Free-Breathing Fast Low-Angle Shot Quiescent-Interval Slice-Selective Magnetic Resonance Angiography for Improved Detection of Vascular Stenoses in the Pelvis and Abdomen: Technical Development.
Free-Breathing Fast Low-Angle Shot Quiescent-Interval Slice-Selective Magnetic Resonance Angiography for Improved Detection of Vascular Stenoses in the Pelvis and Abdomen: Technical Development.
复制标题
自由呼吸快速低角度拍摄静态间隔切片选择性磁共振血管造影用于改进骨盆和腹部血管狭窄的检测：技术开发。
DOI：
10.1097/rli.0000000000000592
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发表时间：
2019
影响因子：
6.7
通讯作者：
Edelman,RobertR
中科院分区：
文献类型：
--
作者：
Varga-Szemes,Akos;Aherne,EmilyA;Schoepf,UJoseph;Todoran,ThomasM;Koktzoglou,Ioannis;Edelman,RobertR
目的平衡稳态自由旋进静止间隔选择性切片（bSSFP QISS）磁共振血管造影（MRA）对于外周动脉疾病（PAD）的非造影评价是准确的;然而，缺点包括在腹部和骨盆成像时需要屏气，以及对非共振伪影敏感。本研究的目的是评价基于自由呼吸快速小角度激发的QISS在骨盆和腹部的图像质量和诊断准确性比较FLASH QISS技术与bSSFP QISS技术在PAD患者中的应用，以CT血管造影作为参考。（69±10岁，17名男性）PAD患者在2018年4月至12月期间入组了这项机构审查委员会批准的符合健康保险携带和责任法案的前瞻性研究。患者在3 T下使用标准bSSFP QISS和原型自由呼吸桡动脉FLASH和Cartesian-FLASH QISS进行非造影MRA。一部分患者（n= 22）还接受了计算机断层扫描血管造影术作为参考标准。评价了每例患者横跨腹部、骨盆和大腿上部区域的9个动脉节段。客观（信号强度比和相对标准差）和主观图像质量（4分制）和狭窄（> 50%）进行了评价，由2个读者和比较，使用单向方差分析，Wilcoxon，和McNemar测试，resultsA共179血管段可用于分析所有QISS技术。bSSFP、Radial-FLASH和Cartesian-FLASH QISS技术之间的信号强度比（P= 0.428）和相对标准差（P= 0.220）无显著差异。Radial-FLASH QISS显示了最佳的图像质量（P< 0.0001）和最高的阅片员间一致性（κ= 0.721）。bSSFP、Radial-FLASH和Cartesian-FLASH QISS检测大于50%狭窄的灵敏度值分别为76.0%、84.0%和80.0%，而特异性值分别为97.6%、94.0%和92.8%。此外，FLASH QISS一贯减少off-resonance伪影相比bSSFP QISS. ConclusionsFree呼吸FLASH QISS MRA技术提供了更好的图像质量和灵敏度，高特异性，并减少了非共振伪影的血管狭窄检测在腹部和骨盆。
ObjectivesBalanced steady-state free precession-based quiescent-interval slice-selective (bSSFP QISS) magnetic resonance angiography (MRA) is accurate for the noncontrast evaluation of peripheral arterial disease (PAD); however, drawbacks include the need for breath-holding when imaging the abdomen and pelvis, and sensitivity to off-resonance artifacts. The purpose of this study was to evaluate the image quality and diagnostic accuracy in the pelvis and abdomen of free-breathing fast low-angle shot-based QISS (FLASH QISS) techniques in comparison to bSSFP QISS in patients with PAD, using computed tomographic angiography as the reference.Materials and MethodsTwenty-seven patients (69±10 years, 17 men) with PAD were enrolled in this institutional review board–approved, Health Insurance Portability and Accountability Act–compliant prospective study between April and December 2018. Patients underwent noncontrast MRA using standard bSSFP QISS and prototype free-breathing radial-FLASH and Cartesian-FLASH QISS at 3 T. A subset of patients (n= 22) also underwent computed tomographic angiography as the reference standard. Nine arterial segments per patient were evaluated spanning the abdomen, pelvis, and upper thigh regions. Objective (signal intensity ratio and relative standard deviation) and subjective image quality (4-point scale) and stenosis (> 50%) were evaluated by 2 readers and compared using one-way analysis of variance, Wilcoxon, and McNemar tests, respectively.ResultsA total of 179 vascular segments were available for analysis by all QISS techniques. No significant difference was observed among bSSFP, radial-FLASH, and Cartesian-FLASH QISS techniques in signal intensity ratio (P= 0.428) and relative standard deviation (P= 0.220). Radial-FLASH QISS demonstrated the best image quality (P< 0.0001) and the highest interreader agreement (κ= 0.721). The sensitivity values of bSSFP, radial-FLASH, and Cartesian-FLASH QISS for the detection of greater than 50% stenosis were 76.0%, 84.0%, and 80.0%, respectively, whereas specificity values were 97.6%, 94.0%, and 92.8%, respectively. Moreover, FLASH QISS consistently reduced off-resonance artifacts compared with bSSFP QISS.ConclusionsFree-breathing FLASH QISS MRA techniques provide improved image quality and sensitivity, high specificity, and reduced off-resonance artifacts for vascular stenosis detection in the abdomen and pelvis.