Saleh Roya S, Patel Swati, Lee Margaret H, Boechat M Ines, Ratib Osman, Saraiva Carla R, Finn J Paul
Department of Radiology, Division of Diagnostic Cardiovascular Imaging, Magnetic Resonance Research Center, University of California Los Angeles, Los Angeles, CA 90095-7206, USA.
Radiology. 2007 Jun;243(3):837-46. doi: 10.1148/radiol.2433060155.
To retrospectively determine if controlled apnea improves the image quality of contrast material--enhanced magnetic resonance (MR) angiography of the chest and abdomen in children.
Institutional review board approval and waiver of informed consent were obtained for this HIPAA-compliant study. The authors evaluated contrast-enhanced MR angiographic procedures performed in the chest, abdomen, or both, in 23 children (14 boys, nine girls; age range, 1 month to 8 years) who were under general anesthesia. All patients underwent mechanical ventilation with preoxygenation (100% oxygen) prior to controlled apnea during image acquisition. In control subjects, the authors assessed contrast-enhanced MR angiographic procedures performed in the chest, abdomen, or both, in 23 children (matched for age and type of study with children in the controlled apnea group; 11 boys, 12 girls; age range, 1 month to 8 years) who were under general anesthesia (n=15) or deep sedation (n=8) and were breathing spontaneously during image acquisition. MR angiograms of the chest, abdomen, or both, were assessed for image quality, motion artifacts, and vessel definition by two radiologists working in consensus with a subjective grading scale. Wilcoxon signed rank test was used to assess differences in measurements.
Image quality was rated excellent in 97% (30 of 31) of studies with controlled apnea and in 30% (nine of 31) of control studies (P<.001). Motion artifacts were absent in 97% (30 of 31) of studies with controlled apnea and 13% (four of 31) of control studies (P<.001). Vessel sharpness was rated as being significantly better on images obtained with controlled apnea (P<.05). There were no complications caused by anesthesia or sedation in either group.
Controlled apnea is highly effective in children for eliminating respiratory motion artifacts with contrast-enhanced MR angiographic studies, resulting in greatly improved image quality and spatial resolution.
回顾性确定控制性呼吸暂停是否能改善儿童胸部和腹部对比剂增强磁共振（MR）血管造影的图像质量。
本符合健康保险流通与责任法案（HIPAA）的研究获得了机构审查委员会的批准并免除了知情同意。作者评估了23例接受全身麻醉的儿童（14例男孩，9例女孩；年龄范围1个月至8岁）胸部、腹部或两者的对比增强MR血管造影检查。在图像采集期间进行控制性呼吸暂停前，所有患者均接受机械通气并预充氧（100%氧气）。在对照组中，作者评估了23例接受全身麻醉（n = 15）或深度镇静（n = 8）且在图像采集期间自主呼吸的儿童（年龄和研究类型与控制性呼吸暂停组儿童匹配；11例男孩，12例女孩；年龄范围1个月至8岁）胸部、腹部或两者的对比增强MR血管造影检查。由两位放射科医生根据主观评分量表共同评估胸部、腹部或两者的MR血管造影图像的质量、运动伪影和血管清晰度。采用Wilcoxon符号秩检验评估测量结果的差异。
在97%（31例中的30例）的控制性呼吸暂停研究中图像质量被评为优秀，而在30%（31例中的9例）的对照研究中为优秀（P <.001）。在97%（31例中的30例）的控制性呼吸暂停研究中无运动伪影，而在13%（31例中的4例）的对照研究中无运动伪影（P <.001）。在控制性呼吸暂停获得的图像上血管清晰度被评为明显更好（P <.05）。两组均未出现由麻醉或镇静引起的并发症。
对于儿童对比增强MR血管造影研究，控制性呼吸暂停在消除呼吸运动伪影方面非常有效，可显著提高图像质量和空间分辨率。
