Department of Radiology, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Vienna, Austria.
Eur Radiol. 2011 Oct;21(10):2158-65. doi: 10.1007/s00330-011-2145-z. Epub 2011 May 10.
The aim of this study was to assess whether visualisation of in-stent changes can be improved with high-resolution, steady-state, blood pool contrast-enhanced MR angiography compared with first-pass MR angiography. Intra-arterial digital subtraction angiography (DSA) served as the reference standard.
Twenty patients after stent placement in the superficial femoral artery (SFA) underwent MRA prior to reintervention. MRA of the SFA includes first-pass MRA as well as 3D high-resolution MRA in the steady state (SS-MRA) after injection of Gadofosveset trisodium. Sensitivity and specificity values for the detection of significant in-stent lesions by means of SS-MRA were calculated at the proximal, middle and distal stent segments in comparison to DSA. Kappa statistics were used to determine agreement between the two techniques.
Sensitivity and specificity values for the detection of significant stenosis with SS-MRA reached 95% in the proximal, 100% in the middle and 100% in the distal stent segment. Kappa coefficients between SS-MRA and DSA were 0.789, 0.797 and 0.859 for the proximal, middle and distal segments, whereas the Kappa coefficients for FP-MRA were 0,211, 0,200 and 0,594 in these segments, respectively.
Detection of in stent stenosis is significantly improved using SS MRA, in comparison to state-of-the-art FP-MRA.
本研究旨在评估与首过 MR 血管造影相比，高分辨率、稳态、血池对比增强磁共振血管造影是否能改善支架内变化的可视化效果。以动脉数字减影血管造影（DSA）作为参考标准。
20 例股浅动脉（SFA）支架置入后患者在再次介入治疗前接受 MRA 检查。SFA 的 MRA 包括首过 MRA 和注射钆喷酸葡胺后稳态（SS-MRA）的 3D 高分辨率 MRA。在近端、中段和远端支架节段，计算 SS-MRA 检测支架内明显病变的敏感性和特异性值，并与 DSA 进行比较。采用 Kappa 统计分析两种技术之间的一致性。
SS-MRA 检测近端、中段和远端支架节段明显狭窄的敏感性和特异性值分别为 95%、100%和 100%。SS-MRA 与 DSA 之间的 Kappa 系数分别为 0.789、0.797 和 0.859，而 FP-MRA 的 Kappa 系数分别为 0.211、0.200 和 0.594。
与先进的首过 MR 血管造影相比，SS MRA 显著提高了支架内狭窄的检测能力。
