Respiratory self-navigated postcontrast whole-heart coronary MR angiography: initial experience in patients.
Respiratory self-navigated postcontrast whole-heart coronary MR angiography: initial experience in patients.
复制标题
呼吸自导航对比后全心冠状动脉磁共振血管造影：患者的初步经验。
作者：
D. Piccini;P. Monney;C. Sierro;S. Coppo;G. Bonanno;Ruud B. van Heeswijk;Jérôme Chaptinel;G. Vincenti;J. de Blois;S. Koestner;T. Rutz;A. Littmann;M. Zenge;J. Schwitter;M. Stuber
目的
旨在评估在转诊进行诊断性心脏 MR 成像的患者队列中，全心冠状动脉磁共振 (MR) 血管造影的呼吸自导航的诊断性能。
材料和方法
这项机构审查委员会批准的研究已获得所有参与者的书面知情同意书。因冠状动脉疾病 (n = 40)、心肌病 (n = 14)、先天性异常 (n = 17) 或“其他”(n = 7) 而转诊进行心脏 MR 成像的 78 名患者（平均年龄，48.5 岁 ± 20.7 [标准差]；53 名男性患者）在使用造影剂后进行了自导航冠状动脉 MR 血管造影。记录检查持续时间，并通过共识读数评估每个冠状动脉节段的图像质量。测量血管清晰度、长度和直径。通过方差分析和 t 检验比较近端、中端和远端节段的定量值。当获得 X 射线血管造影结果时，进行了双盲比较。
结果
当具有不同心脏 MR 成像适应症的患者通过自导航冠状动脉 MR 血管造影进行检查时，平均需要 7.38 分钟± 1.85 才能获得具有 1.15 毫米各向同性空间分辨率的全心脏数据集。 92.3%的病例可以看到冠状动脉主段和近端节段，而分别有84.0%和55.8%的病例可以看到中段和远端节段。近端节段的主观评分和血管清晰度显着高于中端和远端节段 (P < .05)。在所有病例中都可以确认或排除冠状动脉异常。在 31 名可获得参考标准 X 射线冠状动脉造影结果的患者中，狭窄检测的每血管敏感性和特异性分别为 64.7% 和 85.0%。
结论
自导航冠状动脉磁共振血管造影序列显示出冠状动脉成像的前景。然而，需要改进技术来提高图像质量，特别是在更远端的冠状动脉段。
PURPOSE
To assess the diagnostic performance of respiratory self-navigation for whole-heart coronary magnetic resonance (MR) angiography in a patient cohort referred for diagnostic cardiac MR imaging.
MATERIALS AND METHODS
Written informed consent was obtained from all participants for this institutional review board-approved study. Self-navigated coronary MR angiography was performed after administration of a contrast agent in 78 patients (mean age, 48.5 years ± 20.7 [standard deviation]; 53 male patients) referred for cardiac MR imaging because of coronary artery disease (n = 40), cardiomyopathy (n = 14), congenital anomaly (n = 17), or "other" (n = 7). Examination duration was recorded, and the image quality for each coronary segment was assessed with consensus reading. Vessel sharpness, length, and diameter were measured. Quantitative values in proximal, middle, and distal segments were compared by using analysis of variance and t tests. A double-blinded comparison with the results of x-ray angiography was performed when such results were available.
RESULTS
When patients with different indications for cardiac MR imaging were examined with self-navigated postcontrast coronary MR angiography, whole-heart data sets with 1.15-mm isotropic spatial resolution were acquired in an average of 7.38 minutes ± 1.85. The main and proximal coronary segments could be visualized in 92.3% of cases, while the middle and distal segments could be visualized in 84.0% and 55.8% of cases, respectively. Subjective scores and vessel sharpness were significantly higher in the proximal segments than in the middle and distal segments (P < .05). Anomalies of the coronary arteries could be confirmed or excluded in all cases. Per-vessel sensitivity and specificity for stenosis detection were 64.7% and 85.0%, respectively, in the 31 patients for whom reference standard x-ray coronary angiography results were available.
CONCLUSION
The self-navigated coronary MR angiography sequence shows promise for coronary imaging. However, technical improvements are needed to improve image quality, especially in the more distal coronary segments.
DOI：
10.1056/nejmoa0907272
发表时间：
2010-03-11
期刊：
The New England journal of medicine
影响因子：
--
作者：
Patel MR;Peterson ED;Dai D;Brennan JM;Redberg RF;Anderson HV;Brindis RG;Douglas PS
通讯作者：
Douglas PS
影响因子：
19.7
作者：
Hu, Peng;Chuang, Michael L.;Nezafat, Reza
通讯作者：
Nezafat, Reza