磁共振评价模型猪心肌缺血的ROC曲线分析

 目的 针对多种心脏MR检查方法进行不同组合联用，评价各种方法对慢性缺血心肌的检出率，探寻适合临床运用的最优组合。方法 选择左旋支放置Ameroid环制作慢性心肌缺血模型猪成功者13只。以冠状动脉造影结果及病理电镜组织学为标准，缺血心肌节段的检出分别采用单纯静息心脏电影(Cine)、静息首过灌注(FPrest)、负荷首过灌注(FPstress)、延迟增强(DE-MR)、静息负荷双期灌注(FP-dual-phase)、静息心脏电影+负荷灌注(Cine+FPstress) 多种评价方法。分别在不同方法下对各心肌节段诊断的确定性评分，用于ROC曲线分析。结果 各检查中以Cine+FPstress组合的灵敏度、特异度及曲线下面积均最大，分别为0.903、0.887和0.9273，与其他各组间差异存在统计学意义（P<0.05）。结论 静息电影联合负荷心肌灌注扫描检测心肌缺血的准确性最高，适用于临床，尤其对疑似冠心病的患者检出有帮助。

The ROC analysis of MR imaging techniques in evaluating myocardial ischemia of pigs

Objective To evaluate the myocardial ischemia using the combination of multiple cardiac magnetic resonance(MR) imaging techniques in the chronic myocardial ischemia model of pigs.The aim was to find an optimum set for clinical use. Methods Chronic myocardial ischemic animal model of 13 pigs was established successfully by setting the Ameroid contract ring in left circumflex coronary.The imaging diagnosis methods involved rest cine alone,rest or/and stress myocardial perfusion imaging,DE-MRI alone and rest cine binding stress myocardial perfusion imaging.The results of coronary angiography and histopathology were used as the reference standard of myocardial ischemia.The score of various protocols in detecting myocardial ischemia was recorded to ROC curve. Results In analysis of myocardial ischemia(78/208),rest cine combined with stress first-pass perfusion MR imaging yielded the highest sensitivity of 90.3%,specificity of 88.7%,and accuracy of 92.7% among all methods with statistical significance. Conclusions Rest cine combined with stress first-pass perfusion MR imaging is fit for clinical routine with high accuracy in detecting myocardial ischemia,specially for suspected coronary artery disease(CAD) patients.