Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
Br J Radiol. 2011 Oct;84(1006):883-9. doi: 10.1259/bjr/16555263. Epub 2010 Nov 16.
This prospective study compares MRI of atherosclerotic plaque in the abdominal aorta at 3 T with that at 1.5 T in patients suffering from hereditary hyperlipidaemia, a major risk factor for atherosclerosis.
MRI of the abdominal aorta at 1.5 and 3 T was performed in 21 patients (mean age 58 years). The study protocol consisted of proton density (PD), T(1), T(2) and fat-saturated T(2) weighted black blood images of the abdominal aorta in corresponding orientation. Two independent radiologists performed image rating. First, image quality was rated on a five-point scale. Second, atherosclerotic plaques were scored according to the modified American Heart Association (AHA) classification and analysed for field strength-related differences. Weighted κ statistics were calculated to assess interobserver agreement.
Interobserver agreement was substantial for nearly all categories. MRI at 3 T offered superior image quality in all contrast weightings, most significantly in T(1) and T(2) weighted techniques. Plaque burden in the study collective was unexpectedly moderate. The majority of plaques were classified as AHA III lesions; no lesions were classified above AHA V. There was no significant influence of the field strength regarding the AHA classification.
Abdominal aortal plaque screening is basically feasible at both field strengths, whereas the image quality is rated superior at 3 T. However, the role of the method in clinical practice remains uncertain, since substantial findings in the high-risk collective were scarce.
本前瞻性研究比较了遗传性高脂血症患者腹主动脉粥样硬化斑块的 3T MRI 与 1.5T MRI,遗传性高脂血症是动脉粥样硬化的一个主要危险因素。
对 21 例(平均年龄 58 岁)遗传性高脂血症患者进行了 1.5T 和 3T 腹主动脉 MRI 检查。研究方案包括质子密度(PD)、T1、T2 和脂肪饱和 T2 加权黑血图像,以相应的方位采集腹主动脉图像。两位独立的放射科医生进行图像评分。首先,对图像质量进行五分制评分。其次,根据改良的美国心脏协会(AHA)分类对粥样斑块进行评分,并分析与场强相关的差异。采用加权 κ 统计评估观察者间的一致性。
几乎所有类别的观察者间一致性都很高。在所有对比加权中,3T 的 MRI 提供了更好的图像质量,在 T1 和 T2 加权技术中最为显著。研究人群中的斑块负荷出乎意料地适中。大多数斑块被归类为 AHA III 病变;没有病变被归类为 AHA V 以上。场强对 AHA 分类没有显著影响。
在两种场强下,腹主动脉斑块筛查基本可行,而 3T 的图像质量更高。然而,该方法在临床实践中的作用仍不确定,因为在高危人群中发现了大量实质性的发现。