Sommer T, Hofer U, Hackenbroch M, Meyer C, Flacke S, Schmiedel A, Schmitz C, Thiemann K, Omran H, Schild H
Radiologische Universitätsklinik Bonn.
Rofo. 2002 Apr;174(4):459-66. doi: 10.1055/s-2002-25121.
To evaluate the clinical value of high-resolution coronary MR angiography (coronary MRA) in a large group of patients with suspected coronary artery disease.
107 patients with suspected coronary artery disease underwent free-breathing coronary MRA (Intera, 1.5 T, Philips Medical Systems). To compensate for artefacts due to respiratory motion, a right hemidiaphragmatic navigator with real time-time slice correction was used. An ECG-gated, fat-suppressed, 3D segmented-k-space gradient echo sequence (in plane resolution 0.70 x 0.79 mm(2)) was used. Cardiac catheterization with selective coronary angiography was performed in all patients. Visualization of the coronary arteries (CA) was qualitatively assessed using a four-point grading scale.
Image quality of grade 1 was achieved in 24 %, grade 2 in 48 %, grade 3 in 24 % and grade in in 4 % of patients. Based on an evaluation of the coronary MRAs of all patients (n = 107) sensitivity and specificity for the detection of stenoses > 60 % in the proximal and middle main coronary arteries were 74 % and 63 %, respectively. In coronary MRAs with good quality [grade 1 and 2, n = 77/107 (72 %)] sensitivity and specificity for the detection of coronary stenoses were 88 % and 91 %, respectively.
Submillimeter 3D coronary MRA with real-time navigator correction allows high quality imaging of the proximal and middle main coronary arteries with good sensitivity and specificity for detection of stenoses > 50 % in selected patients. However, in about 28 % of patients image quality is severely impaired.
评估高分辨率冠状动脉磁共振血管造影（冠状动脉MRA）在一大组疑似冠心病患者中的临床价值。
107例疑似冠心病患者接受了自由呼吸冠状动脉MRA检查（Intera，1.5T，飞利浦医疗系统）。为补偿呼吸运动引起的伪影，使用了带有实时切片校正的右半膈肌导航器。采用心电图门控、脂肪抑制、3D分段k空间梯度回波序列（平面分辨率0.70×0.79mm²）。所有患者均进行了选择性冠状动脉造影的心脏导管检查。使用四点分级量表对冠状动脉（CA）的可视化进行定性评估。
24%的患者图像质量达到1级，48%达到2级，24%达到3级，4%达到4级。基于对所有患者（n = 107）冠状动脉MRA的评估，检测近端和中段主要冠状动脉狭窄>60%的敏感性和特异性分别为74%和63%。在质量良好的冠状动脉MRA（1级和2级，n = 77/107（72%））中，检测冠状动脉狭窄的敏感性和特异性分别为88%和91%。
具有实时导航器校正的亚毫米3D冠状动脉MRA能够对近端和中段主要冠状动脉进行高质量成像，对选定患者检测>50%的狭窄具有良好的敏感性和特异性。然而，约28%的患者图像质量严重受损。
