Cardiovascular magnetic resonance imaging of aorto-iliac and ilio-femoral vascular calcifications using proton density-weighted in-phase stack of stars
Cardiovascular magnetic resonance imaging of aorto-iliac and ilio-femoral vascular calcifications using proton density-weighted in-phase stack of stars
复制标题
DOI：
10.1186/s12968-018-0479-2
复制
发表时间：
2018-08-06
影响因子：
6.4
通讯作者：
Edelman, Robert R.
中科院分区：
文献类型：
--
作者：
Serhal, Ali;Koktzoglou, Ioannis;Edelman, Robert R.
背景：比较心血管磁共振（CMR）血管造影与计算机断层血管造影（CTA），其主要缺陷是无法可靠地成像周围血管钙化，这可能影响介入策略的选择和患者预后。最近，磁共振成像使用质子密度加权，同相叠星（PDIP-SOS）技术已被证明能够检测这些钙化。本研究的目的有两个：(1)确定磁场强度是否影响髂-股动脉钙化的表观大小和显著性；(2)确定该技术能否准确应用于主动脉-髂动脉钙化成像。主体：研究了两组患者。在第一组中，20名患者在1.5特斯拉时进行髂-股动脉钙化成像，12名患者在3特斯拉时进行成像。在第二队列中，10名患者在3 Tesla和1名患者在1.5 Tesla下进行主动脉-髂动脉钙化成像。以CTA为参考标准，采用半自动化技术进行定性图像分析和定量分析。定性地说，大多数PDIP-SOS CMR图像对血管钙化的检测具有良好到优异的置信度，读取器间一致性良好到优异（髂-股区域kappa = 0.67, P < 0.001；主动脉-髂区域kappa = 0.80, P < 0.01）。PDIP-SOS CMR和CTA测量两个区域的钙化体积之间总体上有极好的相关性（r = 0.98, P < 0.001）和一致性（类内相关系数= 0.97,P < 0.001），在1.5特斯拉和3特斯拉时，髂股钙化的表现没有明显差异。CMR的病变体积略低于CTA。结论：应用PDIP-SOS CMR，可在不到6分钟的时间内同时评估主动脉-髂和髂-股钙化，与CTA具有良好的相关性和一致性。我们的研究结果表明，PDIP-SOS CMR为介入前评估周围血管钙负荷提供了一种可靠的替代CT方法。
Background: Comparing cardiovascular magnetic resonance (CMR) angiography with computed tomography angiography (CTA), a major deficiency has been its inability to reliably image peripheral vascular calcifications that may impact the choice of interventional strategy and influence patient prognosis. Recently, MRI using a proton density-weighted, in-phase stack of stars (PDIP-SOS) technique has proved capable of detecting these calcifications. The goal of the present study was two-fold: (1) to determine whether magnetic field strength impacts the apparent size and conspicuity of ilio-femoral arterial calcifications; and (2) to determine whether the technique can be accurately applied to image aorto-iliac arterial calcifications.Main body: Two patient cohorts were studied. For the first cohort, ilio-femoral arterial calcifications were imaged at 1.5 Tesla in 20 patients and at 3 Tesla in 12 patients. For the second cohort, aorto-iliac arterial calcifications were imaged in 10 patients at 3 Tesla and one patient at 1.5 Tesla. Qualitative image analysis as well as quantitative analysis using a semi-automated technique were performed using CTA as the reference standard.Qualitatively, most PDIP-SOS CMR images showed good-to-excellent confidence to detect vascular calcifications, with good-to-excellent inter-reader agreement (kappa = 0.67 for ilio-femoral region, P < 0.001; kappa = 0.80 for aorto-iliac region, P < 0.01). There was an overall excellent correlation (r = 0.98, P < 0.001) and agreement (intraclass correlation coefficient = 0.97, P < 0.001) between PDIP-SOS CMR and CTA measures of calcification volume in both regions, with no overt difference in performance at 1.5 Tesla vs. 3 Tesla for ilio-femoral calcifications. CMR lesion volumes were slightly lower than those measured for CTA.Conclusion: Using PDIP-SOS CMR, aorto-iliac and ilio-femoral calcifications could be simultaneously evaluated at 3 Tesla in less than six minutes with excellent correlation and agreement to CTA. Our results suggest that PDIP-SOS CMR provides a reliable alternative to CT for pre-interventional evaluation of peripheral vascular calcium burden.