Kalden P, Kreitner K F, Wittlinger T, Voigtländer T, Krummenauer F, Schreiber W, Thelen M
Klinik und Poliklinik für Radiologie, Johannes-Gutenberg-Universität, Mainz.
Rofo. 1999 May;170(5):442-8. doi: 10.1055/s-2007-1011071.
To evaluate the patency of coronary artery bypass grafts with a 2D T2-weighted breath-hold turbo-spin-echo sequence.
38 patients with 97 grafts (19 internal mammary artery and 78 saphenous vein grafts) and a total of 120 distal anastomoses were studied at 1.5 Tesla in supine position using a phased array body coil. An ECG gated 2D T2-weighted breath-hold turbo-spin-echo sequence (HASTE) was performed. Reference method was selective coronary angiography. The image material was evaluated independently by two radiologists (observer one, a radiological fellow and the second a staff radiologist).
Observer 1 reached a sensitivity of 96% (72/75) and a specificity of 91% (20/22), positive predictive value was 97%, negative predictive value 87%. 79 of the 97 (81%) patent distal anastomoses were correctly identified. Observer 2 achieved a sensitivity of 92% (69/75) and a specificity of 82% (18/22), positive and negative predictive values were 95% and 75% respectively. From 97 patent distal anastomoses 59 (61%) were recognized. The interobserver agreement was good (Cohen's kappa = 68%, p-value [McNemar] = 58%).
Using the HASTE sequence a reliable assessment of graft patency is possible. This sequence is a helpful tool for planning flow measurements and 3D MR angiography.
采用二维T2加权屏气涡轮自旋回波序列评估冠状动脉搭桥术移植物的通畅情况。
对38例患者的97处移植物（19处胸廓内动脉和78处大隐静脉移植物）以及总共120处远端吻合口进行研究，患者在1.5特斯拉场强下仰卧位，使用相控阵体线圈。采用心电图门控二维T2加权屏气涡轮自旋回波序列（HASTE）进行检查。参考方法为选择性冠状动脉造影。影像资料由两名放射科医生独立评估（观察者1为放射科住院医师，观察者2为放射科主治医师）。
观察者1的敏感度为96%（72/75），特异度为91%（20/22），阳性预测值为97%，阴性预测值为87%。97处通畅的远端吻合口中有79处（81%）被正确识别。观察者2的敏感度为92%（69/75），特异度为82%（18/22），阳性和阴性预测值分别为95%和75%。97处通畅的远端吻合口中有59处（61%）被识别。观察者间一致性良好（科恩kappa值 = 68%，p值[麦克尼马尔检验] = 58%）。
使用HASTE序列可以对移植物通畅情况进行可靠评估。该序列是用于规划血流测量和三维磁共振血管造影的有用工具。
