Department of Radiology, Shanghai Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Eur Radiol. 2011 Jun;21(6):1311-22. doi: 10.1007/s00330-010-2028-8. Epub 2010 Dec 14.
This study was to evaluate diagnostic performance of unenhanced electrocardiography-gated fast spin echo based MRA with variable flip angle on 3.0 T for assessment of calf arteries in patients with peripheral arterial occlusive disease (PAOD).
64 patients underwent unenhanced MRA (UE), time-resolved contrast-enhanced MRA of the calf and bolus-chase contrast-enhanced lower peripheral MRA (BCE). Diagnostic performance of UE was evaluated and compared with contrast-enhanced MRA in 61 patients and x-ray angiography in 10 patients.
With UE, 852 of 960 segments (88.75%) were diagnostic even in patients with arrhythmia, demonstrating similar image quality with those on BCE (P > 0.05). For those diagnostic segments, statistics revealed good agreement between unenhanced and contrast-enhanced techniques with a Kappa value of 0.77 and 0.75 for stenosis detection and visualized vessel length, respectively. When using X-ray angiography as reference standard, no significant difference was found between UE and contrast-enhanced MRA concerning sensitivity and specificity in depiction of severe stenosis and occlusion (P > 0.05).
Although further technical refinements are required, this optimized UE technique may be used as a supplement to contrast-enhanced MRA particularly in patients with PAOD in whom venous contamination occurs frequently.
本研究旨在评估在 3.0T 下应用可变翻转角的无对比剂心电门控快速自旋回波磁共振血管成像（MRA）技术对下肢外周动脉阻塞性疾病（PAOD）患者的小腿动脉进行诊断的效能。
64 例患者行无对比剂 MRA（UE）、时间分辨对比增强 MRA 及对比剂追踪 MRA 检查。对 UE 的诊断性能进行评估，并与 61 例患者的对比增强 MRA 和 10 例患者的 X 线血管造影结果进行比较。
UE 可诊断 960 个节段中的 852 个（88.75%），即使在心律失常患者中也具有相似的图像质量，与 BCE 相似（P＞0.05）。对于这些可诊断的节段，UE 与对比增强技术之间具有良好的一致性，其狭窄检测和可视血管长度的 Kappa 值分别为 0.77 和 0.75。以 X 线血管造影为参考标准，UE 和对比增强 MRA 在重度狭窄和闭塞的显示中，其敏感性和特异性均无显著差异（P＞0.05）。
尽管还需要进一步的技术改进，但这种优化的 UE 技术可作为对比增强 MRA 的补充，尤其适用于经常发生静脉污染的 PAOD 患者。
