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目的评估导航回波自由呼吸状态下3D高分辨率MR心肌延迟强化成像(delayed enhancement MRI,DE-MRI)检测心肌梗死灶的优势。资料与方法将40例经临床及单光子计算机体层扫描(SPECT)确诊的心肌缺血患者纳入本研究,同时分别接受导航回波触发自由呼吸与屏气采集两种3D高分辨率DE-MRI。采用统计学方法对比分析两组图像的质量评分、心肌梗死范围及对比噪声比(CNR)。结果 40例患者中35例受检者的数据采集获得成功,占87.5%。导航的平均效率为(38±6)%,自由呼吸下数据的平均采集时间为(340±52)s(267～445 s)。自由呼吸与屏气采集图像的质量评分分别为2.3±0.8、1.9±1.0(P=0.14);心肌梗死区的体积分别为(614.8±742.8)mm3、(652.2±774.9)mm3(P=0.012);CNR为21.4±12.7、19.9±12.8(P=0.169)。线性回归分析显示两种采集方式心肌梗死体积具有非常好的相关性(r2=0.997)。结论导航回波自由呼吸DE-MRI能获得较好的图像质量、更清晰的心肌梗死范围,同时具有进一步提高空间分辨率的潜力。
Objective To assess the advantage of myocardial infarct size in 3D high resolution MR myocardial delayed enhanced MRI (DE-MRI) under free breathing of navigation echo. Materials and Methods 40 cases of myocardial ischemia diagnosed by clinical and single-photon computed tomography (SPECT) were included in this study. Two types of 3D high-resolution DE-MRI triggered by navigator echo triggered breath-hold and breath-hold were also included. Statistical analysis was used to compare the quality scores of the two groups of images, infarct size and contrast-to-noise ratio (CNR). Results Data acquisition of 35 subjects in 40 patients was successful, accounting for 87.5%. The average navigation efficiency was (38 ± 6)%, and the average acquisition time under free breath was (340 ± 52) s (267 to 445 s). The scores of free breath and breath hold images were 2.3 ± 0.8 and 1.9 ± 1.0 respectively (P = 0.14). The volume of myocardial infarction area were (614.8 ± 742.8) mm3 and (652.2 ± 774.9) mm3 respectively (P = 0.012) CNR was 21.4 ± 12.7, 19.9 ± 12.8 (P = 0.169). Linear regression analysis showed a very good correlation between the two acquisition volumes for myocardial infarction (r2 = 0.997). Conclusions Navigator-echo free-breathing DE-MRI can achieve better image quality and a more clear range of myocardial infarction, and has the potential to further improve the spatial resolution.