Duerinckx A J, Atkinson D, Hurwitz R
Radiology Service, VA Medical Center, West Los Angeles, CA 90073, USA.
J Magn Reson Imaging. 1998 Jul-Aug;8(4):896-902. doi: 10.1002/jmri.1880080420.
The ability to noninvasively assess the patency of coronary stents would represent a significant advance. We evaluated the safety and ability of two-dimensional coronary MR angiography in imaging stents and suggesting patency. Coronary MR angiography of 26 coronary stents (Palmaz-Schatz) was performed in 16 patients 39 to 73 years of age. Studies were performed between 2 and 4 months after stent placement. All patients were symptom free at the time of imaging. Coronary MR angiography was performed with a commercial 1.5-T MR imager using an electrocardiographically gated pulse sequence with breath-holding. Images were obtained in mid-diastole with and without fat suppression. Image artifacts caused by the metal in the stents were clearly visualized in all 26 stents (100% sensitivity for stent detection). Arterial flow signal was seen in the coronary artery or graft distal to the stent in 25 of 26 cases (96%). All patients, except for the one in which distal flow could not be seen, remained symptom free for >2 years. The distribution of stent locations was as follows: 10 in the right coronary artery (RCA), 10 in the left anterior descending coronary artery (LAD), 2 in the left circumflex coronary artery, and 4 in saphenous vein grafts (SVGs) to RCA. One patient had 2 RCA and 2 LAD stents, one had 3 RCA and 1 LAD stents, one had 3 SVG stents, and two had double RCA stents. Coronary MR angiography is safe for noninvasive imaging of coronary stents, and in the proper clinical setting, it can be used to help suggest patency.
非侵入性评估冠状动脉支架通畅性的能力将是一项重大进展。我们评估了二维冠状动脉磁共振血管造影在成像支架及提示通畅性方面的安全性和能力。对16例年龄在39至73岁之间的患者进行了26个冠状动脉支架(Palmaz-Schatz支架)的冠状动脉磁共振血管造影检查。研究在支架置入后2至4个月进行。所有患者在成像时均无症状。使用商用1.5-T磁共振成像仪,采用心电图门控屏气脉冲序列进行冠状动脉磁共振血管造影。在舒张中期采集有和没有脂肪抑制的图像。在所有26个支架中均清晰可见由支架内金属引起的图像伪影(支架检测的敏感性为100%)。26例中有25例(96%)在支架远端的冠状动脉或移植物中可见动脉血流信号。除1例未见远端血流的患者外,所有患者均保持无症状状态超过2年。支架位置分布如下:右冠状动脉(RCA)10个,左前降支冠状动脉(LAD)10个,左旋支冠状动脉2个,大隐静脉移植至RCA的血管(SVG)4个。1例患者有2个RCA和2个LAD支架,1例有3个RCA和1个LAD支架,1例有3个SVG支架,2例有双RCA支架。冠状动脉磁共振血管造影对于冠状动脉支架的非侵入性成像是安全的,在适当的临床环境中,可用于帮助提示通畅性。