老年人冠状动脉可扩张性的无创评估：一项与磁共振血管造影相关的可行性研究。
Noninvasive evaluation of coronary distensibility in older adults: a feasibility study with MR angiography.
机构信息
Department of Radiology, Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611, USA.
出版信息
Radiology. 2011 Dec;261(3):771-8. doi: 10.1148/radiol.11110573. Epub 2011 Aug 26.
PURPOSE
To assess the feasibility of using magnetic resonance (MR) angiography to noninvasively measure the coronary distensibility index (CDI) in older adults.
MATERIALS AND METHODS
This study was approved by the institutional review board and was compliant with HIPAA. Informed consent was obtained from all participants. Three-dimensional MR angiography was performed in 23 patients with type 2 diabetes mellitus (DM) (mean age, 72.9 years ± 5.8 [standard deviation]; age range, 65-84 years; 12 men, 11 women) and 50 healthy aging control subjects (mean age, 73.1 years ± 5.6; age range, 64-84 years; 28 men, 22 women). Imaging data were acquired in the rest periods of cardiac motion identified during end systole and middiastole. For imaging data with different acquisition windows, cross-sectional coronary planes were reconstructed and matched for the same anatomy according to coronary landmarks. The CDI, defined as [(lumen area at systole--lumen area at diastole)/(lumen area at diastole × pulse pressure)] × 1000, was compared between patients with DM and control subjects by using the Student t test. With the same protocol, CDIs were calculated in 10 randomly selected subjects by two independent readers. In addition, MR angiography (in systole and diastole) was repeated in those 10 subjects after repositioning.
RESULTS
CDIs were measured in 43 coronary segments of patients with DM and in 124 coronary segments of control subjects. The mean CDI in patients with DM was significantly lower than that in control subjects (2.79 mm Hg(-1) ± 2.12 vs 9.14 mm Hg(-1) ± 5.87, respectively; P < .001). CDI measurements showed good intraobserver (r = 0.914), interobserver (r = 0.820), and imaging-repeat imaging agreements (r = 0.811).
CONCLUSION
Coronary MR angiography is a reproducible and repeatable noninvasive method for detecting significant differences in coronary distensibility between patients with DM and healthy aging control subjects.
目的
评估磁共振（MR）血管造影术无创测量老年患者冠状动脉扩张指数（CDI）的可行性。
材料与方法
本研究经机构审查委员会批准，并符合 HIPAA 规定。所有参与者均获得知情同意。对 23 例 2 型糖尿病（DM）患者（平均年龄 72.9 岁±5.8[标准差]；年龄范围 65-84 岁；男 12 例，女 11 例）和 50 例健康老年对照者（平均年龄 73.1 岁±5.6；年龄范围 64-84 岁；男 28 例，女 22 例）进行三维 MR 血管造影。在心脏运动末期和中末期识别的静止期采集影像数据。对于具有不同采集窗口的成像数据，根据冠状动脉标志物重建冠状动脉的冠状切面并匹配相同解剖结构。DM 患者和对照组之间的 CDI 通过学生 t 检验进行比较，定义为[(收缩期管腔面积-舒张期管腔面积)/(舒张期管腔面积×脉压)]×1000。使用相同的方案，由两位独立的读者对 10 名随机选择的受试者计算 CDI。此外，在这 10 名受试者重新定位后，对他们重复进行磁共振血管造影（收缩期和舒张期）。
结果
在 DM 患者的 43 个冠状动脉节段和对照组的 124 个冠状动脉节段中测量了 CDI。DM 患者的平均 CDI 明显低于对照组（分别为 2.79mmHg（-1）±2.12 和 9.14mmHg（-1）±5.87，P<.001）。CDI 测量值具有良好的观察者内（r=0.914）、观察者间（r=0.820）和影像学重复成像一致性（r=0.811）。
结论
冠状动脉 MR 血管造影术是一种可重复性和可重复的无创方法，可检测 DM 患者和健康老年对照组之间冠状动脉扩张性的显著差异。
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