Mayo Clinic, Rochester, Minnesota 55905, USA.
J Magn Reson Imaging. 2010 Jun;31(6):1411-8. doi: 10.1002/jmri.22194.
To assess the performance of a three-dimensional (3D) non-contrast respiratory-triggered steady state free precession (SSFP) pulse sequence for detection of renal artery stenosis.
A total of 64 patients who had non-contrast MR angiography (NC MRA) and 3D contrast-enhanced MRA (CE MRA) performed during the same exam and three patients who had NC MRA followed by conventional catheter angiography within one month of the MRI exam were included in this retrospective study. Two blinded readers evaluated NC MRA images for the presence of significant renal artery stenosis and also rated their diagnostic confidence and evaluated the images for artifact. A similar analysis was performed for CE MRA images by two additional blinded readers, and discrepancies were resolved by consensus reading.
The 67 patients had 168 main and accessory renal arteries, with significant (>50%) stenosis in 34 arteries on CE MRA or conventional angiography. The two NC MRA readers had sensitivity and specificity for detection of significant stenosis of 94%/82% and 82%/87% respectively on a per renal artery basis.
There was good agreement between CE MRA and NC MRA for detection of significant renal artery stenosis. This technique should prove useful in evaluating patients with suspected renovascular hypertension who are unable to undergo CE MRA.
评估一种用于检测肾动脉狭窄的三维（3D）非对比呼吸触发稳态自由进动（SSFP）脉冲序列的性能。
本回顾性研究共纳入 64 例患者，这些患者在同一次检查中同时进行了非对比性磁共振血管造影（NC MRA）和 3D 对比增强磁共振血管造影（CE MRA），以及 3 例在 MRI 检查后一个月内行 NC MRA 后行传统导管血管造影的患者。两名盲法读者评估 NC MRA 图像中是否存在显著的肾动脉狭窄，并对其诊断信心进行评分，同时评估图像中的伪影。另外两名盲法读者对 CE MRA 图像进行了类似的分析，通过共识阅读解决了差异。
67 例患者共 168 条主肾动脉和副肾动脉，CE MRA 或传统血管造影显示 34 条动脉存在>50%的狭窄。两名 NC MRA 读者对每一条肾动脉的检测的敏感性和特异性分别为 94%/82%和 82%/87%。
CE MRA 和 NC MRA 检测显著肾动脉狭窄的结果具有良好的一致性。这项技术在评估无法进行 CE MRA 的疑似肾血管性高血压患者方面应该很有用。
