Willmann Jurgen K, Wildermuth Simon, Pfammatter Thomas, Roos Justus E, Seifert Burkhardt, Hilfiker Paul R, Marincek Borut, Weishaupt Dominik
Institute of Diagnostic Radiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.
Radiology. 2003 Mar;226(3):798-811. doi: 10.1148/radiol.2271020014. Epub 2003 Jan 31.
To compare contrast material-enhanced three-dimensional (3D) magnetic resonance (MR) angiography and multi-detector row computed tomographic (CT) angiography in the same patients for assessment of the aortoiliac and renal arteries, with digital subtraction angiography (DSA) as the standard of reference.
DSA, 3D MR angiography, and multi-detector row CT angiography were performed in 46 consecutive patients. A total of 769 arterial segments were analyzed for arterial stenosis by using a four-point grading system. Aneurysmal changes were noted. The time required for performing 3D reconstructions and image analysis of both MR and CT data sets was measured. Patient acceptance for each modality was assessed with a visual analogue scale. Statistical analysis of data was performed.
Sensitivity of MR angiography for detection of hemodynamically significant arterial stenosis was 92% for reader 1 and 93% for reader 2, and specificity was 100% and 99%, respectively. Sensitivity of CT angiography was 91% for reader 1 and 92% for reader 2, and specificity was 99% and 99%, respectively. Differences between the two modalities were not significant. Interobserver and intermodality agreement was excellent (kappa = 0.88-0.90). The time for performance of 3D reconstruction and image analysis of CT data sets was significantly longer than that for MR data sets (P <.001). Patient acceptance was best for CT angiography (P =.016).
There is no statistically significant difference between 3D MR angiography and multi-detector row CT angiography in the detection of hemodynamically significant arterial stenosis of the aortoiliac and renal arteries.
在同一组患者中比较对比剂增强三维（3D）磁共振（MR）血管造影和多排螺旋计算机断层扫描（CT）血管造影对腹主动脉-髂动脉及肾动脉的评估效果，以数字减影血管造影（DSA）作为参考标准。
对46例连续患者进行了DSA、3D MR血管造影和多排螺旋CT血管造影检查。采用四点分级系统对总共769个动脉节段的动脉狭窄情况进行分析，并记录动脉瘤样改变。测量了对MR和CT数据集进行3D重建及图像分析所需的时间。采用视觉模拟评分法评估患者对每种检查方式的接受程度。对数据进行统计学分析。
MR血管造影检测血流动力学意义上显著动脉狭窄的敏感度，读者1为92%，读者2为93%；特异度分别为100%和99%。CT血管造影的敏感度，读者1为91%，读者2为92%；特异度分别为99%和99%。两种检查方式之间的差异无统计学意义。观察者间及不同检查方式间的一致性良好（kappa = 0.88 - 0.90）。CT数据集进行3D重建及图像分析的时间显著长于MR数据集（P <. = 0.016）。
在检测腹主动脉-髂动脉及肾动脉血流动力学意义上显著的动脉狭窄方面，3D MR血管造影和多排螺旋CT血管造影之间无统计学显著差异。
