Evaluation of Dural Arteriovenous Fistulas with 4D Contrast-Enhanced MR Angiography at 3T
Evaluation of Dural Arteriovenous Fistulas with 4D Contrast-Enhanced MR Angiography at 3T
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DOI：
10.3174/ajnr.a1898
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发表时间：
2010-01-01
影响因子：
3.5
通讯作者：
Yamashita, Y.
中科院分区：
文献类型：
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作者：
Nishimura, S.;Hirai, T.;Yamashita, Y.
背景和目的：3T 四维对比增强磁共振血管造影 (4D-CE-MRA) 可以取代数字减影血管造影 (DSA)，用于颅内硬脑膜动静脉瘘 (DAVF) 患者的某些诊断目的。本研究的目的是检验以下假设：3T 下的 4D-CE-MRA 能够与 DSA 一样表征颅内 DAVF。 材料和方法：研究人群由 18 名连续颅内 DAVF 患者组成（11 名女性，7 名男性；年龄范围为 35-82 岁；平均年龄为 64.8 岁）。他们在 3T 和 DSA 下接受了 4D-CF-MRA。 4D-CE-MRA 系列结合了随机分段中心 k 空间排序、锁孔成像、灵敏度编码和半傅立叶成像。我们每 1.9 秒获得 30 次动态扫描，空间分辨率为 1 X 1 X 1.5 毫米。两位独立读者审查了主要动脉供血系统、瘘管部位和静脉引流的 4D-CE-MRA 图像。通过 kappa 统计评估观察者间和多方式一致性。结果：DSA 时，8 个瘘管位于横西格莫德窦； 8、海绵窦处； 2，在枕骨大孔附近的窦处。观察者间的一致性对于主要动脉供血系统来说是公平的（kappa = 0.59），对于瘘管部位来说是非常好的（kappa = 0.91），对于静脉引流来说是良好的（kappa = 0.86）。主要动脉供血系统的多模式一致性为中等（kappa = 0.68），而瘘管部位（kappa = 1.0）和静脉引流（kappa = 1.0）的一致性非常好。结论：就瘘管部位和静脉引流而言，4D-CE-MRA 和 DSA 结果之间的一致性为良好到极好。
BACKGROUND AND PURPOSE: Four-dimensional contrast-enhanced MR angiography (4D-CE-MRA) at 3T may replace digital subtraction angrography (DSA) for certain diagnostic purposes in patients with intracranial dural arteriovenous fistula (DAVF). The aim of this study was to test the hypothesis that 4D-CE-MRA at 3T enables the same characterization of intracranial DAVFs as DSA.MATERIALS AND METHODS: The study population consisted of 18 consecutive patients with intracranial DAVFs (11 women, 7 men; age range, 35-82 years; mean age, 64.8 years). They underwent 4D-CF-MRA at 3T and DSA. The 4D-CE-MRA series combined randomly segmented central k-space ordering, keyhole imaging, sensitivity encoding, and half-Fourier imaging. We obtained 30 dynamic scans every 1.9 seconds with a spatial resolution of 1 X 1 X 1.5 mm. Two independent readers reviewed the 4D-CE-MRA images for main arterial feeders, fistula site, and venous drainage. Interobserver and intermodality agreement was assessed by kappa statistics.RESULTS: At DSA, 8 fistulas were located at the transverse sigmord sinus; 8, at the cavernous sinus; and 2, at the sinus adjacent to the foramen magnum. Interobserver agreement was fair for the main arterial feeders (kappa = 0.59), excellent for the fistula site (kappa = 0.91), and good for venous drainage (kappa = 0,86). Intermodality agreement was moderate for the main arterial feeders (kappa = 0.68) and excellent for the fistula site (kappa = 1.0) and venous drainage (kappa = 1.0).CONCLUSIONS: The agreement between 4D-CE-MRA and DSA findings was good to excellent with respect to the fistula site and venous drainage.