Acceleration-selective arterial spin labeling MR angiography for visualization of brain arteriovenous malformations
Acceleration-selective arterial spin labeling MR angiography for visualization of brain arteriovenous malformations
复制标题
加速选择性动脉自旋标记磁共振血管造影用于脑动静脉畸形的可视化
DOI：
10.1007/s00234-019-02217-w
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发表时间：
2019
期刊：
影响因子：
2.8
通讯作者：
H. Honda
中科院分区：
文献类型：
--
作者：
O. Togao;A. Hiwatashi;K. Yamashita;D. Momosaka;M. Obara;A. Nishimura;K. Arimura;N. Hata;K. Iihara;M. Van Cauteren;H. Honda
目的评价加速度选择性动脉自旋标记（AccASL）磁共振血管造影（MRA）与数字减影血管造影（DSA）和飞行时间（TOF）磁共振血管造影（MRA）在显示脑动静脉畸形（AVM）中的性能。方法21例脑AVM患者（平均年龄31.1 ± 18.6岁;男11例，女10例）行TOF和AccASL磁共振血管造影和DSA检查。两名神经放射科医生进行了一项观察员研究，包括检测、病灶大小、功能、静脉引流模式和Spetzler-Martin（SM）分级。评价包括参照DSA对每个AVM组件进行可视化，并评估对比度噪声比（CNR）。Kappa统计量，重复测量方差分析，Wilcoxon配对检验，配对t检验used. ResultsTwo观察员检测到更多的AVM与AccASL（95.2%，90.5%观察员1和2）比TOF（76.2%和71.4%，分别）。AccASL和DSA之间的模态间一致性对于观察者1的功能、静脉引流模式和SM等级几乎是完美的，对于观察者2的静脉引流模式是中度的，对于功能和SM等级是实质性的。对于供血动脉（AccASL，4.5 ± 1.0 vs. TOF，3.9 ± 1.5，p = 0.0214）、病灶（4.6 ± 1.1 vs. 3.2 ± 1.5，p = 0.0006）和引流静脉（4.6 ± 1.0 vs. 2.2 ± 1.1，p < 0.0001），AccASL的可视化评分分别高于TOF。AccASL组病灶CNRs明显高于TOF组（29.9 ± 16.7 vs. 20.8 ± 16.5，p = 0.0002），与引流静脉相同（23.2 ± 13.0对比12.6 ± 12.0，p = 0.0010），结论与TOF相比，AccASL能更好地显示脑AVM，并且在不使用造影剂的情况下可用于分级。
PurposeTo evaluate the performance of acceleration-selective arterial spin labeling (AccASL) MR angiography in the visualization of brain arteriovenous malformations (AVMs) in comparison with digital subtraction angiography (DSA) and time-of-flight (TOF) MR angiography.MethodsTwenty-one patients with brain AVM (mean age 31.1 ± 18.6 years; 11 males, 10 females) underwent TOF and AccASL MR angiography and DSA. Two neuroradiologists conducted an observer study for detection, nidus size, eloquence, venous drainage pattern, and Spetzler-Martin (SM) grade. The evaluations included the visualization of each AVM component with reference to DSA and assessments of contrast-to-noise ratio (CNR). The kappa statistic, repeated measures analysis of variance, Wilcoxon matched pairs test, and paired t test were used.ResultsBoth observers detected more AVMs with AccASL (95.2%, 90.5% for Observers 1 and 2) than with TOF (76.2% and 71.4%, respectively). The inter-modality agreement between AccASL and DSA was almost perfect for the eloquence, venous drainage pattern, and SM grade for Observer 1 and moderate for the venous drainage pattern and substantial for the eloquence and SM grade for Observer 2. The visualization scores were higher with AccASL than with TOF for the feeding artery (AccASL, 4.5 ± 1.0 vs. TOF, 3.9 ± 1.5, p = 0.0214), nidus (4.6 ± 1.1 vs. 3.2 ± 1.5, p = 0.0006), and draining vein (4.6 ± 1.0 vs. 2.2 ± 1.1, p < 0.0001), respectively. The CNRs in the nidus were higher in AccASL than in TOF (29.9 ± 16.7 vs. 20.8 ± 16.5, p = 0.0002), as in the draining vein (23.2 ± 13.0 vs. 12.6 ± 12.0, p = 0.0010), respectively.ConclusionsAccASL better visualized brain AVMs compared with TOF and was useful for grading without the use of contrast agents.