血池与细胞外钆螯合物用于血管性胸廓出口综合征功能磁共振评估的比较

Comparison of blood pool and extracellular gadolinium chelate for functional MR evaluation of vascular thoracic outlet syndrome.

作者信息

Lim Ruth P, Bruno Mary, Rosenkrantz Andrew B, Kim Danny C, Mulholland Thomas, Kwon Jane, Palfrey Amy P, Ogedegbe Olugbenga

机构信息

New York University School of Medicine, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, 660 1st Avenue, New York, NY 10016, USA; Austin Health, Department of Radiology, Heidelberg, Victoria 3084, Australia; The University of Melbourne, School of Medicine, Parkville, Victoria 3010, Australia.

New York University School of Medicine, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, 660 1st Avenue, New York, NY 10016, USA.

出版信息

Eur J Radiol. 2014 Jul;83(7):1209-1215. doi: 10.1016/j.ejrad.2014.04.018. Epub 2014 Apr 30.

DOI:10.1016/j.ejrad.2014.04.018

PMID:24840478

Abstract

OBJECTIVE

To compare performance of single-injection blood pool agent (gadofosveset trisodium, BPA) against dual-injection extracellular contrast (gadopentetate dimeglumine, ECA) for MRA/MRV in assessment of suspected vascular TOS.

MATERIALS AND METHODS

Thirty-one patients referred for vascular TOS evaluation were assessed with BPA (n=18) or ECA (n=13) MRA/MRV in arm abduction and adduction. Images were retrospectively assessed for: image quality (1=non-diagnostic, 5=excellent), vessel contrast (1=same signal as muscle, 4=much brighter than muscle) and vascular pathology by two independent readers, with a separate experienced reader providing reference assessment of vascular pathology.

RESULTS

Median image quality was diagnostic or better (score ≥ 3) for ECA and BPA at all time points, with BPA image quality superior at abduction late (BPA 4.5, ECA 4, p=0.042) and ECA image quality superior at adduction-early (BPA 4.5; ECA 4.0, p=0.018). High qualitative vessel contrast (mean score ≥ 3) was observed at all time points with both BPA and ECA, with superior BPA vessel contrast at abduction-late (BPA 3.97 ± 0.12; ECA 3.73 ± 0.26, p=0.007) and ECA at adduction-early (BPA 3.42 ± 0.52; ECA 3.96 ± 0.14, p<0.001). Readers readily identified arterial and venous pathology with BPA, similar to ECA examinations.

CONCLUSION

Single-injection BPA MRA/MRV for TOS evaluation demonstrated diagnostic image quality and high vessel contrast, similar to dual-injection ECA imaging, enabling identification of fixed and functional arterial and venous pathology.

摘要

目的

比较单注射血池剂（钆布醇三钠，BPA）与双注射细胞外对比剂（钆喷酸葡胺，ECA）用于磁共振血管造影/磁共振静脉造影（MRA/MRV）评估疑似血管性胸廓出口综合征（TOS）的性能。

材料与方法

31例因血管性TOS评估而转诊的患者在手臂外展和内收时接受了BPA（n = 18）或ECA（n = 13）MRA/MRV检查。由两名独立阅片者对图像进行回顾性评估，评估内容包括：图像质量（1 = 非诊断性，5 = 优秀）、血管对比度（1 = 与肌肉信号相同，4 = 比肌肉亮得多）以及血管病变情况，另由一名经验丰富的阅片者单独提供血管病变的参考评估。

结果

在所有时间点，ECA和BPA的图像质量中位数均为诊断性或更好（评分≥3），其中BPA在晚期外展时图像质量更佳（BPA 4.5，ECA 4，p = 0.042），而ECA在内收早期图像质量更佳（BPA 4.5；ECA 4.0，p = 0.018）。在所有时间点，BPA和ECA均观察到高质量的血管对比度（平均评分≥3），其中BPA在晚期外展时血管对比度更佳（BPA 3.97±0.12；ECA 3.73±0.26，p = 0.007），而ECA在内收早期时更佳（BPA 3.42±0.52；ECA 3.96±0.14，p<0.001）。阅片者使用BPA能像使用ECA检查一样轻松识别动脉和静脉病变。