Sutter Reto, Nanz Daniel, Lutz Amelie M, Pfammatter Thomas, Seifert Burkhardt, Struwe Anja, Heilmaier Christina, Weishaupt Dominik, Marincek Borut, Willmann Jürgen K
Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland.
Radiology. 2007 Oct;245(1):276-84. doi: 10.1148/radiol.2451062081. Epub 2007 Aug 23.
To prospectively compare the image quality, sensitivity, and specificity of three-dimensional gadolinium-enhanced magnetic resonance (MR) angiography accelerated by parallel acquisition (ie, fast MR angiography) with MR angiography not accelerated by parallel acquisition (ie, conventional MR angiography) for assessment of aortoiliac and renal arteries, with digital subtraction angiography (DSA) as the reference standard.
The study was approved by the institutional review board; informed consent was obtained from all patients. Forty consecutive patients (33 men, seven women; mean age, 63 years) suspected of having aortoiliac and renal arterial stenoses and thus examined with DSA underwent both fast (mean imaging time, 17 seconds) and conventional (mean imaging time, 29 seconds) MR angiography. The arterial tree was divided into segments for image analysis. Two readers independently evaluated all MR angiograms for image quality, presence of arterial stenosis, and renal arterial variants. Image quality, sensitivity, and specificity were analyzed on per-patient and per-segment bases for multiple comparisons (with Bonferroni correction) and for dependencies between segments (with patient as the primary sample unit). Interobserver agreement was evaluated by using kappa statistics.
Overall, the image quality with fast MR angiography was significantly better (P=.001) than that with conventional MR angiography. At per-segment analysis, the image quality of fast MR angiograms of the distal renal artery tended to be better than that of conventional MR angiograms of these vessels. Differences in sensitivity for the detection of arterial stenosis between the two MR angiography techniques were not significant for either reader. Interobserver agreement in the detection of variant renal artery anatomy was excellent with both conventional and fast MR angiography (kappa=1.00).
Fast MR angiography and conventional MR angiography do not differ significantly in terms of arterial stenosis grading or renal arterial variant detection.
前瞻性比较采用并行采集加速的三维钆增强磁共振（MR）血管造影（即快速MR血管造影）与未采用并行采集加速的MR血管造影（即传统MR血管造影）在评估腹主动脉-髂动脉和肾动脉方面的图像质量、敏感性和特异性，以数字减影血管造影（DSA）作为参考标准。
本研究经机构审查委员会批准；所有患者均签署知情同意书。连续40例怀疑患有腹主动脉-髂动脉和肾动脉狭窄并因此接受DSA检查的患者（33例男性，7例女性；平均年龄63岁）接受了快速（平均成像时间17秒）和传统（平均成像时间29秒）MR血管造影检查。将动脉树分为若干节段进行图像分析。两名阅片者独立评估所有MR血管造影图像的质量、动脉狭窄的存在情况以及肾动脉变异情况。在患者和节段层面分析图像质量、敏感性和特异性，以进行多重比较（采用Bonferroni校正）以及分析节段之间的相关性（以患者作为主要样本单位）。采用kappa统计量评估观察者间的一致性。
总体而言，快速MR血管造影的图像质量明显优于传统MR血管造影（P = 0.001）。在节段分析中，肾动脉远端快速MR血管造影图像的质量往往优于这些血管的传统MR血管造影图像。两种MR血管造影技术在检测动脉狭窄的敏感性方面，对于任何一位阅片者而言差异均无统计学意义。在检测肾动脉变异解剖结构方面，传统和快速MR血管造影的观察者间一致性均极佳（kappa = 1.00）。
快速MR血管造影和传统MR血管造影在动脉狭窄分级或肾动脉变异检测方面无显著差异。
