Maki Jeffrey H, Wilson Gregory J, Eubank William B, Glickerman David J, Millan Juan A, Hoogeveen Romhild M
Department of Radiology (S113), University of Washington, Puget Sound VA Health Care System, 1660 S Colombian Way, Seattle, WA 98108, USA.
AJR Am J Roentgenol. 2007 Jun;188(6):W540-6. doi: 10.2214/AJR.06.1138.
The purpose of our study was to determine how well unenhanced navigator-gated steady-state free precession (Nav SSFP) MR angiography (MRA) performs as a screening test for the detection of renal artery stenosis.
Forty patients referred to rule out renal artery stenosis were imaged using an optimized Nav SSFP MRA sequence before conventional contrast-enhanced MRA (CE-MRA). Two radiologists evaluated Nav SSFP for maximum stenosis measurement, and comparison was made with CE-MRA results.
Fifteen of the 40 patients had greater than 50% renal artery stenosis as determined on CE-MRA. Sensitivity for detecting renal artery stenosis with Nav SSFP was 100%; specificity, 84%; negative predictive value, 100%; and positive predictive value, 79%. The average mean stenosis difference between Nav SSFP and CE-MRA was 10% +/- 9%.
Sensitivity and negative predictive value for the detection of renal artery stenosis using Nav SSFP were perfect, with an acceptable specificity of 84%. This suggests Nav SSFP is a promising technique for simple unenhanced screening for the detection of renal artery stenosis.
本研究的目的是确定非增强导航门控稳态自由进动（Nav SSFP）磁共振血管造影（MRA）作为检测肾动脉狭窄的筛查试验的效果如何。
40例因排除肾动脉狭窄而转诊的患者在进行传统对比增强MRA（CE-MRA）之前，使用优化的Nav SSFP MRA序列进行成像。两名放射科医生评估Nav SSFP以测量最大狭窄程度，并与CE-MRA结果进行比较。
在CE-MRA检查中，40例患者中有15例肾动脉狭窄超过50%。Nav SSFP检测肾动脉狭窄的敏感性为100%；特异性为84%；阴性预测值为100%；阳性预测值为79%。Nav SSFP与CE-MRA之间的平均狭窄差异为10%±9%。
使用Nav SSFP检测肾动脉狭窄的敏感性和阴性预测值极佳，特异性为84%，可以接受。这表明Nav SSFP是一种有前景的技术，可用于简单的非增强筛查以检测肾动脉狭窄。
