MULTICENTER TRIAL TO EVALUATE VASCULAR MAGNETIC-RESONANCE ANGIOGRAPHY OF THE LOWER-EXTREMITY
MULTICENTER TRIAL TO EVALUATE VASCULAR MAGNETIC-RESONANCE ANGIOGRAPHY OF THE LOWER-EXTREMITY
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DOI：
10.1001/jama.274.11.875
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发表时间：
1995-09-20
影响因子：
120.7
通讯作者：
MCNEIL, BJ
中科院分区：
文献类型：
--
作者：
BAUM, RA;RUTTER, CM;MCNEIL, BJ
目标。评估磁共振血管造影（MRA）在严重下肢动脉粥样硬化闭塞症患者术前评估中的价值，并评估快速进行严格技术评估的可行性。对具有严重腹股沟下外周血管疾病体征或症状的连续患者进行了盲法前瞻性研究，这些患者是经皮或手术干预的候选人，使用描述性统计和多变量logistic分析，将MRA与造影剂动脉造影（CA）（当前技术）进行比较，以成像腿部和足部的15个动脉节段。术中造影是“金”标准。还研究了将MRA添加到计划治疗中使用的信息的效果。六家美国医院一家社区医院病人共有155例; 84%伴有静息痛或组织损失。CA和MRA区分未闭节段和完全闭塞节段的敏感性分别为83%和85%，两者的特异性均为81%，对于区分接近正常节段（适合作为旁路移植物末端），CA的敏感性低于MRA（77%比82%），但特异性更高（92%比84%）。在调整了同一读者的影响后，MRA正确区分专利段的几率是CA的1.6倍（P
Objectives.-To assess the value of magnetic resonance angiography (MRA) in presurgical evaluation of patients with severe lower limb atherosclerotic occlusive disease and to assess the feasibility of rapidly conducting rigorous technology assessment.Design.-Blinded, prospective study of consecutive patients with signs or symptoms of severe infrainguinal peripheral vascular disease who were candidates for percutaneous or surgical intervention, Using both descriptive statistics and multivariate logistic analyses, MRA was compared with contrast arteriography (CA) (the current technique) for imaging 15 arterial segments of the leg and foot. Intraoperative contrast angiography was the ''gold'' standard. Also studied was the effect of adding MRA to the information used in planning treatment.Setting.-Six US hospitals, one a community hospital.Patients.-A total of 155; 84% with either rest pain or tissue loss.Results.-Sensitivity in distinguishing patent segments from completely occluded segments was 83% for CA and 85% for MRA; both had 81% specificity, For distinguishing near-normal segments (suitable as bypass graft termini), CA was less sensitive than MRA (77% vs 82%), but more specific (92% vs 84%). After adjusting for same-reader effects, odds of correctly distinguishing patent segments were 1.6 times as great for MRA as for CA (P