Three-Dimensional Imaging of Pulmonary Veins by a Novel Steady-State Free-Precession Magnetic Resonance Angiography Technique Without the Use of Intravenous Contrast Agent Initial Experience
Three-Dimensional Imaging of Pulmonary Veins by a Novel Steady-State Free-Precession Magnetic Resonance Angiography Technique Without the Use of Intravenous Contrast Agent Initial Experience
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DOI：
10.1097/rli.0b013e3181a7c6cb
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发表时间：
2009-08-01
影响因子：
6.7
通讯作者：
Ruehm, Stefan
中科院分区：
文献类型：
--
作者：
Krishnam, Mayil S.;Tomasian, Anderanik;Ruehm, Stefan
目的：评价非选择性射频激励下三维稳态自由进动（SSFP）磁共振血管造影（MRA）在不静脉注射螯合钆的情况下成像肺静脉（PVS）的可行性，并将结果与常规对比增强MRA （CE-MRA）进行对比分析。材料和方法：连续40例有房颤病史的患者接受了自由呼吸呼吸导航门控心电图触发的无造影剂的SSFP MRA和传统的高分辨率3D胸腔CE-MRA，时间为1.5 t。两名读者评估了两个数据集的血管清晰度（从0，不可见，到3，清晰）、伪影和口径。采用Wilcoxon、配对t检验和kappa系数进行统计学分析。结果：在SSFP MRA上，读者1和2分别评价96.4%（160/166）和97%（161/166）的片段具有诊断可视性和清晰度（k = 0.82）。在CE-MRA数据集上，所有片段都被两个阅读器评为具有诊断可见性和清晰度（k = 0.86）。各阅读器数据集之间肺静脉段的可视性和清晰度差异无统计学意义（P[r] 0.05）。读者1(2)分别在SSFP和CE-MRA数据集上识别了27（28）和35（32）个运动伪影。CE-MRA和SSFP数据组的口径差异无统计学意义（P < 0.05）。结论：我们的研究表明，非切片选择性SSFP MRA在没有静脉造影剂的情况下3D描绘pv是可行的。这种新的MRA技术可用于某些心房颤动患者，在射频消融前评估通向左心房的PV口的数量和大小。
Purpose: To evaluate the feasibility of 3-dimensional (3D) steady-state free-precession (SSFP) magnetic resonance angiography (MRA) using nonselective radiofirequency excitation for imaging of pulmonary veins (PVS) without intravenous gadolinium chelate and to correlate the results with conventional contrast-enhanced MRA (CE-MRA).Material and Methods: Forty consecutive patients with history of atrial fibrillation underwent free-breathing respiratory navigator-gated electrocardiogram-triggered SSFP MRA without contrast administration and conventional high-resolution 3D CE-MRA of the thorax at 1.5 T. Two readers assessed both datasets for vascular definition (from 0, not visualized, to 3, excellent definition), artifacts, and ostial diameters. Statistical analysis was performed using Wilcoxon, paired t test, and kappa coefficient.Results: On SSFP MRA, readers 1 and 2 graded 96.4% (160/166) and 97% (161/166) of the segments as having diagnostic visibility and sharpness, respectively (k = 0.82). On CE-MRA datasets, all segments were graded as having diagnostic visibility and sharpness by both readers (k = 0.86). No significant difference existed for visibility and sharpness of pulmonary venous segments between the datasets for each reader (P[r] > 0.05). Reader 1 (2) identified 27 (28) and 35 (32) motion artifacts on SSFP and CE-MRA datasets, respectively. No significant difference was found to exist between ostial diameters on CE-MRA and SSFP datasets (P > 0.05).Conclusion: Our study shows that 3D depiction of PVs without intravenous contrast is feasible with nonslice-selective SSFP MRA. This novel MRA technique may be used in certain patients with atrial fibrillation to assess the number and size of PV ostia draining to the left atrium prior to radiofirequency ablation.