Kessler W, Achenbach S, Moshage W, Zink D, Ropers D, Kroeker R, Nitz W, Laub G, Bachmann K
Medizinische Klinik II, Universität Erlangen-Nürnberg.
Z Kardiol. 1998 Feb;87(2):119-27. doi: 10.1007/s003920050163.
Respiratory gated MR coronary angiography is a new MR imaging technique which permits reconstruction of the coronary arteries from a three-dimensional data set obtained from contiguous parallel sections. In this study, respiratory gated MR angiography was applied to assess significant coronary artery stenoses (> or = 50%). MR imaging was performed in 68 patients (50 men, 18 women) who had been referred to cardiac catheterization because of suspected or known coronary artery disease. The evaluation of coronary artery stenoses was performed in a blinded manner in the proximal, middle, and distal vessel segments after multiplanar coronary reconstruction of the MR images. Of the 680 coronary segments, 275 (40%) were located outside the imaging volume and were, therefore, excluded from further analysis. The highest sensitivity for stenosis detection was found in the proximal left anterior descending (LAD) and right coronary artery (RCA) with 75% and 71%, respectively. The overall sensitivity, however, was low with 48%. The overall specificity was 92%. The positive and negative predictive values were 67% and 85%, respectively. This study shows that significant coronary artery stenoses, especially in the proximal LAD and RCA, can be correctly identified using respiratory gated MR angiography. However, further technical improvements are necessary before this method may become a reliable diagnostic tool in clinical practice.
呼吸门控磁共振冠状动脉造影是一种新的磁共振成像技术,它可以从连续平行层面获取的三维数据集中重建冠状动脉。在本研究中,应用呼吸门控磁共振血管造影来评估显著的冠状动脉狭窄(≥50%)。对68例因疑似或已知冠状动脉疾病而转诊至心脏导管检查的患者(50例男性,18例女性)进行了磁共振成像检查。在对磁共振图像进行多平面冠状动脉重建后,以盲法对冠状动脉近端、中段和远端节段的狭窄情况进行评估。在680个冠状动脉节段中,275个(40%)位于成像容积之外,因此被排除在进一步分析之外。在左前降支(LAD)近端和右冠状动脉(RCA)中发现的狭窄检测敏感性最高,分别为75%和71%。然而,总体敏感性较低,为48%。总体特异性为92%。阳性和阴性预测值分别为67%和85%。本研究表明,使用呼吸门控磁共振血管造影可以正确识别显著的冠状动脉狭窄,尤其是在LAD近端和RCA。然而,在该方法成为临床实践中可靠的诊断工具之前,还需要进一步的技术改进。