3D nongadolinium-enhanced ECG-gated MRA of the distal lower extremities: Preliminary clinical experience
3D nongadolinium-enhanced ECG-gated MRA of the distal lower extremities: Preliminary clinical experience
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DOI：
10.1002/jmri.21416
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发表时间：
2008-07-01
影响因子：
4.4
通讯作者：
Lee, Vivian S.
中科院分区：
文献类型：
--
作者：
Lim, Ruth P.;Hecht, Elizabeth M.;Lee, Vivian S.
目的：报告我们的初步经验，实施非对比增强心电图（ECG）门控快速自旋回波磁共振血管造影（MRA）技术评估的小腿arteries.Materials和方法：非对比MRA图像的36例临床患者检查了6个月的时间内，由两个放射科医生的长度和程度的动脉段的硬化进行了评价。该技术的诊断信心也被记录下来。参考标准是一个共识阅读由两个放射科医师使用的非造影技术结合两个钆增强techniques：团注追踪和时间分辨imaging.Results：对于狭窄评价的非造影技术表现出准确性79.4%（1083/1364），敏感性85.4%（437/512），特异性75.8%（646/852）。该序列具有较高的阴性预测值（92.3%，646/700）。该技术存在严重伪影，导致17名患者（47.2%）的诊断信心较差。这些包括序列特有的运动（n = 7）和伪影，包括不准确的触发延迟（n = 5）、线性伪影（n = 7）和血管模糊（n = 5）。当仅考虑具有满意诊断信心的患者时，准确性、敏感性和阴性预测值分别为92.2%（661/717）、92.4%（158/171）和97.5%（503/516）。我们的研究结果表明，当技术上成功时，使用ECG门控快速自旋回波的非对比增强MRA可以提供小腿和足动脉的准确成像。然而，需要进一步的开发和优化，以提高该技术的鲁棒性。
Purpose: To report our initial experience implementing a noncontrast-enhanced electrocardiograph (ECG) gated fast spin echo magnetic resonance angiography (MRA) technique for assessment of the calf arteries.Materials and Methods: Noncontrast MRA images of 36 clinical patients examined over a 6-month period were evaluated by two radiologists for length and degree of sterrosis of arterial segments. Diagnostic confidence In the technique was also recorded. The reference standard was a consensus reading by both radiologists using the noncontrast technique combined with two gadolinium-enhanced techniques: bolus-chase and time-resolved imaging.Results: For stenosis evaluation the noncontrast technique demonstrated accuracy 79.4% (1083/1364), sensitivity 85.4% (437/512), and specificity 75.8% (646/852). The sequence demonstrated high negative predictive value (92.3%, 646/700). The technique had serious artifacts leading to poor diagnostic confidence in 17 patients (47.2%). These included motion (n = 7) and artifacts specific to the sequence, including inaccurate trigger delays (n = 5), linear artifact (n = 7), and vessel blurring (n = 5). When only patients in whom there was satisfactory diagnostic confidence were considered, accuracy, sensitivity, and negative predictive value were 92.2% (661/717), 92.4% (158/171), and 97.5% (503/516), respectively.Conclusion: Our results indicate that when technically successful, noncontrast-enhanced MRA using ECG-gated fast spin echo can provide accurate imaging of the calf and pedal arteries. However, further development and optimization are needed to improve the robustness of the technique.