Francois Christopher J, Shors Stephanie M, Bonow Robert O, Finn J Paul
Department of Radiology, Northwestern University Medical School, Chicago, Ill, USA.
Radiology. 2003 May;227(2):447-52. doi: 10.1148/radiol.2272020366. Epub 2003 Apr 3.
To build a database of arm-to-aorta circulation times for contrast enhancement and to determine if measured transit times can help in discrimination between patients with and patients without heart disease.
Findings at test-bolus examinations performed before acquisition of contrast material-enhanced magnetic resonance (MR) angiographic images of the head and neck were retrospectively reviewed. The times from test-bolus injection to first and peak enhancement in regions of interest were recorded in 77 patients with coronary artery disease, left ventricular hypertrophy, and/or impaired left ventricular function and 33 control subjects. Transit times in patients and control subjects were compared with Student t test. Linear regression was performed to measure the correlation coefficient.
Transit times in patients with heart disease, including those with a normal ejection fraction, were significantly prolonged compared with those in control subjects (P <.05). Mean time to peak enhancement in the carotid artery bifurcation was 16.6 seconds +/- 1.9 (SD) and 20.8 seconds +/- 3.9 in control subjects and patients, respectively. Threshold value of 18 seconds for time to peak signal intensity in the carotid artery bifurcation provided highest combination of sensitivity and specificity. All (11 of 11) patients with an ejection fraction less than 40% and only three (9%) of 33 control subjects had circulation times greater than this threshold. No significant correlation was found between transit times and age, sex, weight, and height.
Transit times measured with MR imaging may help in discrimination between patients with and patients without heart disease, independently of other cardiac functional parameters.
建立用于对比增强的手臂至主动脉循环时间数据库，并确定测量的通过时间是否有助于区分患有和未患有心脏病的患者。
回顾性分析在获取头颈部对比剂增强磁共振（MR）血管造影图像之前进行的团注试验检查结果。记录了77例患有冠状动脉疾病、左心室肥厚和/或左心室功能受损的患者以及33例对照受试者从团注注射到感兴趣区域首次增强和峰值增强的时间。采用Student t检验比较患者和对照受试者的通过时间。进行线性回归以测量相关系数。
与对照受试者相比，包括射血分数正常的患者在内的心脏病患者的通过时间显著延长（P <.05）。对照受试者和患者在颈动脉分叉处达到峰值增强的平均时间分别为16.6秒±1.9（标准差）和20.8秒±3.9。颈动脉分叉处峰值信号强度时间的阈值为18秒时，敏感性和特异性的组合最佳。所有（11例中的11例）射血分数低于40%的患者和33例对照受试者中只有3例（9%）的循环时间超过此阈值。未发现通过时间与年龄、性别、体重和身高之间存在显著相关性。
通过MR成像测量的通过时间可能有助于区分患有和未患有心脏病的患者，而与其他心功能参数无关。
