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心脏磁共振灌注成像用于冠状动脉疾病功能评价:与冠状动脉造影和血流储备分数的比较

世界核心医学期刊文摘（心脏病学分册） 2006年第12期2卷 27-28页

作者： rieber j. Huber A. Erhard I. 郭俊 Medizinische Poliklinik der Universitt Mnchen Innenstadt Ziemssenstr. 1 80336Mnchen Germany

Aims: Cardiac magnetic resonance perfusion imaging(CMRI) is a promising technique for non-invasive measurement of myocardial perfusion reserve. Fractional flowreserve(FFR) is an established invasive method for functional assessment of coronary artery disease(CAD). To prospectively assess the diagnostic value of CMRI for the detection of haemodynamically significant coronary lesions, compared with coronary angiography(CA) and FFR. Methods and results: Forty-three patients with suspected or known CAD underwent CA, CMRI, and FFR measurement. First pass magnetic resonance perfusion examination was performed during hyperaemia(140 μg/kg/min adenosine over 6 min) and at rest. One hundred and twenty-nine perfusion territories were assessed by semi-quantitative evaluation of signal intensity-time curves using the myocardial perfusion reserve index(MPRI)[upslopestress(corrected)/ upsloperest(corrected)]. Perfusion territories were categorized as normal(coronary stenosis≤50%), intermediate(stenosis >50%and FFR >0.75), or severe(stenosis >50%and FFR≤0.75 or total occlusion). MPRI values(±SD) were significantly different between the three categories[normal, 2.2±0.5 vs. intermediate, 1.8±0.5(P=0.005) and intermediate vs. severe, 1.2±0.3(P< 0.001)]. An MPRI cut-off value of 1.5(derived from receiver operating characteristics analysis) distinguished haemodynamically relevant(severe) from non-relevant(normal and intermediate) stenoses with a sensitivity of 88%(CI 74-100%)and a specificity of 90%(CI 84-96%). Conclusion: In contrast to earlier studies that compared CMRI with morphological examination(CA) alone, the present study compared CMRI with CA plus a standard invasive functional assessment(FFR) and demonstrated that CMRI is able to distinguish haemodynamically relevant from non-relevant coronary lesions with a high sensitivity and specificity and may therefore contribute to clinical decision-making.

关键词：冠状动脉造影冠脉造影心血管造影功能评价血流储备分数心脏磁共振冠状动脉疾病灌注成像

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维普期刊数据库

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西罗莫司洗脱支架置入和β射线照射治疗支架内再狭窄病变:比较容积血管内超声所评估的急性获得和晚期丢失的潜在机制

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世界核心医学期刊文摘（心脏病学分册） 2006年第1期2卷 30-31页

作者： Schiele T. M. Knig A. rieber j. 王亭忠 Dr.Kardiologie Klinikum der Universitt München-Innenstadt Ziemssenstrasse 1 80336 Munich Germany

Background: The aim of the study was to compare the angioplasty mechanisms of drug(sirolimus)-eluting stent(DES) implantation and vascular brachytherapy(VBT) for the treatment of in-stent restenosis(ISR) as assessed by intravascular ultrasound(IVUS). Methods: We performed IVUS in 53 patients(28 DES, 25 VBT) before and after angioplasty of ISR and at 6-month follow-up. Cross-sectional areas of the external elastic membrane, the stent, and the lumen were measured. Plaque +media, peristent plaque, and intimal hyperplasia areas were calculated, respectively. Results: Clinical and IVUS baseline characteristics did not differ between groups at baseline. After the index procedure, the lumen at the stent site was smaller in the DES group(DES 6.7±2.0 mm2 vs VBT 7.5±2.2 mm2, P=.042). Because of less intimal hyperplasia(DES 0.2±0.5 mm2 vs VBT 0.7±0.7 mm2, P=.043), the lumen dimensions revealed no difference between groups at follow-up(DES 6.5±2.3 mm2 vs VBT 6.8±2.2 mm2, P=.374). At the reference site, the index procedure led to a similar increase of plaque +media(DES 0.9±0.9 mm2 vs VBT 0.6±1.2 mm2, P=.150). At follow-up, the plaque +media was significantly smaller in the DES group(DES 8.0±6.6 mm2 vs VBT 9.9±7.8 mm2, P=.013). Conclusions: Drug-eluting stent for the treatment of ISR more effectively inhibits neointima formation when compared with VBT. Yet insufficient stent expansion might be a reason for device failure and should be avoided. At the reference site, lumen loss by an increased plaque burden, as has been well recognized following VBT, is not present with DES.

关键词：支架内再狭窄病变 β射线照射治疗血管内超声支架置入西罗莫司洗脱血管成形术潜在晚期急性

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维普期刊数据库

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冠状动脉支架植入术后节段性血流储备对心脏事件的预测价值:多变量分析结果

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世界核心医学期刊文摘（心脏病学分册） 2005年第7期1卷 31-31页

作者： Klauss V. Erdin P. rieber j. 郝广华 Dr.Department of Cardiology Medizinische Poliklinik-Innenstadt University of Munich Ziemssenstrasse 1 D-80336 Munich Germany

Obj.ctive: To determine the prognostic value of fractional flow reserve(FFR) measurements after coronary stent implantation including multiple clinical and angiographic parameters collected in one centre. Methods: 119 consecutive patients were enrolled who had a stent implanted with the use of a pressure wire as a guidewire. Patients were followed up for at least six months. Any death, myocardial infarction, and target vessel revascularisation were considered maj.r adverse cardiac events(MACE). Multivariate logistic regression was used to determine adj.sted odds ratios(OR) and 95%confidence intervals(CI) for FFR and covariates. Results: Complete follow up data were available for all 119 patients. Pre-interventional FFR increased from 0.65(0.15) to 0.94(0.06)(p< 0.0001) after stent implantation. Eighteen MACE(15%) occurred during follow up including 15(12.6%) target vessel revascularisations. Final FFR was significantly higher in patients without than in patients with an event(0.95(0.05) v 0.88(0.08), p=0.001). In the multivariate logistic regression analysis, only final FFR< 0.95(OR 6.22, 95%CI 1.79 to 21.62,p=0.004) and reduced left ventricular function(OR 0.95, 95%CI 0.92 to 0.99, p=0.021) remained as significant independent predictors for MACE. Conclusion: These results including multiple parameters underline that FFR after coronary stenting is a strong and independent predictor for subsequent cardiac events after six months’follow up.

关键词：预测价值心脏事件血运重建术靶血管预后价值支架植入术随访过程多变量分析左心室功能冠状动脉支架术

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维普期刊数据库

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CT心肌动态与单次灌注成像对照研究

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国际医学放射学杂志 2014年第1期 64-65页

作者： A.M.Huber V.Leber B.M.Gramer D.Muenzel A.Leber j.rieber 戚思 Institute for diagnostic and interventional radiology Klinikumrechts der Isar der TechnischenUniversitát MünchenIsmaninger Str.2281675 MunichGermany

目的研究CT心肌动态灌注成像对于冠状动脉狭窄所致心肌血流动力学异常的诊断准确性,并与冠状动脉造影及冠状动脉血流储备分数(FFR)比较。方法本研究经伦

关键词：灌注成像心肌曲线下面积定量参数 CT 冠状动脉造影冠脉造影心血管造影

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钙化斑块:薄层平板CT和64层螺旋CT的面积测量及与组织病理学的对比

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国际医学放射学杂志 2008年第A6期31卷 505-506页

作者： A.Sarwar j.rieber E.A.Q.Mooyaart S.K.Seneviratne S.L.Houser F.Bamberg 李树荣 Cardiac MR PET CT Program Massachusetts General Hospital 165 Cambridge St 4th Floor Suite 400 Boston MA 02114.

目的本研究的目的是使用多层螺旋CT和平板容积CT对离体冠状动脉标本进行检查,以病理结果为标准,比较其钙化斑块的面积,评估两者的溢出伪影。

关键词：钙化斑块 CT 组织病理学面积测量离体心脏伦理委员会

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维普期刊数据库

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