Diagnostic accuracy of stress first-pass contrast-enhanced myocardial perfusion MRI compared with stress myocardial perfusion scintigraphy
Diagnostic accuracy of stress first-pass contrast-enhanced myocardial perfusion MRI compared with stress myocardial perfusion scintigraphy
复制标题
DOI：
10.2214/ajr.185.1.01850095
复制
发表时间：
2005-07-01
影响因子：
5
通讯作者：
Takeda, K
中科院分区：
文献类型：
--
作者：
Sakuma, H;Suzawa, N;Takeda, K
目标。本研究的目的是比较饱和恢复快速快速低角闪光(Turbo Flash)和负荷心肌灌注核素扫描(Turbo Flash)所获得的负荷灌注MRI对负荷心肌灌注成像的诊断准确性。最近的研究表明，首过增强心肌灌注MRI可以提供冠状动脉低限狭窄的无创性检测。对40例疑似冠状动脉疾病患者在静息和负荷状态下进行首过增强磁共振成像。所有患者均行无衰减校正的Tl-201SPECT和冠状动脉造影术。两名评价者在不知道冠状动脉造影术结果的情况下独立分配五个置信度等级中的一个进行受试者操作特征(ROC)分析。结果：40例患者中有21例(52.5%)冠状动脉管腔狭窄程度大于或等于70%。MRI检测单个冠状动脉明显狭窄的ROC曲线下面积分别为0.86(观察者1)和0.84(观察者2)。(201)T1SPECT的这两个值分别为0.79(观察者1，p=不显著)和0.72(观察者2，p=不显著)。结论饱和恢复Turbo Flash负荷灌注MRI的诊断准确率与201Tl负荷SPECT相当。首次负荷增强MRI是一种非侵入性技术，可作为负荷心肌灌注显像的替代方法。
OBJECTIVE. The purpose of this study was to determine the diagnostic accuracy of stress perfusion MRI acquired with saturation-recovery prepared turbo fast low-angle shot (turbo FLASH) compared with stress myocardial perfusion scintigraphy. Recent studies show that first-pass contrast-enhanced myocardial perfusion MRI can provide noninvasive detection of low-limiting stenosis in the coronary artery.MATERIALS AND METHODS. First-pass contrast-enhanced MR images were acquired at rest and during stress in 40 patients with suspected coronary artery disease. All patients underwent thallium-201 SPECT without attenuation correction and coronary angiography. Two reviewers independently assigned one of five confidence grades without knowing the results of coronary angiography for receiver operating characteristic (ROC) analysis. Luminal stenosis > 70% on coronary angiography was used as a reference standard.RESULTS. On coronary angiography, 70% or greater diameter stenosis of the coronary artery was observed in 21 (52.5%) of 40 patients. The areas under the ROC curve for detection of significant stenosis in the individual coronary artery were 0.86 (observer 1) and 0.84 (observer 2) for MRI. These values were 0.79 (observer 1, p = not significant) and 0.72 (observer 2, p = not significant) for (201)T1 SPECT.CONCLUSION. The diagnostic accuracy of stress perfusion MRI acquired with saturation-recovery-prepared turbo FLASH was comparable with that of stress 201Tl SPECT. Stress first-pass contrast-enhanced MRI is a noninvasive technique that can be used as an alternative to stress myocardial per-fusion scintigraphy.