在冠状动脉疾病中通过2D/4D流量和Cine MRI或平面化度测量大动脉硬度:一项病例对照研究
Lan-Anh Nguyen1, Sophia Houriez-Gombaud-Saintonge2, Etienne Puymirat1,3
1Université Paris Cité, PARCC, INSERM, F-75015 Paris, France.
Journal of clinical medicine
|June 10, 2023
概括
四维 (4D) 流动MRI通过测量大动脉硬度来准确识别冠状动脉疾病 (CAD) 患者. 这种先进的成像技术显示出优越的诊断性能,与评估高风险个体大动脉硬性的其他方法相比.
科学领域:
- 心血管成像 - 心血管成像
- 生物医学工程 生物医学工程
- 诊断医学 诊断医学
背景情况:
- 大动脉硬是心血管健康的关键指标.
- 传统的方法,如平面度和二维相对比 (PC) MRI,在评估大动脉硬性方面存在局限性,特别是在心血管疾病患者中.
- 4D流MRI是评估大动脉生物力学的一个新兴技术.
研究的目的:
- 在患有高风险冠状动脉疾病 (CAD) 的患者中,使用平面化度和各种MRI技术研究大动脉硬度测量的诊断价值.
- 为了比较4D流动MRI,2DPCMRI和平面化度仪在识别严重稳定的CAD方面的性能.
主要方法:
- 预期招募35名多血管CAD和心肌梗塞患者,与18名健康对照人群相比.
- 使用MRI测量上升性大动脉延伸性,大动脉的二维脉冲波速度 (PWV) 和四维PWV.
- 在MRI后立即通过平面化度测量关节至关节的PWV (cf PWV).
主要成果:
- 虽然大动脉张力没有显著差异,但cf PWV,2D PWV和4D PWV在CAD患者中与对照组相比显著增加 (p < 0.001).
- 接收机操作特征 (ROC) 分析显示,4D PWV (0.97) 的曲线下面积 (AUC) 是最高的,这表明诊断能力优越.
- 在12.9m/s的最佳4DPWV值下,在区分CAD患者中实现了88.6%的灵敏度和94.4%的特异性.
结论:
- 四维 (4D) 流量MRI衍生的PWV在将严重稳定的CAD患者与对照患者区分开来时表现出最高的诊断性能.
- 4D流MRI是高风险CAD人群中大动脉硬性的非侵入性评估的一个有前途的工具.
- 这种技术在诊断准确性方面超过了2D流MRI PWV,cf PWV和大动脉延伸性,用于严重的CAD检测.
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