Diagnostic accuracy and efficiency of combined acquisition of low-dose time-resolved and single-phase high-resolution contrast-enhanced magnetic resonance angiography in a single session for pre-angiographic evaluation of spinal vascular disease
Diagnostic accuracy and efficiency of combined acquisition of low-dose time-resolved and single-phase high-resolution contrast-enhanced magnetic resonance angiography in a single session for pre-angiographic evaluation of spinal vascular disease
复制标题
单次低剂量时间分辨和单相高分辨率对比增强磁共振血管造影联合采集用于脊髓血管疾病血管造影前评估的诊断准确性和效率
DOI：
10.1371/journal.pone.0214289
复制
发表时间：
2019
期刊：
影响因子：
3.7
通讯作者：
B. Kim
中科院分区：
文献类型：
--
作者：
Jae Ho Shin;Yangsean Choi;B. Park;N. Shin;J. Jang;H. Choi;S. Jung;K. Ahn;B. Kim
背景/目的本研究的目的是评估组合低剂量、时间分辨（TR）和单相高分辨率（HR）对比增强MRA（CE-MRA）作为脊髓血管疾病的血管造影前研究的实用性和有效性。材料和方法 对 17 名连续疑似脊髓血管疾病的患者进行回顾性分析。所有患者均接受低剂量 TR CE-MRA 和 3 特斯拉三维单相 HR CE-MRA 联合检查，然后在 90 天内进行常规脊柱数字减影血管造影 (DSA)。六名患者接受了额外的脊柱 MRA 和 DSA 治疗随访。根据存在、疾病类型、偏侧性、脊柱水平和动脉供血管数量对脊柱病变进行分析。结果低剂量TR CE-MRA有助于对两名高或低病变水平患者进行后续HR CE-MRA的正确定位。对于脊髓血管疾病的初步检测，CE-MRA 的敏感性、特异性和准确性分别为 93.3% (n = 14/15)、100% (n = 3/3) 和 94.4% (n = 17/18)。在硬脑膜动静脉瘘 (AVF)、髓周 AVF、脊髓动静脉畸形 (AVM) 和椎管外 AVM 的表征中，CE-MRA 在阳性结果中正确表征了 86.7% (n = 13/15)，在包括阴性结果的几例患者中正确表征了 88.9% (n = 16/18)。 CE-MRA 显示 80% (n = 12/15) 的动脉供血动脉定位在 1 个椎骨水平内匹配，每个病变定位匹配 78.3% (n = 18/23)。结论低剂量 TR CE-MRA 和 3 特斯拉单相 HR CE-MRA 组合是一种有效且准确的单次血管造影前评估脊髓血管疾病的无创工具。
Background/Purpose The purpose of this study was to evaluate the utility and efficacy of combined low-dose, time-resolved (TR) and single-phase high-resolution (HR) contrast-enhanced MRA (CE-MRA) as a pre-angiographic study for spinal vascular disease. Materials and methods Seventeen consecutive patients with suspected spinal vascular disease were retrospectively reviewed. All patients underwent combined low-dose TR CE-MRA and three-dimensional single-phase HR CE-MRA at 3 Tesla, followed by conventional spinal digital subtraction angiography (DSA) within 90 days. Six patients underwent additional spinal MRA and DSA for treatment follow-up. Spinal lesions were analyzed in terms of presence, disease type, laterality, spinal level, and number of arterial feeders. Results Low-dose TR CE-MRA helped proper localization of subsequent HR CE-MRA in two patients with high or low level of the lesion. For initial detection of spinal vascular disease, sensitivity, specificity and accuracy of CE-MRA were 93.3% (n = 14/15), 100% (n = 3/3), and 94.4% (n = 17/18), respectively. In characterization of dural arteriovenous fistula (AVF), perimedullary AVF, spinal cord arteriovenous malformation (AVM), and extraspinal AVM, CE-MRA correctly characterized in 86.7% (n = 13/15) among the positive findings, and in 88.9% (n = 16/18) among the several patients including negative results. CE-MRA showed matched per-case localization of arterial feeders within 1 vertebral level in 80% (n = 12/15), and matched per-lesion localization in 78.3% (n = 18/23). Conclusion Combined low-dose TR CE-MRA and single-phase HR CE-MRA at 3 Tesla was an effective and accurate non-invasive tool for the pre-angiographic evaluation of spinal vascular diseases in a single session.