冠状动脉磁共振血管成像和CT对可疑冠心病患者心脏事件的预测价值的比较研究

摘要 目的：探讨与比较冠状动脉核磁共振(MR)血管成像和CT对可疑冠心病患者心脏事件的预测价值。方法：2018年4月到2020年10月选择在本院诊治的103例可疑冠心病患者作为研究对象，所有患者都给予冠状动脉MRI血管成像与64层螺旋CT冠状动脉成像检查，记录影像学特征。随访患者的预后并进行预测价值分析。结果：103例可疑冠心病患者随访到2021年4月1日，发生心血管不良终点事件23例(不良事件组)，发生率为22.3%。不良事件组的MRI血管成像显示右冠状动脉血管长度与内径都低于非不良事件组(P<0.05)。不良事件组的CT显示斑块率、斑块性质等与非不良事件组对比差异有统计学意义(P<0.05)，两组斑块位置对比差异无统计学意义(P>0.05)。多因素Cox回归分析显示斑块性质、斑块率、右冠状动脉血管长度与内径都为导致心血管不良终点事件的重要因素(P<0.05)。结论：冠状动脉MRI血管成像和CT都可有效预测可疑冠心病患者心脏事件发生情况，能满足临床诊断可疑冠心病与预测预后的要求。

Comparative Study of Coronary MRI and CT in Predicting Cardiac Events in Patients with Suspected Coronary Heart Disease

ABSTRACT Objective: To explore and compare the predictive value of coronary artery magnetic resonance (MR) angiography and CT in predicting cardiac events in patients with suspected coronary heart disease. Methods: From April 2018 to October 2020, 103 cases of patients with suspected coronary heart disease diagnosed and treated in our hospital were selected as the research objects. All patients were given coronary MRI angiography and 64-CTCA examination, recorded the imaging features. Followed up the prognosis of patients and analyzed the predictive value. Results: Followed up to April 1, 2021, there were 23 cases of adverse cardiovascular endpoint events were occurred in the 103 cases(adverse event group), the incidence rates were 22.3%. MRI angiography in the adverse event group showed that the length and inner diameter of the right coronary artery were lower than those in the non-adverse event group (P<0.05). The CT of the adverse event group showed that there were statistically significant differences in plaque rate and plaque properties compared with the non-adverse event group (P<0.05). There were no statistically significant difference in the position of plaque compared between the two groups(P>0.05). Multivariate Cox regression analysis showed that the nature of plaque, the rate of plaque, the length and inner diameter of the right coronary artery were all important factors leaded to adverse cardiovascular end points(P<0.05). Conclusion: Both coronary MRI angiography and CT can effectively predict the occurrence of cardiac events in patients with suspected coronary heart disease, and can meet the requirements of clinical diagnosis of suspected coronary heart disease and prediction of prognosis.