Meyer Carsten, Strach Katharina, Thomas Daniel, Litt Harold, Nähle Claas P, Tiemann Klaus, Schwenger Ulrich, Schild Hans H, Sommer Torsten
Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53129, Bonn, Germany.
Eur Radiol. 2008 Feb;18(2):226-33. doi: 10.1007/s00330-007-0746-3. Epub 2007 Sep 13.
To implement a high-resolution first-pass myocardial perfusion imaging protocol (HRPI) at 3 T, and to evaluate the feasibility, image quality and accuracy of this approach prospectively in patients with suspected CAD. We hypothesized that utilizing the gain in SNR at 3 T to increase spatial resolution would reduce partial volume effects and subendocardial dark rim artifacts in comparison to 1.5 T. HRPI studies were performed on 60 patients using a segmented k-space gradient echo sequence (in plane resolution 1.97 x 1.94 mm(2)). Semiquantitative assessment of dark rim artifacts was performed for the stress studies on a slice-by-slice basis. Qualitative visual analysis was compared to quantitative coronary angiography (QCA) results; hemodynamically significant CAD was defined as stenosis >or=70% at QCA. Dark rim artifacts appeared in 108 of 180 slices (average extent 1.3 +/- 1.2 mm representing 11.8 +/- 10.8% of the transmural myocardial thickness). Sensitivity, specifity, and test accuracy for the detection of significant CAD were 89%,79%, and 85%. HRPI studies at 3 T are feasible in a clinical setting, providing good image quality and high accuracy for detection of significant CAD. The presence of dark rim artifacts does not appear to represent a diagnostic problem when using a HRPI approach.
在3T场强下实施高分辨率首次通过心肌灌注成像方案(HRPI),并前瞻性评估该方法在疑似冠心病患者中的可行性、图像质量和准确性。我们假设,与1.5T相比,利用3T场强下信噪比的提高来增加空间分辨率,将减少部分容积效应和心内膜下暗边伪影。对60例患者进行了HRPI研究,采用分段k空间梯度回波序列(平面分辨率1.97×1.94mm²)。对负荷研究逐片进行暗边伪影的半定量评估。将定性视觉分析与定量冠状动脉造影(QCA)结果进行比较;血流动力学意义上的显著CAD定义为QCA时狭窄≥70%。180个层面中有108个出现暗边伪影(平均范围1.3±1.2mm,占心肌透壁厚度的11.8±10.8%)。检测显著CAD的敏感性、特异性和检验准确性分别为89%、79%和85%。3T场强下的HRPI研究在临床环境中是可行的,为检测显著CAD提供了良好的图像质量和高准确性。使用HRPI方法时,暗边伪影的存在似乎并不构成诊断问题。