Nielsen Yousef Wirenfeldt, Eiberg Jonas P, Løgager Vibeke B, Just Sven, Schroeder Torben V, Thomsen Henrik S
Department of Radiology, Copenhagen University Hospital Herlev, Herlev Ringvej, Denmark.
Acta Radiol. 2010 Apr;51(3):277-83. doi: 10.3109/02841850903482893.
Whole-body magnetic resonance angiography (WB-MRA) is a noninvasive method for diagnosing the systemic distribution of atherosclerosis. Numerous studies have demonstrated the feasibility and diagnostic performance of WB-MRA, but no studies have investigated patient acceptance of this imaging method.
To measure patient acceptance of WB-MRA compared to the gold standard, digital subtraction angiography (DSA), in patients with peripheral arterial disease (PAD).
In a prospective design, 79 consecutive patients (51 male, mean age 67 years) with symptomatic PAD, scheduled to undergo both WB-MRA and DSA, were included. Patient acceptance of each imaging procedure was assessed with a postal questionnaire (13 questions). A five-point rank scale (1, no discomfort; 5, severe discomfort) was used to grade patient discomfort.
One patient was excluded from data analysis (did not undergo DSA). Of the remaining 78 patients, 69 completed the questionnaire (response rate 88%). Overall discomfort scores were higher in DSA compared to WB-MRA (mean 2.1 and 1.7, respectively; P = 0.06). In WB-MRA, overall discomfort was strongly correlated to feeling confined in the MRI system (R = 0.77, P< 0.001). In DSA, discomfort was strongly correlated to arterial puncture (R = 0.66, P< 0.001) and contrast injection (R= 0.65, P< 0.001). Injection of iodinated contrast agent at DSA was graded more uncomfortable than injection of gadolinium-based contrast agent at WB-MRA (mean 2.1 vs. 1.5, respectively; P<0.001). Sixty-two patients (90%) were willing to repeat WB-MRA, and 64 patients (93%) would repeat DSA if they needed another vascular examination. Forty-one patients preferred WB-MRA (60%), 12 patients preferred DSA (17%), and 16 patients had no preference (23%). Patient preference of WB-MRA over DSA was statistically significant (P< 0.001).
Patient acceptance of WB-MRA is superior to that of DSA in patients with PAD, with the majority of patients preferring WB-MRA.
全身磁共振血管造影（WB-MRA）是一种用于诊断动脉粥样硬化全身分布的非侵入性方法。众多研究已证实WB-MRA的可行性和诊断性能，但尚无研究调查患者对这种成像方法的接受程度。
在患有外周动脉疾病（PAD）的患者中，比较患者对WB-MRA与金标准数字减影血管造影（DSA）的接受程度。
采用前瞻性设计，纳入79例连续的有症状PAD患者（51例男性，平均年龄67岁），这些患者计划同时接受WB-MRA和DSA检查。通过邮寄问卷（13个问题）评估患者对每种成像检查的接受程度。采用五点等级量表（1，无不适；5，严重不适）对患者的不适程度进行分级。
1例患者被排除在数据分析之外（未接受DSA检查）。在其余78例患者中，69例完成了问卷（回复率88%）。与WB-MRA相比，DSA的总体不适评分更高（分别为平均2.1和1.7；P = 0.06）。在WB-MRA中，总体不适与在MRI系统中感觉受限密切相关（R = 0.77，P < 0.001）。在DSA中，不适与动脉穿刺（R = 0.66，P < 0.00）和造影剂注射（R = 0.65，P < 0.001）密切相关。DSA中注射碘化造影剂的不适程度分级高于WB-MRA中注射钆基造影剂（分别为平均2.1和1.5；P < 0.001）。62例患者（90%）愿意重复接受WB-MRA检查，64例患者（93%）表示如果需要再次进行血管检查愿意重复接受DSA检查。41例患者更喜欢WB-MRA（60%），12例患者更喜欢DSA（17%），16例患者无偏好（23%）。患者对WB-MRA的偏好超过DSA具有统计学意义（P < 0.001）。
在PAD患者中，患者对WB-MRA的接受程度优于DSA，大多数患者更喜欢WB-MRA。
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