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Imágenes por resonancia magnética dependientes del nivel de oxígeno en la sangre en pacientes con angina inducida por
Matthias G Friedrich1, Thoralf Niendorf, Jeanette Schulz-Menger
1Helios-Klinikum Berlin, Franz-Volhard-Klinik, Kardiologie Charité Campus Berlin-Buch, Medizinische Fakultaet der Humboldt-Universitaet Berlin, Germany. friedrich@fvk-berlin.de
Circulation
|October 15, 2003
Resumen
La resonancia magnética dependiente del nivel de oxígeno en la sangre (BOLD) puede detectar isquemia miocárdica en pacientes con sospecha de enfermedad arterial coronaria. Esta técnica es prometedora para la identificación de estenosis coronarias graves que causan angina inducida por el estrés.
Área de la Ciencia:
- Imágenes cardiovasculares por imágenes.
- Diagnóstico médico Diagnóstico médico
- Fisiología Fisiología Fisiología.
Sus antecedentes:
- La resonancia magnética dependiente del nivel de oxígeno en la sangre (BOLD) evalúa la oxigenación del tejido.
- La resonancia magnética en negrita puede ayudar a detectar isquemia miocárdica en pacientes con sospecha de enfermedad arterial coronaria.
Objetivo del estudio:
- Evaluar la utilidad de la resonancia magnética BOLD inducida por adenosina en la identificación de la isquemia miocárdica.
- Para correlacionar los hallazgos de resonancia magnética BOLD con angiografía coronaria y SPECT en pacientes con angina de pecho inducida por el estrés.
Principales métodos:
- Se utilizó una secuencia de imágenes planas de eco sensible a T2* en 25 pacientes con angina inducida por el estrés.
- La resonancia magnética BOLD se realizó antes y durante la administración de adenosina.
- Los resultados se compararon con la angiografía cuantitativa y la tomografía computarizada por emisión de un solo fotón de adenosina y talio (SPECT).
Principales resultados:
- Se observó una disminución media de la intensidad de la señal en segmentos miocárdicos con estenosis coronarias >75% durante la adenosina.
- La resonancia magnética BOLD demostró una sensibilidad del 88% y una especificidad del 47% para clasificar estenosis graves.
- La correlación con SPECT mostró una variabilidad sustancial.
Conclusiones:
- La resonancia magnética con adenosina BOLD detecta eficazmente la isquemia miocárdica en segmentos asociados con estenosis coronarias severas.
- Otras mejoras en la cobertura espacial y la calidad de la imagen podrían mejorar su potencial de diagnóstico.
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