Bertschinger K M, Nanz D, Buechi M, Luescher T F, Marincek B, von Schulthess G K, Schwitter J
Institute of Diagnostic Radiology, University Hospital, Zurich, Switzerland.
J Magn Reson Imaging. 2001 Nov;14(5):556-62. doi: 10.1002/jmri.1219.
Fast imaging techniques allow monitoring of contrast medium (CM) first-pass kinetics in a multislice mode. Employing shorter recovery times improves cardiac coverage during first-pass conditions, but potentially flattens signal response in the myocardium. The aim of this study was therefore to compare in patients with suspected coronary artery disease (CAD) two echo-planar imaging strategies yielding either extended cardiac coverage or optimized myocardial signal response (protocol A/B, six/four slices; preparation pulse, 60 degrees /90 degrees; delay time, 10/120 msec; readout flip angle, 10 degrees /50 degrees; respectively). In phantoms and myocardium of normal volunteers (N= 10) the CM-induced signal increase was 2.5-3 times higher with protocol B (P < 0.005) than with protocol A. For the detection of individually diseased coronary arteries (> or =1 stenosis with > or =50% diameter reduction on quantitative coronary angiography (QCA)), receiver-operator characteristics of protocol B (signal upslope in 32 sectors/heart) yielded a sensitivity/specificity of 82%/73%, which was superior to protocol A (P < 0.05, N= 14). For the overall detection of CAD, the sensitivity/specificity of protocol B was 85%/81%. An adequate signal response in the myocardium is crucial for a reliable detection of perfusion deficits during first-pass conditions. The presented protocol B detects CAD with a sensitivity and specificity similar to scintigraphic techniques.
快速成像技术可在多层模式下监测造影剂（CM）的首过动力学。采用较短的恢复时间可改善首过状态下的心脏覆盖范围，但可能会使心肌中的信号响应变平。因此，本研究的目的是在疑似冠状动脉疾病（CAD）患者中比较两种回波平面成像策略，一种可提供扩展的心脏覆盖范围，另一种可优化心肌信号响应（方案A/B，六/四层；准备脉冲，60度/90度；延迟时间，10/120毫秒；读出翻转角，10度/50度）。在正常志愿者（N = 10）的体模和心肌中，方案B引起的CM信号增加比方案A高2.5 - 3倍（P < 0.005）。对于检测单个病变冠状动脉（定量冠状动脉造影（QCA）显示≥1处狭窄且直径减少≥50%），方案B（32个扇区/心脏的信号上升斜率）的受试者工作特征曲线得出的敏感性/特异性为82%/73%，优于方案A（P < 0.05，N = 14）。对于CAD的总体检测，方案B的敏感性/特异性为85%/81%。心肌中足够的信号响应对于在首过状态下可靠检测灌注缺损至关重要。所提出的方案B检测CAD的敏感性和特异性与闪烁扫描技术相似。
