Hagspiel Klaus D, Nandalur Kiran, Pruett Timothy L, Leung Daniel A, Angle J Fritz, Spinosa David J, Matsumoto Alan H, Ahmed Hossam, Sanfey Hilary A, Sawyer Robert G, Burkholder Brian, Brayman Kenneth L
Department of Radiology and Division of Transplant Surgery, University of Virginia Health System, PO Box 800170, 1215 Lee St, Charlottesville, VA 22908, USA.
Radiology. 2007 Feb;242(2):590-9. doi: 10.1148/radiol.2422041261.
To retrospectively evaluate high-spatial-resolution contrast material-enhanced three-dimensional (3D) magnetic resonance (MR) angiography for assessment of vascular complications of pancreas allografts.
The institutional review board approved the study and waived the requirement for informed patient consent owing to the retrospective nature of the study with use of an anonymous-subject database. The study was HIPAA compliant. The clinical and MR angiography findings in 11 patients (eight men, three women; mean age, 43 years; age range, 30-54 years) who had a history of pancreatic transplant dysfunction and underwent a total of 13 contrast-enhanced 3D MR angiography examinations were retrospectively reviewed. Comparison with conventional angiography findings was possible for four MR angiography examinations, comparison with surgical findings was possible for two examinations, and clinical follow-up was possible for all examinations. Two observers in consensus and blinded to the clinical results performed image analysis of the arterial and venous segments. Classification agreement was assessed with quadratic weighted kappa statistics.
Ten MR angiography examinations revealed vascular complications or signs suggestive of rejection. Only three examinations were considered to have completely normal results. All major complications were detected and included complete or partial arterial graft occlusion, stenosis of the arterial Y-graft caused by a kink, complete venous thrombosis, and arteriovenous fistula with pseudoaneurysm formation. For 46 arterial segments and 15 venous segments with angiographic and/or surgical comparison, overall agreement with MR angiography findings was nearly perfect (mean kappa, 0.983; standard error of the mean, 0.128).
High-spatial-resolution MR angiography of pancreas allografts enables assessment of the arterial and venous vascular anatomy and can be used to reliably identify clinically relevant vascular complications.
回顾性评估高空间分辨率对比剂增强三维（3D）磁共振（MR）血管造影术在评估胰腺移植血管并发症中的应用。
由于本研究使用匿名受试者数据库的回顾性性质，机构审查委员会批准了该研究并免除了患者知情同意的要求。该研究符合健康保险流通与责任法案（HIPAA）。回顾性分析了11例有胰腺移植功能障碍病史且共接受13次对比剂增强3D MR血管造影检查的患者（8例男性，3例女性；平均年龄43岁；年龄范围30 - 54岁）的临床和MR血管造影结果。4次MR血管造影检查可与传统血管造影结果进行比较，2次检查可与手术结果进行比较，所有检查均可进行临床随访。两名观察者达成共识且对临床结果不知情，对动脉和静脉段进行图像分析。采用二次加权kappa统计评估分类一致性。
10次MR血管造影检查发现血管并发症或提示排斥反应的征象。只有3次检查被认为结果完全正常。所有主要并发症均被检测到，包括动脉移植物完全或部分闭塞、Y形动脉移植物因扭结导致的狭窄、完全性静脉血栓形成以及伴有假性动脉瘤形成的动静脉瘘。对于46个动脉段和15个静脉段进行了血管造影和/或手术比较，与MR血管造影结果的总体一致性近乎完美（平均kappa值为0.983；平均标准误为0.128）。
胰腺移植的高空间分辨率MR血管造影术能够评估动脉和静脉血管解剖结构，并可用于可靠地识别临床相关的血管并发症。
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