 98% (95% CI 96% to 98%), and 94% (95% CI 96% to 96%).CONCLUSIONS Whole-heart coronary MR angiography allows for noninvasive detection of significant narrowing in coronary arterial segments with a diameter of 2 min with moderate sensitivity and high specificity.