A Prospective Study for Comparison of MR and CT Imaging for Detection of Coronary Artery Stenosis
A Prospective Study for Comparison of MR and CT Imaging for Detection of Coronary Artery Stenosis
复制标题
DOI：
10.1016/j.jcmg.2010.10.007
复制
发表时间：
2011-01-01
影响因子：
14
通讯作者：
Fleck, Eckart
中科院分区：
文献类型：
--
作者：
Hamdan, Ashraf;Asbach, Patrick;Fleck, Eckart
目的本研究的目的是直接比较磁共振成像（MRI）和多层计算机断层扫描（CT）在检测冠状动脉狭窄方面的诊断准确性。背景这两种成像方式已成为潜在的无创冠状动脉成像方式；然而，与 MRI 不同，CT 会使患者暴露于辐射和碘造影剂。 方法 对 120 名疑似或已知冠状动脉疾病的连续患者前瞻性地在选择性 X 射线血管造影前接受 32 通道 3.0-T MRI 和 64 层 CT。将这 2 种方法检测直径≥ 1.5 mm 节段的显着冠状动脉狭窄（≥ 50% 管腔直径狭窄）的诊断准确性与作为参考标准的定量有创冠状动脉造影进行比较。 结果 在基于患者的分析中，MRI 和 CT 血管造影显示类似的诊断准确性，分别为 83%（95% 置信区间 [CI]：75 至 87）与 87%（95% CI：80 至 87）。 92), p = 0.38;敏感性为 87%（95% CI：76 至 93）与 90%（95% CI：80 至 95），p = 0.16；特异性分别为 77%（95% CI：63 至 87）和 83%（95% CI：70 至 91），p = 0.06。所有左主干或三支血管病变病例均经MRI和CT血管造影正确诊断。在基于患者的分析中，MRI 和 CT 血管造影在识别随后接受血运重建的患者方面相似：MRI 的接受者-操作者特征曲线下面积为 0.78（95% CI：0.69 至 0.87），CT 血管造影为 0.82（95% CI：0.74 至 0.90）。结论 32 通道 3.0-T MRI 和64 层 CT 血管造影同样可以识别疑似或已知冠状动脉疾病、计划进行选择性冠状动脉造影的患者的显着冠状动脉狭窄。然而，CT 血管造影显示出提高诊断性能的有利趋势。 （J Am Coll Cardiol Img 2011；4:50-61）(C) 2011 年，美国心脏病学会基金会
OBJECTIVES The purpose of the present study was to directly compare the diagnostic accuracy of magnetic resonance imaging (MRI) and multislice computed tomography (CT) for the detection of coronary artery stenosis.BACKGROUND Both imaging modalities have emerged as potential noninvasive coronary imaging modalities; however, CT-unlike MRI-exposes patients to radiation and iodinated contrast agent.METHODS One hundred twenty consecutive patients with suspected or known coronary artery disease prospectively underwent 32-channel 3.0-T MRI and 64-slice CT before elective X-ray angiography. The diagnostic accuracy of the 2 modalities for detecting significant coronary stenosis (>= 50% luminal diameter stenosis) in segments >= 1.5 mm diameter was compared with quantitative invasive coronary angiography as the reference standard.RESULTS In the patient-based analysis MRI and CT angiography showed similar diagnostic accuracy of 83% (95% confidence interval [CI]: 75 to 87) versus 87% (95% CI: 80 to 92), p = 0.38; sensitivity of 87% (95% CI: 76 to 93) versus 90% (95% CI: 80 to 95), p = 0.16; and specificity of 77% (95% CI: 63 to 87) versus 83% (95% CI: 70 to 91), p = 0.06, respectively. All cases of left main or 3-vessel disease were correctly diagnosed by MRI and CT angiography. In the patient-based analysis MRI and CT angiography were similar in their ability to identify patients who subsequently underwent revascularization: the area under the receiver-operator characteristic curve was 0.78 (95% CI: 0.69 to 0.87) for MRI and 0.82 (95% CI: 0.74 to 0.90) for CT angiography.CONCLUSIONS Thirty-two channel 3.0-T MRI and 64-slice CT angiography similarly identify significant coronary stenosis in patients with suspected or known coronary artery disease scheduled for elective coronary angiography. However, CT angiography showed a favorable trend toward higher diagnostic performance. (J Am Coll Cardiol Img 2011;4:50-61) (C) 2011 by the American College of Cardiology Foundation