Ozgun Murat, Hoffmeier Andreas, Kouwenhoven Marc, Botnar René M, Stuber Matthias, Scheld Hans Heinrich, Manning Warren J, Heindel Walter, Maintz David
Department of Clinical Radiology, University of Muenster, Albert-Schweitzer-Strasse 33, Muenster 48129, Germany.
AJR Am J Roentgenol. 2005 Jul;185(1):103-9. doi: 10.2214/ajr.185.1.01850103.
Our objective was to compare two state-of-the-art coronary MRI (CMRI) sequences with regard to image quality and diagnostic accuracy for the detection of coronary artery disease (CAD).
Twenty patients with known CAD were examined with a navigator-gated and corrected free-breathing 3D segmented gradient-echo (turbo field-echo) CMRI sequence and a steady-state free precession sequence (balanced turbo field-echo). CMRI was performed in a transverse plane for the left coronary artery and a double-oblique plane for the right coronary artery system. Subjective image quality (1- to 4-point scale, with 1 indicating excellent quality) and objective image quality parameters were independently determined for both sequences. Sensitivity, specificity, and accuracy for the detection of significant (> or = 50% diameter) coronary artery stenoses were determined as defined in invasive catheter X-ray coronary angiography.
Subjective image quality was superior for the balanced turbo field-echo approach (1.8 +/- 0.9 vs 2.3 +/- 1.0 for turbo field-echo; p < 0.001). Vessel sharpness, signal-to-noise ratio, and contrast-to-noise ratio were all superior for the balanced turbo field-echo approach (p < 0.01 for signal-to-noise ratio and contrast-to-noise ratio). Of the 103 segments, 18% of turbo field-echo segments and 9% of balanced turbo field-echo segments had to be excluded from disease evaluation because of insufficient image quality. Sensitivity, specificity, and accuracy for the detection of significant coronary artery stenoses in the evaluated segments were 92%, 67%, 85%, respectively, for turbo field-echo and 82%, 82%, 81%, respectively, for balanced turbo field-echo.
Balanced turbo field-echo offers improved image quality with significantly fewer nondiagnostic segments when compared with turbo field-echo. For the detection of CAD, both sequences showed comparable accuracy for the visualized segments.
我们的目的是比较两种最先进的冠状动脉磁共振成像（CMRI）序列在检测冠状动脉疾病（CAD）时的图像质量和诊断准确性。
对20例已知CAD患者采用导航门控和校正的自由呼吸三维分段梯度回波（涡轮场回波）CMRI序列以及稳态自由进动序列（平衡涡轮场回波）进行检查。CMRI在横断面上对左冠状动脉进行成像，在双斜面上对右冠状动脉系统进行成像。分别独立确定两种序列的主观图像质量（1至4分制，1分表示质量极佳）和客观图像质量参数。根据有创导管X线冠状动脉造影所定义的标准，确定检测显著（直径≥50%）冠状动脉狭窄的敏感性、特异性和准确性。
平衡涡轮场回波方法的主观图像质量更佳（涡轮场回波为2.3±1.0，平衡涡轮场回波为1.8±0.9；p<0.001）。平衡涡轮场回波方法的血管清晰度、信噪比和对比噪声比均更优（信噪比和对比噪声比p<0.01）。在103个节段中，由于图像质量不足，涡轮场回波节段的18%和平衡涡轮场回波节段的9%被排除在疾病评估之外。对于评估节段中显著冠状动脉狭窄的检测，涡轮场回波的敏感性、特异性和准确性分别为92%、67%、85%，平衡涡轮场回波分别为82%、82%、81%。
与涡轮场回波相比，平衡涡轮场回波提供了更高的图像质量，且非诊断节段明显减少。对于CAD的检测，两种序列在可视化节段上显示出相当的准确性。
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