Biomedical and Metabolic Imaging Branch, The National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
Magn Reson Imaging. 2013 Sep;31(7):1051-8. doi: 10.1016/j.mri.2013.03.011. Epub 2013 May 1.
The purpose of this study was to (a) investigate the image quality of phase-sensitive dual-inversion recovery (PS-DIR) coronary wall imaging in healthy subjects and in subjects with known coronary artery disease (CAD) and to (b) investigate the utilization of PS-DIR at 3T in the assessment of coronary artery thickening in subjects with asymptomatic but variable degrees of CAD.
A total of 37 subjects participated in this institutional review board-approved and HIPAA-compliant study. These included 21 subjects with known CAD as identified on multidetector computed tomography angiography (MDCT). Sixteen healthy subjects without known history of CAD were included. All subjects were scanned using free-breathing PS-DIR magnetic resonance imaging (MRI) for the assessment of coronary wall thickness at 3T. Lumen-tissue contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR) and quantitative vessel parameters including lumen area and wall thickness were measured. Statistical analyses were performed.
PS-DIR was successfully completed in 76% of patients and in 88% of the healthy subjects. Phase-sensitive signed-magnitude reconstruction, compared to modulus-magnitude images, significantly improved lumen-tissue CNR in healthy subjects (26.73±11.95 vs. 14.65±9.57, P<.001) and in patients (21.45±7.61 vs. 16.65±5.85, P<.001). There was no difference in image CNR and SNR between groups. In arterial segments free of plaques, coronary wall was thicker in patients in comparison to healthy subjects (1.74±0.27 mm vs. 1.17±0.14 mm, P<.001), without a change in lumen area (4.51±2.42 mm2 vs. 5.71±3.11mm2, P=.25).
This is the first study to demonstrate the feasibility of successfully obtaining vessel wall images at 3T using PS-DIR in asymptomatic patients with known variable degrees of CAD as detected by MDCT. This was achieved with a fixed subject-invariant planning of blood signal nulling. With that limitation alleviated, PS-DIR coronary wall MRI is capable of detecting arterial thickening and positive arterial remodeling at 3T in asymptomatic CAD.
本研究旨在：(a) 研究相位敏感双反转恢复（PS-DIR）冠状动脉壁成像在健康受试者和已知冠心病（CAD）患者中的图像质量；(b) 研究 PS-DIR 在评估无症状但 CAD 程度不同的患者冠状动脉增厚中的应用。
共有 37 名受试者参加了这项经机构审查委员会批准和 HIPAA 合规的研究。其中 21 名受试者为多排计算机断层血管造影术（MDCT）证实的已知 CAD。纳入 16 名无已知 CAD 病史的健康受试者。所有受试者均采用自由呼吸 PS-DIR 磁共振成像（MRI）在 3T 下评估冠状动脉壁厚度。测量管腔-组织对比噪声比（CNR）、信号噪声比（SNR）和定量血管参数，包括管腔面积和壁厚度。进行了统计分析。
PS-DIR 在 76%的患者和 88%的健康受试者中成功完成。与模绝对值图像相比，相位敏感符号幅度重建显著提高了健康受试者（26.73±11.95 比 14.65±9.57，P<.001）和患者（21.45±7.61 比 16.65±5.85，P<.001）的管腔-组织 CNR。两组间图像 CNR 和 SNR 无差异。在无斑块的动脉节段中，与健康受试者相比，患者的冠状动脉壁更厚（1.74±0.27mm 比 1.17±0.14mm，P<.001），但管腔面积无变化（4.51±2.42mm2 比 5.71±3.11mm2，P=.25）。
这是第一项研究，证明了在通过 MDCT 检测到的无症状、已知 CAD 程度不同的患者中，使用 PS-DIR 在 3T 成功获得血管壁图像的可行性。这是通过对固定的、与受试者无关的血液信号消零进行规划来实现的。消除了这一限制，PS-DIR 冠状动脉壁 MRI 能够在无症状 CAD 中在 3T 下检测到动脉增厚和阳性动脉重构。
