Ladd Susanne C, Debatin Joerg F, Stang Andreas, Bromen Katja, Moebus Susanne, Nuefer Michael, Gizewski Elke, Wanke Isabel, Doerfler Arnd, Ladd Mark E, Benemann Jens, Erbel Raimund, Forsting Michael, Schmermund Axel, Jöckel Karl-Heinz
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany.
Eur Radiol. 2007 Apr;17(4):1035-45. doi: 10.1007/s00330-006-0434-8. Epub 2006 Oct 7.
Coronary heart disease (CHD) patients often show atherosclerotic vascular disease in other vascular territories. We evaluated how often whole-body MR imaging detects concomitant arterial pathologies in CHD patients, and how often these pathologies were not known to the patients previously. Of 4,814 participants in the population-based Heinz Nixdorf Recall Study, 327 reported CHD (i.e., previous coronary bypass surgery, angioplasty); of those, 160 patients (mean age 66.4 years) were examined using MR of the brain, the heart (excluding the coronary arteries), and whole-body MR angiography. The prevalence of each vascular pathology was assessed, correlated to the others and compared to patients' histories. Of the 160 CHD patients, 16 (10%) showed MR signs of stroke, and 77 (48.1%) had a stenosis >50% in at least one extracerebral peripheral artery (other than the coronaries), including 28 (17.5%) with relevant renal artery stenoses, and 20 (12.5%) with relevant extracerebral internal carotid artery stenoses. False negative histories were reported in 12 of 81 cases with myocardial infarctions, and in 11 of 16 cases with cerebrovascular infarctions. This whole-body atherosclerosis MR screening program allows previously unknown concomitant vascular disease to be detected in coronary heart disease patients. Its prospective value should be assessed in further studies.
冠心病（CHD）患者常伴有其他血管区域的动脉粥样硬化性血管疾病。我们评估了全身磁共振成像（MR）检测冠心病患者合并动脉病变的频率，以及这些病变此前不为患者所知的频率。在基于人群的海因茨·尼克斯多夫召回研究的4814名参与者中，327人报告患有冠心病（即既往有冠状动脉搭桥手术、血管成形术史）；其中，160例患者（平均年龄66.4岁）接受了脑部、心脏（不包括冠状动脉）的磁共振成像以及全身磁共振血管造影检查。评估了每种血管病变的患病率，将其相互关联并与患者病史进行比较。在160例冠心病患者中，16例（10%）有中风的磁共振成像迹象，77例（48.1%）至少有一条脑外周围动脉（冠状动脉除外）狭窄>50%，其中28例（17.5%）有相关肾动脉狭窄，20例（12.5%）有相关脑外颈内动脉狭窄。81例心肌梗死患者中有12例、16例脑血管梗死患者中有11例报告有假阴性病史。这种全身动脉粥样硬化磁共振筛查程序能够检测出冠心病患者此前未知的合并血管疾病。其前瞻性价值应在进一步研究中评估。
