Factors associated with false-negative cardiovascular magnetic resonance perfusion studies: A Clinical evaluation of magnetic resonance imaging in coronary artery disease (CE-MARC) substudy.
Factors associated with false-negative cardiovascular magnetic resonance perfusion studies: A Clinical evaluation of magnetic resonance imaging in coronary artery disease (CE-MARC) substudy.
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DOI：
10.1002/jmri.25032
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发表时间：
2016-03
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影响因子：
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通讯作者：
Greenwood JP
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文献类型：
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作者：
Kidambi A;Sourbron S;Maredia N;Motwani M;Brown JM;Nixon J;Everett CC;Plein S;Greenwood JP
在冠状动脉疾病磁共振成像的大型前瞻性临床评估(CE-MARC)研究人群中，检查与假阴性心血管磁共振(MR)灌注研究相关的因素。心肌灌注磁共振对冠心病的诊断具有很高的准确性。然而，MR灌注研究假阴性的原因尚不清楚。CE-MARC前瞻性招募疑似冠心病患者，并强制进行MR、心肌灌注核素扫描和有创血管造影术。这一子分析通过量化冠状动脉造影(QCA)和MR灌注(1.5T，T1加权梯度回波)确定了所有有明显冠状动脉狭窄的患者，使用原始盲图读取。我们参照QCA探讨了与假阴性或真阳性MR灌注结果相关的患者和影像特征。多变量回归分析根据四个特征评估MR灌注假阴性的可能性：图像质量差、三支血管病变、对腺苷的血流动力学反应不足和Duke危险评分(血管造影心肌危险评分)。总共有265名患者(39%)有明显的血管造影疾病(平均年龄62岁，男性79%)。MR灌注假阴性35例(5%)，真阳性230例(34%)。MR灌注成像质量差、三支病变和血流动力学反应不佳在假阴性组和真阳性组之间相似(OR[95%可信区间，CI]：4.1(0.82~2 1.0)，P = 0.0 9；1.2(0.2 0~7.1)，P = 0.85和1.6(0.6 5~3.8)，P = 0.31)。假阴性组的平均Duke危险评分显著低于假阴性组(2.6 ± 1.7vs.5.4 ± 3.0，OR 0.34(0.2 1~0.5 3)，P <； 0.0001)。假阴性的心血管MR灌注研究并不常见，而在血管造影心肌风险较低的患者中更为常见。在CE-MARC中，图像质量差、三支血管病变和血流动力学反应不足与假阴性MR灌注没有显著相关性。J·马根。雷森。成像2016；43：566-573。
To examine factors associated with false‐negative cardiovascular magnetic resonance (MR) perfusion studies within the large prospective Clinical Evaluation of MR imaging in Coronary artery disease (CE‐MARC) study population. Myocardial perfusion MR has excellent diagnostic accuracy to detect coronary heart disease (CHD). However, causes of false‐negative MR perfusion studies are not well understood. CE‐MARC prospectively recruited patients with suspected CHD and mandated MR, myocardial perfusion scintigraphy, and invasive angiography. This subanalysis identified all patients with significant coronary stenosis by quantitative coronary angiography (QCA) and MR perfusion (1.5T, T 1‐weighted gradient echo), using the original blinded image read. We explored patient and imaging characteristics related to false‐negative or true‐positive MR perfusion results, with reference to QCA. Multivariate regression analysis assessed the likelihood of false‐negative MR perfusion according to four characteristics: poor image quality, triple‐vessel disease, inadequate hemodynamic response to adenosine, and Duke jeopardy score (angiographic myocardium‐at‐risk score). In all, 265 (39%) patients had significant angiographic disease (mean age 62, 79% male). Thirty‐five (5%) had false‐negative and 230 (34%) true‐positive MR perfusion. Poor MR perfusion image quality, triple‐vessel disease, and inadequate hemodynamic response were similar between false‐negative and true‐positive groups (odds ratio, OR [95% confidence interval, CI]: 4.1 (0.82–21.0), P = 0.09; 1.2 (0.20–7.1), P = 0.85, and 1.6 (0.65–3.8), P = 0.31, respectively). Mean Duke jeopardy score was significantly lower in the false‐negative group (2.6 ± 1.7 vs. 5.4 ± 3.0, OR 0.34 (0.21–0.53), P < 0.0001). False‐negative cardiovascular MR perfusion studies are uncommon, and more common in patients with lower angiographic myocardium‐at‐risk. In CE‐MARC, poor image quality, triple‐vessel disease, and inadequate hemodynamic response were not significantly associated with false‐negative MR perfusion. J. MAGN. RESON. IMAGING 2016;43:566–573.