Ozgun M, Hoffmeier A, Quante M, Fischbach R, Heindel W, Botnar R, Maintz D
Institut für Klinische Radiologie, Universitätsklinikum Münster.
Rofo. 2006 May;178(5):500-7. doi: 10.1055/s-2006-926650. Epub 2006 Apr 13.
To evaluate a new coronary MR angiography technique covering the whole coronary artery tree in one data set acquisition.
Six healthy volunteers and 15 patients with known CAD were examined with a navigator gated and corrected (NAV) free-breathing 3D steady-state free precession sequence covering the whole heart (WH-MRA) (TR = 5.4, TE = 2.7, SENSE factor = 2, 160 slices, 0.75 mm reconstructed slice thickness, in-plane resolution = 0.99 x 0.99 mm(2), scan time 14 min [50 % NAV efficiency]) and a vessel targeted 3D SSFP MRA sequence (t-MRA) (TR = 5.6 ms, TE = 2.8 ms, 20 slices of 1.5 mm reconstructed slice thickness, in-plane resolution = 0.99 x 0.99 mm(2), scan time = 7 min [50 % NAV efficiency]). Subjective image quality (4-point scale) and objective image quality parameters including vessel sharpness, vessel diameter and CNR were calculated for WH-MRA and t-MRA. In patients, the accuracy for detection of stenosis larger than 50 % was compared to the accuracy of X-ray coronary angiography (XA), which was considered the standard.
WH-MRA demonstrated good vessel visibility in healthy subjects (100 %) whereas vessel visibility in patients was limited (78 % in an 8 segment evaluation). Vessel sharpness was inferior to that of t-MRA in patients (37 vs. 42 %) but equal in healthy subjects (42 %). Vessel diameter did not differ significantly between WH-MRA and t-MRA. CNR was significantly reduced for WH-MRA (CNR 7.4 vs. 11.5). The diagnostic accuracy for the detection of CAD was comparable for both MRA approaches (85.5 vs. 86.2 %).
WH-MRA allows good coronary artery visualization in healthy subjects and patients and provides a simplified scanning procedure and advantages in 3D post-processing. Regarding image parameters and the detection of CAD, the results are comparable to those acquired with t-MRA. The major disadvantage remains the high number of diagnostically insufficient images.
评估一种在一次数据集采集过程中覆盖整个冠状动脉树的新型冠状动脉磁共振血管造影技术。
对6名健康志愿者和15名已知患有冠心病（CAD）的患者进行检查，采用导航门控和校正（NAV）自由呼吸三维稳态自由进动序列覆盖整个心脏（全心脏磁共振血管造影，WH-MRA）（重复时间（TR）=5.4，回波时间（TE）=2.7，敏感度编码（SENSE）因子=2，160层，重建层厚0.75毫米，平面分辨率=0.99×0.99毫米²，扫描时间14分钟[导航效率50%]）以及针对血管的三维稳态自由进动磁共振血管造影序列（目标磁共振血管造影，t-MRA）（TR=5.6毫秒，TE=2.8毫秒，20层，重建层厚1.5毫米，平面分辨率=0.99×0.99毫米²，扫描时间=7分钟[导航效率50%]）。计算WH-MRA和t-MRA的主观图像质量（4分制）以及包括血管清晰度、血管直径和对比噪声比（CNR）在内的客观图像质量参数。在患者中，将大于50%狭窄的检测准确性与被视为标准的X线冠状动脉造影（XA）的准确性进行比较。
WH-MRA在健康受试者中显示出良好的血管可视性（100%），而在患者中的血管可视性有限（在8节段评估中为78%）。患者中血管清晰度低于t-MRA（37%对42%），但在健康受试者中两者相当（42%）。WH-MRA和t-MRA之间的血管直径无显著差异。WH-MRA的CNR显著降低（CNR 7.4对11.5）。两种磁共振血管造影方法检测CAD的诊断准确性相当（85.5%对86.2%）。
WH-MRA在健康受试者和患者中能实现良好的冠状动脉可视化，并提供简化的扫描程序以及三维后处理方面的优势。在图像参数和CAD检测方面，结果与t-MRA相当。主要缺点仍然是诊断不足的图像数量较多。
