目的 评价32通道线圈高并行采集加速3.0 T MR对比增强全心冠状动脉成像(CECMRA)技术的临床应用价值.方法 对拟诊冠心病的60例患者进行32通道线圈3.0 T CE CMRA检查,成像采用心电门控、呼吸导航、扰相位梯度回波序列,加用非选择性反转回波抑制心肌信号,TT为200 ms.以全心覆盖和并行采集方式获取图像数据.增强扫描采用钆贝葡胺(Gd-BOPTA,0.15 mmoL/kg)慢速静脉注射(0.3 ml/s).以X线冠状动脉造影结果作为参考标准,采用四格表χ2检验,评价CE CMRA诊断冠状动脉≥50%狭窄的诊断准确性.结果 60例患者中56例成功完成3.0 T CE CMRA,平均扫描时间为(6.0±1.3)min.CE CMRA在28例患者正确检出至少1个有意义狭窄,其诊断敏感性为93.3%.在26例CAG除外冠心病的患者中,CMRA正确排除了23例,其诊断特异性为88.5%.结论 应用32通道相控阵线圈行高并行采集加速3.0 T CE CMRA检查,可以在减少对比剂用量的同时缩短扫描时间,提高诊断准确性.
Objective To evaluate the diagnostic accuracy of 3.0 T contrast enhanced (CE) whole heart coronary MRA ( CE MRA ) using 32-channel coils with high acceleration factor. Methods Sixty patients with suspected coronary artery disease who were scheduled for coronary angiography (CAG)underwent CE CMRA at 3.0 T MRI scanner. A 32-channel receiver coil was used for data acquisition. For image acquisition, an ECG-triggered, navigator-gated, inversion-recovery prepared, segmented gradient-echo sequence was used with an acceleration factor of three in the phase-encoding direction using GRAPPA reconstruction. Gd-BOPTA (0.15 mmol/kg body weight) was intravenously administered at a rate of 0. 3 ml/s. The diagnostic accuracy in detecting significant stenoses ( ≥50% of vessel lumen) was evaluated using χ2 test with X-ray angiography as the reference. Results Whole-heart CE CMRA was successfully completed in 56 patients who were scheduled for CAG. The averaged imaging time was ( 6. 0 ± 1.3 ) min.3.0 T CE CMRA using 32 channel coils correctly identified significant CAD in 28 patients and correctly ruled out CAD in 23 patients. The sensitivity and specificity were 93. 3% and 88.5% respectively.Conclusion Combined with dedicated 32-channel coils, 3.0 T CE CMRA allows significant reduction in imaging speed and reduced dose of the contrast agent. These improvements resulted in substantially improved overall accuracy of CE CMRA in detecting coronary artery disease.