Willmann Jürgen K, Göpfert Kerstin, Lutz Amelie M, Nanz Daniel, McCormack Lucas, Petrowsky Henrik, Seifert Burkhardt, Hervo Patrice, Marincek Borut, Weishaupt Dominik
Institute of Diagnostic Radiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.
Eur Radiol. 2007 Jan;17(1):229-40. doi: 10.1007/s00330-006-0305-3. Epub 2006 May 16.
The purpose of this study was to compare respiratory-triggered balanced steady-state free precession (bSSFP) with breath-hold contrast-enhanced dynamic two-dimensional (2D) gradient-echo (GRE) and time-of-flight (TOF) magnetic resonance imaging (MRI) for portal and hepatic vein visualization and assessment of portal and hepatic venous variants. Sixty patients with liver disease underwent nonenhanced bSSFP and contrast-enhanced GRE, bSSFP, and TOF imaging. Contrast-to-noise ratios (CNRs) for portal and hepatic veins were measured. Two readers rated the quality of portal and hepatic vein visualization on a 5-point Likert scale. The diagnostic performance of each MRI series in the detection of portal and hepatic venous variants was assessed in 40/60 patients who also underwent contrast-enhanced multidetector-row computed tomography (MDCT). CNRs for portal and hepatic veins were highest on contrast-enhanced bSSFP images. Image quality of portal and hepatic veins was rated higher for nonenhanced bSSFP than for contrast-enhanced GRE (p<0.03) and TOF (p<0.003) and higher for contrast-enhanced than for nonenhanced bSSFP (p<0.003). Compared with MDCT, portal and hepatic venous variants were identified with an accuracy of 99% on bSSFP images, with an excellent interobserver agreement (kappa=0.97). Compared with MDCT, presence of surgically important portal and hepatic venous anatomical variants can be predicted with high accuracy on bSSFP images.
本研究的目的是比较呼吸触发的平衡稳态自由进动（bSSFP）序列与屏气对比增强动态二维（2D）梯度回波（GRE）序列及时间飞跃（TOF）磁共振成像（MRI）在门静脉和肝静脉可视化以及门静脉和肝静脉变异评估方面的表现。60例肝病患者接受了非增强bSSFP序列以及对比增强GRE序列、bSSFP序列和TOF序列成像。测量门静脉和肝静脉的对比噪声比（CNR）。两名阅片者采用5分李克特量表对门静脉和肝静脉的可视化质量进行评分。在另外40例/60例同时接受了对比增强多层螺旋计算机断层扫描（MDCT）的患者中，评估了每个MRI序列在检测门静脉和肝静脉变异方面的诊断性能。门静脉和肝静脉的CNR在对比增强bSSFP图像上最高。非增强bSSFP序列门静脉和肝静脉的图像质量评分高于对比增强GRE序列（p<0.03）和TOF序列（p<0.003），对比增强序列的评分高于非增强bSSFP序列（p<0.003）。与MDCT相比，bSSFP图像对门静脉和肝静脉变异的识别准确率为99%，观察者间一致性良好（kappa=0.97）。与MDCT相比，bSSFP图像能够高精度地预测具有手术重要性的门静脉和肝静脉解剖变异的存在。
