采用心脏磁共振灌注法评估冠状动脉疾病中的心肌缺血：与导管或CT血管造影结果的比较。

Evaluation of myocardial ischemia in coronary artery disease with cardiac MR perfusion method: comparison with the results of catheter or CT angiography.

作者信息

Sait Doğan Mehmet, Yılmaz Erkan, Doğan Sümeyra, Akdeniz Bahri, Barış Nezihi, Teomete Uygar, Iyilikçi Leyla

机构信息

Radiology Clinic, Mardin State Hospital, Mardin, 2Department of Radiology, Dokuz Eylül University School of Medicine, İzmir, 3Radiol- ogy Clinic, Mardin Women's and Children's Hospital, Mardin, 4Department of Cardiology, Dokuz Eylül University School of Medicine, İzmir, Turkey, 5Department of Radiology, University of Miami Miller School of Medicine, Miami/Florida, USA, 6Department of Anesthesi- ology and Reanimation, Dokuz Eylül University School of Medicine, İzmir, Turkey.

出版信息

Med Glas (Zenica). 2013 Feb;10(1):63-9.

PMID:23348164

Abstract

AIM

To evaluate the efficacy of the Cardiac Magnetic Resonance Perfusion (CMRP) method in detection of Coronary Artery Disease (CAD) by comparing CMRP findings with the results of Coronary Computed Tomography Angiography (CCTA) or Catheter Coronary Angiography (CCA).

METHODS

Thirty one patients in whom CMRP was performed along with CCTA or CCA within a month after CMRP between December 2009 and November 2010 were selected for the study. In CMRP, after adenosine administration as a stress agent Balanced TFE sequences were used to gather dynamic images that include the myocardial first pass of contrast media. Image analysis was performed visually. CMRP findings were compared to CCTA or CCA results for each coronary artery territories and for all territories.

RESULTS

Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CMRP test in the identification of patients with significant (≥70%) coronary artery stenosis were 94.7%, 83%, 90.3%, 90%, and 90.9% for all coronary arteries, respectively; 94.4%, 84.6%, 90.3%, 89.4%, and 91.6% for left anterior descending artery, respectively; and 100%, 100%, 100%, 100%, and 100% for circumflex and right coronary artery, respectively. There was no statistically significant difference between angiography methods (CCTA/CCA) and CMRP (p>0.05). Methods had good to perfect consistency (ĸ = 0.79-1.00).

CONCLUSION

CMRP test seems to be a reasonable alternative for catheter angiography, which is considered the gold standard for evaluation of CAD and exclusion of significant coronary artery obstruction.

摘要

目的

通过比较心脏磁共振灌注（CMRP）检查结果与冠状动脉计算机断层扫描血管造影（CCTA）或导管冠状动脉造影（CCA）的结果，评估CMRP方法在检测冠状动脉疾病（CAD）中的疗效。

方法

选取2009年12月至2010年11月期间在CMRP检查后1个月内同时进行CCTA或CCA检查的31例患者进行研究。在CMRP检查中，使用腺苷作为应激剂，之后采用平衡式快速场回波序列采集动态图像，包括造影剂首次通过心肌的图像。进行视觉图像分析。将CMRP检查结果与每支冠状动脉区域及所有区域的CCTA或CCA结果进行比较。

结果

CMRP检查在识别显著（≥70%）冠状动脉狭窄患者时，对所有冠状动脉的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为94.7%、83%、90.3%、90%和90.9%；对左前降支的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为94.4%、84.6%、90.3%、89.4%和91.6%；对回旋支和右冠状动脉的敏感性、特异性、准确性、阳性预测值和阴性预测值均为100%。血管造影方法（CCTA/CCA）与CMRP之间无统计学显著差异（p>0.05）。两种方法具有良好至完美的一致性（ĸ = 0.79 - 1.00）。