Vogt F M, Herborn C U, Parsons E C, Kröger K, Barkhausen J, Goyen M
Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Uniklinikum Essen, Essen.
Rofo. 2007 Apr;179(4):412-20. doi: 10.1055/s-2006-927371.
To prospectively assess the accuracy of contrast-enhanced MR angiography of the aortoiliac arteries using the blood pool agent Vasovist compared to unenhanced time-of-flight MRA. Conventional digital subtraction angiography served as the standard of reference.
Twenty-nine patients with suspected or known peripheral arterial occlusive disease (PAOD) were examined by means of contrast-enhanced aortoiliac MR angiography using a dosage of 0.03 mmol/kg bodyweight Vasovist. Unenhanced two-dimensional time-of-flight (TOF) MRA of the same anatomic region was performed immediately prior to injection of the contrast agent. This study was approved by the local Institutional Review Board and informed consent was obtained from all subjects. Both contrast-enhanced and unenhanced MRA images were compared to conventional angiography with respect to the presence of vascular stenosis. Three independent, blinded readers evaluated vessel stenosis and occlusion on the basis of DSA and MR angiographic image readings. Sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve were analyzed. Correlations between readers of conventional angiograms were calculated and compared to the MR results.
In the case of pooled readings, unenhanced TOF MR angiography had a sensitivity of 42.6 %, a specificity of 78.4 % and an accuracy of 74.9 % for detection of clinically significant (>50 %) stenosis. Vasovist-enhanced MRA showed significant improvement in sensitivity (83.3 %), specificity (88.8 %) and accuracy (88.3 %) compared to TOF MRA (p<0.01). The areas under the receiver operating characteristic curve for quantitative measurements increased significantly (p<0.01) in the case of Vasovist-enhanced MRA compared to TOF MRA. All readers found fewer images uninterpretable with Vasovist enhancement and the agreement regarding stenosis location and degree of stenosis between MR angiography and DSA improved substantially after Vasovist administration compared to the noncontrast examination.
MR angiography using the blood pool agent Vasovist is a feasible and minimally invasive alternative to DSA and provides angiograms of the aortoiliac region with high sensitivity, specificity, and diagnostic accuracy.
前瞻性评估使用血池造影剂 Vasovist 的对比增强磁共振血管造影（MRA）对主髂动脉成像的准确性，并与非增强时间飞跃法 MRA 进行比较。传统数字减影血管造影（DSA）作为参考标准。
29 例疑似或已知外周动脉闭塞性疾病（PAOD）的患者接受了使用剂量为 0.03 mmol/kg 体重的 Vasovist 的对比增强主髂动脉 MRA 检查。在注射造影剂前立即对同一解剖区域进行非增强二维时间飞跃（TOF）MRA 检查。本研究经当地机构审查委员会批准，并获得所有受试者的知情同意。将对比增强和非增强 MRA 图像与传统血管造影在血管狭窄情况方面进行比较。三位独立的、不知情的阅片者根据 DSA 和 MR 血管造影图像读数评估血管狭窄和闭塞情况。分析敏感性、特异性、准确性以及受试者操作特征曲线下面积。计算传统血管造影阅片者之间的相关性并与 MR 结果进行比较。
在汇总读数的情况下，非增强 TOF MR 血管造影检测临床显著（>50%）狭窄的敏感性为 42.6%，特异性为 78.4%，准确性为 74.9%。与 TOF MRA 相比，Vasovist 增强 MRA 在敏感性（83.3%）、特异性（88.8%）和准确性（88.3%）方面有显著提高（p<0.01）。与 TOF MRA 相比，Vasovist增强 MRA 定量测量的受试者操作特征曲线下面积显著增加（p<0.01）。所有阅片者发现 Vasovist 增强后难以解读的图像更少，与非增强检查相比，Vasovist 给药后 MR 血管造影与 DSA 在狭窄位置和狭窄程度方面的一致性有显著改善。
使用血池造影剂 Vasovist 的 MR 血管造影是一种可行的、微创的替代 DSA 的方法，可提供主髂动脉区域的血管造影，具有高敏感性、特异性和诊断准确性。
