Johnson Casey P, Weavers Paul T, Borisch Eric A, Grimm Roger C, Hulshizer Thomas C, LaPlante Christine C, Rossman Phillip J, Glockner James F, Young Phillip M, Riederer Stephen J
From the Department of Radiology, University of Iowa, Iowa City, Iowa (C.P.J.); and MR Research Laboratory and Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.T.W., E.A.B., R.C.G., T.C.H., C.C.L., P.J.R., J.F.G., P.M.Y., S.J.R.).
Radiology. 2014 Jul;272(1):241-51. doi: 10.1148/radiol.14131603. Epub 2014 Mar 14.
To determine the feasibility of using real-time fluoroscopic tracking for bolus-chase magnetic resonance (MR) angiography of peripheral vasculature to image three stations from the aortoiliac bifurcation to the pedal arteries.
This prospective study was institutional review board approved and HIPAA compliant. Eight healthy volunteers (three men; mean age, 48 years; age range, 30-81 years) and 13 patients suspected of having peripheral arterial disease (five men; mean age, 67 years; age range, 47-81 years) were enrolled and provided informed consent. All subjects were imaged with the fluoroscopic tracking MR angiographic protocol. Ten patients also underwent a clinical computed tomographic (CT) angiographic runoff examination. Two readers scored the MR angiographic studies for vessel signal intensity and sharpness and presence of confounding artifacts and venous contamination at 35 arterial segments. Mean aggregate scores were assessed. The paired MR angiographic and CT angiographic studies also were scored for visualization of disease, reader confidence, and overall diagnostic quality and were compared by using a Wilcoxon signed rank test.
Real-time fluoroscopic tracking performed well technically in all studies. Vessel segments were scored good to excellent in all but the following categories: For vessel signal intensity and sharpness, the abdominal aorta, iliac arteries, distal plantar arteries, and plantar arch were scored as fair to good; and for presence of confounding artifacts, the abdominal aorta and iliac arteries were scored as fair. The MR angiograms and CT angiograms did not differ significantly in any scoring category (reader 1: P = .50, .39, and .39; reader 2: P = .41, .61, and .33, respectively). CT scores were substantially better in 20% (four of 20) and 25% (five of 20) of the pooled evaluations for the visualization of disease and overall image quality categories, respectively, versus 5% (one of 20) for MR scores in both categories.
Three-station bolus-chase MR angiography with real-time fluoroscopic tracking provided high-spatial-resolution arteriograms of the peripheral vasculature, enabled precise triggering of table motion, and compared well with CT angiograms.
确定使用实时荧光透视跟踪技术进行外周血管团注追踪磁共振（MR）血管造影，以对从腹主动脉髂总动脉分叉至足部动脉的三个部位进行成像的可行性。
本前瞻性研究经机构审查委员会批准且符合健康保险流通与责任法案（HIPAA）规定。纳入8名健康志愿者（3名男性；平均年龄48岁；年龄范围30 - 81岁）和13名疑似患有外周动脉疾病的患者（5名男性；平均年龄67岁；年龄范围47 - 81岁），并获得他们的知情同意。所有受试者均采用荧光透视跟踪MR血管造影方案进行成像。10名患者还接受了临床计算机断层扫描（CT）血管造影的下肢血管检查。两名阅片者对MR血管造影研究进行评分，评估35个动脉节段的血管信号强度、清晰度以及是否存在混淆伪影和静脉污染。计算平均总分。对配对的MR血管造影和CT血管造影研究的疾病可视化、阅片者信心及总体诊断质量进行评分，并采用Wilcoxon符号秩检验进行比较。
在所有研究中，实时荧光透视跟踪技术在技术上表现良好。除以下情况外，血管节段评分均为良好至优秀：对于血管信号强度和清晰度，腹主动脉、髂动脉、足底远侧动脉和足底弓评分为中等至良好；对于是否存在混淆伪影，腹主动脉和髂动脉评分为中等。在任何评分类别中，MR血管造影和CT血管造影均无显著差异（阅片者1：P = 0.50、0.39和0.39；阅片者2：P分别为0.41、0.61和0.33）。在疾病可视化和总体图像质量类别中，CT评分在汇总评估中分别有20%（20例中的4例）和25%（20例中的5例）显著优于MR评分，而MR评分在这两个类别中均为5%（20例中的1例）。
采用实时荧光透视跟踪技术的三部位团注追踪MR血管造影可提供外周血管的高空间分辨率动脉造影图像，能够精确触发检查床移动，且与CT血管造影效果相当。
