Objective To compare the detective ability of 3. OT whole heart contrast enhanced coronary magnetic resonance angiography (CE-CMRA) and conventional coronary angiography (CAG) for coronary artery diseases (CAD) , and to explore the clinical application feasibility of 3. OT CE-CMRA. Methods CE-CMRA and CAG were performed within one week in 30 patients with suspected CAD. Successful CE-CMRA was obtained in 26 patients, ECG-gated, respiratory gating, inversion recovery sequences and segmented gradient echo sequence techniques were used. MultiHance (0. 2 ml/kg) and 15 ml saline were injected in sequence with speed of 0. 3 ml/s. After 60 s' delay, the images were collected. The diagnostic sensitivity, specificity and accuracy of CE-CMRA in detecting stenosis were evaluated using X-ray angiography as the reference. Kappa consistency test was used to evaluate the consistency of two methods. Results The accuracy of CE-CMRA for the patients, segments and blood vessels was 84. 62% (22/26), 78. 30% (285/364) and 87. 50% (56/64), respectively) while the positive predictive value was 81.82% (9/11), 81.05% (124/153) and 91.67% (22/24), respectively, the negative predictive value was 89. 47% (17/19), 80.62% (208/258) and 90. 32% (56/62), respectively. CE-CMRA could display 86. 15% (112/130) of the right coronary artery, 100% of the left main artery (26/26), 98. 46% (128/130) of the anterior descending artery and 83. 33% (65/78) of the circumflex artery. IV quality grading images were obtained in 17 patients, while IE in 8 and II in 1 patient. Conclusion 3. 0T CE-CMRA can provide qualified images, and can be used as a method for detecting CAD.%目的 比较3.0T磁共振全心对比增强冠状动脉成像(CE-CMRA)与传统冠状动脉造影(CAG)对可疑冠心病(CAD)检出的能力,探讨临床应用3.0T CE-CMRA的可行性.方法 对30例可疑CAD患者在1周内先后行CAG和CE-CMRA检查.CE-CMRA检查应用心电门控、呼吸门控、反转回复序列、分段梯度回波序列,以0.3 ml/s速率注入钆贝酸二葡甲胺(0.2 ml/kg)和15 ml生理盐水,延迟60 s开始采集数据.以传统CAG为金标准,计算CE-CMRA的诊断敏感度,特异度和准确率.应用Kappa一致性检验评价两种检查方法的一致性.结果 成功完成26例CE-CMRA检查,CE-CMRA诊断CAD患者、段落、各支血管的准确率分别为84.62％ (22/26)、78.30％ (285/364)、87.50％ (56/64),阳性预测值分别为81.82％(9/11)、81.05％ (124/153)、91.67％(22/24),阴性预测值分别为89.47％ (17/19)、80.62％ (208/258)、90.32％(56/62).CE-CMRA对右冠状动脉的显示率为86.15％(112/130);左主干100％ (26/26);前降支98.46％(128/130);回旋支83.33％(65/78).26例CE-CMRA中,17例图像为Ⅳ级,8例为Ⅲ级图像,1例为Ⅱ级图像,无0级和Ⅰ级图像.结论 3.0T CE-CMRA的图像质量符合诊断要求,可作为检出CAD的一种方法.
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