Cardiovascular Division, King's College London BHF Centre of Excellence, and NIHR Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, The Rayne Institute, St. Thomas' Hospital, London, United Kingdom.
J Am Coll Cardiol. 2011 Jan 4;57(1):70-5. doi: 10.1016/j.jacc.2010.09.019.
The objective of this study was to compare visual and quantitative analysis of high spatial resolution cardiac magnetic resonance (CMR) perfusion at 3.0-T against invasively determined fractional flow reserve (FFR).
High spatial resolution CMR myocardial perfusion imaging for the detection of coronary artery disease (CAD) has recently been proposed but requires further clinical validation.
Forty-two patients (33 men, age 57.4 ± 9.6 years) with known or suspected CAD underwent rest and adenosine-stress k-space and time sensitivity encoding accelerated perfusion CMR at 3.0-T achieving in-plane spatial resolution of 1.2 × 1.2 mm(2). The FFR was measured in all vessels with >50% severity stenosis. Fractional flow reserve <0.75 was considered hemodynamically significant. Two blinded observers visually interpreted the CMR data. Separately, myocardial perfusion reserve (MPR) was estimated using Fermi-constrained deconvolution.
Of 126 coronary vessels, 52 underwent pressure wire assessment. Of these, 27 lesions had an FFR <0.75. Sensitivity and specificity of visual CMR analysis to detect stenoses at a threshold of FFR <0.75 were 0.82 and 0.94 (p < 0.0001), respectively, with an area under the receiver-operator characteristic curve of 0.92 (p < 0.0001). From quantitative analysis, the optimum MPR to detect such lesions was 1.58, with a sensitivity of 0.80, specificity of 0.89 (p < 0.0001), and area under the curve of 0.89 (p < 0.0001).
High-resolution CMR MPR at 3.0-T can be used to detect flow-limiting CAD as defined by FFR, using both visual and quantitative analyses.
本研究旨在比较高空间分辨率心脏磁共振（CMR）灌注的视觉和定量分析与侵入性测定的血流储备分数（FFR）。
高空间分辨率 CMR 心肌灌注成像用于检测冠状动脉疾病（CAD）最近已被提出，但需要进一步的临床验证。
42 例（33 名男性，年龄 57.4±9.6 岁）已知或疑似 CAD 患者接受静息和腺苷负荷 K 空间和时间灵敏度编码加速灌注 CMR 检查，在 3.0-T 实现 1.2×1.2mm²的平面空间分辨率。所有狭窄程度>50%的血管均测量 FFR。FFR<0.75 被认为具有血流动力学意义。两位盲法观察者对 CMR 数据进行了视觉解读。此外，使用费米约束反卷积估计心肌灌注储备（MPR）。
在 126 个冠状动脉中，52 个进行了压力导丝评估。其中，27 个病变的 FFR<0.75。视觉 CMR 分析检测 FFR<0.75 阈值狭窄的敏感度和特异度分别为 0.82 和 0.94（p<0.0001），受试者工作特征曲线下面积为 0.92（p<0.0001）。从定量分析来看，检测此类病变的最佳 MPR 为 1.58，其敏感度为 0.80，特异度为 0.89（p<0.0001），曲线下面积为 0.89（p<0.0001）。
3.0-T 高分辨率 CMR MPR 可用于通过视觉和定量分析检测以 FFR 定义的血流受限 CAD。
