Maintz David, Aepfelbacher Franz C, Kissinger Kraig V, Botnar René M, Danias Peter G, Heindel Walter, Manning Warren J, Stuber Matthias
Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
AJR Am J Roentgenol. 2004 Feb;182(2):515-21. doi: 10.2214/ajr.182.2.1820515.
The optimal coronary MR angiography sequence has yet to be determined. We sought to quantitatively and qualitatively compare four coronary MR angiography sequences. SUBJECTS AND METHODS. Free-breathing coronary MR angiography was performed in 12 patients using four imaging sequences (turbo field-echo, fast spin-echo, balanced fast field-echo, and spiral turbo field-echo). Quantitative comparisons, including signal-to-noise ratio, contrast-to-noise ratio, vessel diameter, and vessel sharpness, were performed using a semiautomated analysis tool. Accuracy for detection of hemodynamically significant disease (> 50%) was assessed in comparison with radiographic coronary angiography.
Signal-to-noise and contrast-to-noise ratios were markedly increased using the spiral (25.7 +/- 5.7 and 15.2 +/- 3.9) and balanced fast field-echo (23.5 +/- 11.7 and 14.4 +/- 8.1) sequences compared with the turbo field-echo (12.5 +/- 2.7 and 8.3 +/- 2.6) sequence (p < 0.05). Vessel diameter was smaller with the spiral sequence (2.6 +/- 0.5 mm) than with the other techniques (turbo field-echo, 3.0 +/- 0.5 mm, p = 0.6; balanced fast field-echo, 3.1 +/- 0.5 mm, p < 0.01; fast spin-echo, 3.1 +/- 0.5 mm, p < 0.01). Vessel sharpness was highest with the balanced fast field-echo sequence (61.6% +/- 8.5% compared with turbo field-echo, 44.0% +/- 6.6%; spiral, 44.7% +/- 6.5%; fast spin-echo, 18.4% +/- 6.7%; p < 0.001). The overall accuracies of the sequences were similar (range, 74% for turbo field-echo, 79% for spiral). Scanning time for the fast spin-echo sequences was longest (10.5 +/- 0.6 min), and for the spiral acquisitions was shortest (5.2 +/- 0.3 min).
Advantages in signal-to-noise and contrast-to-noise ratios, vessel sharpness, and the qualitative results appear to favor spiral and balanced fast field-echo coronary MR angiography sequences, although subjective accuracy for the detection of coronary artery disease was similar to that of other sequences.
最佳的冠状动脉磁共振血管造影序列尚未确定。我们试图对四种冠状动脉磁共振血管造影序列进行定量和定性比较。
对12例患者采用四种成像序列(快速场回波、快速自旋回波、平衡快速场回波和螺旋快速场回波)进行自由呼吸下的冠状动脉磁共振血管造影。使用半自动分析工具进行定量比较,包括信噪比、对比噪声比、血管直径和血管清晰度。与放射状冠状动脉造影相比,评估检测血流动力学显著病变(>50%)的准确性。
与快速场回波序列(12.5±2.7和8.3±2.6)相比,螺旋序列(25.7±5.7和15.2±3.9)和平衡快速场回波序列(23.5±11.7和14.4±8.1)的信噪比和对比噪声比显著提高(p<0.05)。螺旋序列的血管直径(2.6±0.5mm)小于其他技术(快速场回波,3.0±0.5mm,p=0.6;平衡快速场回波,3.1±0.5mm,p<0.01;快速自旋回波,3.1±0.5mm,p<0.01)。平衡快速场回波序列的血管清晰度最高(61.6%±8.5%,而快速场回波为44.0%±6.6%;螺旋序列为44.7%±6.5%;快速自旋回波为18.4%±6.7%;p<0.001)。各序列的总体准确性相似(范围:快速场回波为74%,螺旋序列为79%)。快速自旋回波序列的扫描时间最长(10.5±0.6分钟),螺旋采集的扫描时间最短(5.2±0.3分钟)。
信噪比、对比噪声比、血管清晰度方面的优势以及定性结果似乎有利于螺旋和平衡快速场回波冠状动脉磁共振血管造影序列,尽管检测冠状动脉疾病的主观准确性与其他序列相似。