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【medical-news】动态MRA诊断先心病
动态MRA诊断先心病
Improved imaging and therapeutic options have resulted in more congenital heart problems being diagnosed than in the past. Researchers in Germany believe they have found an easy, reliable way to deliver functional information in adult patients with complex congenital heart disease -- MRI.
Specifically, time-resolved contrast-enhanced MR angiography (MRA) of the thorax readily diagnoses adults with congenital heart disease quickly and reliably, according to Dr. Oliver Mohrs from Alice Hospital in Darmstadt, Germany; Dr. Steffen Petersen from the University of Oxford in the U.K., Dr. Thomas Voigtlaender from Cardiovascular Center Bethanien in Frankfurt, Germany; and colleagues.
随着影像学技术和治疗技术的发展，先心病诊断较过去明显增多。德国科学家认为他们找到了快速、可靠的成年人复杂先心病功能成像的新方法-MRI。根据德国爱丽丝医院 Oliver Mohrs博士，英国牛津大学Steffen Petersen博士和德国弗兰克发北山尼心血管中心Thomas Voigtlaender博士的介绍，动态增强MR血管成像能够可靠快速的诊断先心病。
For many patients who underwent surgical correction during childhood for congenital heart defects and have since reached adulthood, "the complex anatomy is not fully known, surgical reports are unavailable, and patients are lost to follow-up," the authors wrote.
对于幼儿时期因先心病进行手术的大部分病人，应经达到成年。著者注意到：“他们的心血管解剖结构复杂，无法获得手术记录，而且能够给他们提供信息的父母也应经过世。”
"During adolescence, nonspecific clinical symptoms such as dyspnea, fatigue, or arrhythmias may develop. In contrast to neonates and children, in whom a wealth of information can be rapidly gained by echocardiography, older patients need a different diagnostic technique to reveal the underlying and surgical anatomy" (American Journal of Roentgenology, October 2006, Vol. 187, pp. 1107-1114).
青年时期，不典型临床表现包括喘憋，无力，心律不齐。新生儿和儿童通过超声心动就可以获得大量的信息，但在与成年病人，需要一种不同的技术显示解剖及手术后改变。
MRI's utility is well-established for both diagnostic and functional imaging, though keeping imaging time to a minimum requires knowing the underlying diagnosis before specific functional tests are conducted, the authors wrote. Time-resolved contrast-enhanced MRA, which combines tomographic and projection imaging methods, is a fast way to obtain the maximum information very quickly during a single procedure.
MRI在诊断和功能成像方面已经很成熟，但是为了缩短检查时间，检查前就需要有明确的目的。动态增强MRA结合特殊的成像技术，可以一个步骤就可以快速获得最大程度的信息量。
The study sought to evaluate the diagnostic accuracy of time-resolved contrast-enhanced MRA of the thorax in adult patients with known or suspected complex congenital heart disease.
本研究主要是为了评价动态增强MRA评价成年人可疑或者确诊先心病的准确性
The researchers examined 20 patients (mean age, 38 ?14 years; range, 16-73 years) with congenital heart disease who underwent contrast-enhanced turbo fast low-angle shot MRA. The radiologists acquired 30 consecutive coronal 3D slabs with a one-second frame rate; the mask (first dataset) was subtracted from subsequent images.
研究20例病人（平均年龄38±14岁，范围16-73岁），进行动态增强快速小角度脉冲MRA，以1秒的时间窗获得30的连续冠状3D的动态，所有的图像同第一幅蒙片相减。
Image quality was evaluated on a five-point scale (1, not assessable; 5, excellent image quality), and the images were examined for 12 diagnostic parameters. Each parameter yielded one point for correct diagnosis, summarized into three categories including anatomy of the main thoracic vessels, sequential cardiac anatomy, and shunt detection.
图像质量采用5点评价法（1，很差，5，非常好），根据12个参数评价图像。每个图像对于正确诊断都有1分的贡献，总共分成三类：主要血管的解剖，心脏动态结构变化，血管分流的检测。
The results were compared with a combined clinical reference comprising medical or surgical reports and other imaging studies, all of which served as the reference standard.
参考标准包括临床及手术资料和其他影像学检查资料。
The results showed a mean image quality of 3.7 ± 1.0, the authors wrote, and 220 of 240 (92%) of the single diagnostic parameters could be analyzed using a binary approach.
结果显示平均图像质量未3.7 ± 1.0，92%的参数可以进行分析。
"The percentage of maximum diagnostic points, the sensitivity, the specificity, and the positive and the negative predictive values were all 100% for the anatomy of the main thoracic vessels; 97%, 87%, 100%, 100%, and 96% for sequential cardiac anatomy; and 93%, 93%, 92%, 88%, and 96% for shunt detection," Mohrs and his study team wrote.
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作者:admin@医学,生命科学 2010-11-03 05:11
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