Comparison of Nonenhanced MR Angiographic Subtraction Techniques for Infragenual Arteries at 1.5 T: A Preliminary Study-猫眼课题宝

DOI：

10.1148/radiol.12120859

发表时间：

2013-04-01

期刊：

RADIOLOGY

影响因子：

19.7

通讯作者：

中科院分区：

医学1区

文献类型：

作者：

Lim, Ruth P.;Fan, Zhaoyang;Lee, Vivian S.

目的：评价三种非增强方法：可变重聚焦翻转角度快速自旋回波磁共振血管成像(可变重聚焦快速自旋回波磁共振血管成像)和恒定重聚焦快速自旋回波磁共振血管成像(恒定重聚焦快速自旋回波磁共振血管成像)和流动敏感去相法(FSD)制备的稳态自由进动磁共振血管成像(FSD MR)对小腿动脉的诊断性能。21例患者(男13例，女8例；平均年龄62.6岁)行1.5T小腿站可变FA MR、恒定FA MR和FSD MR检查，并以Gd增强MR为参照。图像质量和狭窄严重程度由两名放射科医生在不了解临床数据的情况下对每条腿的13个节段进行评估。同时行Constant-FA MR和FSD MR联合读数。结果：在546个动脉节段中，148个动脉节段(27.1%)存在明显的血流动力学狭窄(<50%)。所有平扫MR序列的图像质量均令人满意。FSD MR明显优于其他两种序列(P&lt；0.0001)，视野缩小5 cm；9.6%可变FA MR、9.6%恒定FA MR和0%FSD MR节段评估的非诊断性图像质量评分，主要来自高舒张期血流(可变FA MR)和运动伪影(恒定FA MR)。FSD MR的狭窄敏感性和特异性分别为80.3%和81.7%，高于恒定FA MR(72.3%，P=.086)和可变FA MR(75.9%，P=.54)和可变FA MR(75.6%，P=.22)。联合应用Constant-FA MR和FSD MR的敏感性(81.8%)和特异性(88.3%)均高于Constant-FA MR(P=0.0076)、Variable-FA MR(P=0.0044)和FSD MR(P=0.0013)。所有序列的阴性预测值(NPV)均为：93.2%，Constant-FA MR；94.7%，Variable-FA MR；91.7%，FSD MR；以及92.9%，Constant-FA MR和FSD MR。结论：在1.5T时，所有平扫MR血管成像方法对血流动力学显著狭窄的图像质量和NPV均令人满意。(C)RSNA，2013年

Purpose: To evaluate diagnostic performance of three nonenhanced methods: variable-refocusing-flip angle (FA) fast spin-echo (SE)-based magnetic resonance (MR) angiography (variable FA MR) and constant-refocusing-FA fast SE-based MR angiography (constant-FA MR) and flow-sensitive dephasing (FSD)-prepared steady-state free precession MR angiography (FSD MR) for calf arteries, with dual-injection three-station contrast material-enhanced MR angiography (gadolinium-enhanced MR) as reference.Materials and Methods: This prospective study was institutional review board approved and HIPAA compliant, with informed consent. Twenty-one patients (13 men, eight women; mean age, 62.6 years) underwent calf-station variable-FA MR, constant-FA MR, and FSD MR at 1.5 T, with gadolinium-enhanced MR as reference. Image quality and stenosis severity were assessed in 13 segments per leg by two radiologists blinded to clinical data. Combined constant-FA MR and FSD MR reading was also performed. Methods were compared (logistic regression for correlated data) for diagnostic accuracy.Results: Of 546 arterial segments, 148 (27.1%) had a hemodynamically significant (>= 50%) stenosis. Image quality was satisfactory for all nonenhanced MR sequences. FSD MR was significantly superior to both other sequences (P < .0001), with 5-cm smaller field of view; 9.6% variable-FA MR, 9.6% constant-FA MR, and 0% FSD MR segmental evaluations had nondiagnostic image quality scores, mainly from high diastolic flow (variable-FA MR) and motion artifact (constant-FA MR). Stenosis sensitivity and specificity were highest for FSD MR (80.3% and 81.7%, respectively), compared with those for constant-FA MR (72.3%, P = .086; and 81.8%, P = .96) and variable-FA MR (75.9%, P = .54; and 75.6%, P = .22). Combined constant-FA MR and FSD MR had superior sensitivity (81.8%) and specificity (88.3%) compared with constant-FA MR (P = .0076), variable-FA MR (P = .0044), and FSD MR (P = .0013). All sequences had an excellent negative predictive value (NPV): 93.2%, constant-FA MR; 94.7%, variable-FA MR; 91.7%, FSD MR; and 92.9%, combined constant-FA MR and FSD MR.Conclusion: At 1.5 T, all evaluated nonenhanced MR angiographic methods demonstrated satisfactory image quality and excellent NPV for hemodynamically significant stenosis. (C)RSNA, 2013

Comparison of Nonenhanced MR Angiographic Subtraction Techniques for Infragenual Arteries at 1.5 T: A Preliminary Study

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