Image quality and diagnostic accuracy of unenhanced SSFP MR angiography compared with conventional contrast-enhanced MR angiography for the assessment of thoracic aortic diseases.
Image quality and diagnostic accuracy of unenhanced SSFP MR angiography compared with conventional contrast-enhanced MR angiography for the assessment of thoracic aortic diseases.
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DOI：
10.1007/s00330-009-1672-3
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发表时间：
2010-06
影响因子：
5.9
通讯作者：
Ruehm SG
中科院分区：
文献类型：
--
作者：
Krishnam MS;Tomasian A;Malik S;Desphande V;Laub G;Ruehm SG
本研究的目的是确定三维（3D）非增强稳态自由进动（SSFP）磁共振血管造影（MRA）评估胸主动脉疾病的图像质量和诊断准确性。连续50例已知或疑似胸主动脉疾病的患者在1.5 T时进行了自由呼吸心电图门控的非增强SSFP MRA，并进行了非选择性射频激发和对比增强（CE） MRA。两位读者独立评估了这两个数据集在主动脉根部、升主动脉、主动脉弓、降主动脉和主动脉上动脉起源的图像质量，以及异常发现。测定两个数据集的信噪比（SNR）和噪声对比比（CNR）。确定非增强SSFP MRA诊断主动脉异常的敏感性、特异性和诊断准确性。在这两个数据集上都可以自信地检测到异常的主动脉发现，包括动脉瘤（n = 47）、缩窄（n = 14）、夹层（n = 12）、主动脉移植（n = 6）、壁内血肿（n = 11）、主动脉弓壁上血栓（n = 1）和穿透性主动脉溃疡（n = 9）。以CE-MRA作为参考标准，SSFP MRA检测主动脉疾病的敏感性、特异性和诊断准确性均为100%。主动脉根部在SSFP MRA上的图像质量显著高于主动脉根部（P < 0.001），而其他主动脉段的图像质量差异无统计学意义（P < 0.05）。SSFP MRA各节段的SNR和CNR值均较高（P < 0.01）。我们的研究结果表明，自由呼吸导航门控的非选择性射频激发3D SSFP MRA是一种很有前途的技术，可以提供高图像质量和诊断准确性，无需静脉注射造影剂来评估胸主动脉疾病。
The purpose of this study was to determine the image quality and diagnostic accuracy of three-dimensional (3D) unenhanced steady state free precession (SSFP) magnetic resonance angiography (MRA) for the evaluation of thoracic aortic diseases. Fifty consecutive patients with known or suspected thoracic aortic disease underwent free-breathing ECG-gated unenhanced SSFP MRA with non-selective radiofrequency excitation and contrast-enhanced (CE) MRA of the thorax at 1.5 T. Two readers independently evaluated the two datasets for image quality in the aortic root, ascending aorta, aortic arch, descending aorta, and origins of supra-aortic arteries, and for abnormal findings. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were determined for both datasets. Sensitivity, specificity, and diagnostic accuracy of unenhanced SSFP MRA for the diagnosis of aortic abnormalities were determined. Abnormal aortic findings, including aneurysm (n = 47), coarctation (n = 14), dissection (n = 12), aortic graft (n = 6), intramural hematoma (n = 11), mural thrombus in the aortic arch (n = 1), and penetrating aortic ulcer (n = 9), were confidently detected on both datasets. Sensitivity, specificity, and diagnostic accuracy of SSFP MRA for the detection of aortic disease were 100% with CE-MRA serving as a reference standard. Image quality of the aortic root was significantly higher on SSFP MRA (P < 0.001) with no significant difference for other aortic segments (P > 0.05). SNR and CNR values were higher for all segments on SSFP MRA (P < 0.01). Our results suggest that free-breathing navigator-gated 3D SSFP MRA with non-selective radiofrequency excitation is a promising technique that provides high image quality and diagnostic accuracy for the assessment of thoracic aortic disease without the need for intravenous contrast material.
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影响因子：
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