Zhao Huilin, Wang Jinnan, Liu Xiaosheng, Zhao Xihai, Hippe Daniel S, Cao Ye, Wan Jieqing, Yuan Chun, Xu Jianrong
From the Departments of Radiology (H.Z., X.L., Y.C., J.X.) and Neurosurgery (J. Wan), Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 1630 Dongfang Road, Shanghai 200127, China; Philips Research North America, Briarliff Manor, NY (J. Wang); Department of Radiology, University of Washington, Seattle, Wash (J. Wang, D.S.H., C.Y.); and Biomedical Engineering & Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing, China (X.Z.).
Radiology. 2015 Feb;274(2):508-16. doi: 10.1148/radiol.14132687. Epub 2014 Oct 3.
To assess fast three-dimensional (3D) black-blood (BB) magnetic resonance (MR) imaging as a noninvasive alternative to intraarterial digital subtraction angiography (DSA) at quantifying moderate to severe carotid artery atherosclerotic disease.
Local ethics committee approval and written informed patient consent were obtained for this study. Sixty-five carotid arteries from 52 patients with at least 50% stenosis underwent 3D BB MR imaging and DSA. Quantitative measurements, including stenosis, lesion length, and the presence or absence of plaque ulceration, obtained with the two modalities were independently determined. Sensitivity and specificity, the intraclass correlation coefficient (ICC), Cohen κ, and Bland-Altman analysis were used to assess the agreement.
Excellent agreement in measuring luminal stenosis was found between 3D BB MR imaging and DSA (ICC, 0.96; 95% confidence interval [CI]: 0.93, 0.97). Three-dimensional BB MR imaging was also found to have high sensitivity (91.7%), specificity (96.2%), and agreement (Cohen κ, 0.85; 95% CI: 0.66, 0.99) with DSA for detection of ulcers. Good agreement was found between lesion length measured by using 3D BB MR imaging and DSA (ICC, 0.75; 95% CI: 0.51, 0.84). However, lesion length measurements by using 3D BB MR imaging were, on average, 4.0 mm longer than those measured by using DSA (P < .001).
Three-dimensional BB MR imaging is a noninvasive and accurate way to quantify moderate to severe carotid artery atherosclerotic disease. With fast acquisition and large coverage, 3D BB MR imaging has the potential to become an alternative imaging approach in evaluating the severity of atherosclerosis.
评估快速三维（3D）黑血（BB）磁共振（MR）成像作为一种非侵入性方法，用于在量化中度至重度颈动脉粥样硬化疾病时替代动脉内数字减影血管造影（DSA）。
本研究获得了当地伦理委员会的批准和患者的书面知情同意。对52例至少有50%狭窄的患者的65条颈动脉进行了3D BB MR成像和DSA检查。通过这两种方式获得的定量测量结果，包括狭窄程度、病变长度以及斑块溃疡的有无，由独立人员进行确定。使用灵敏度和特异度、组内相关系数（ICC）、Cohen κ以及Bland-Altman分析来评估一致性。
3D BB MR成像和DSA在测量管腔狭窄方面具有极好的一致性（ICC，0.96；95%置信区间[CI]：0.93，0.97）。还发现3D BB MR成像在检测溃疡方面与DSA具有高灵敏度（91.7%）、特异度（96.2%）和一致性（Cohen κ，0.85；95% CI：0.66，0.99）。通过3D BB MR成像和DSA测量的病变长度之间具有良好的一致性（ICC，0.75；95% CI：0.51，0.84）。然而，通过3D BB MR成像测量的病变长度平均比通过DSA测量的长4.0 mm（P <.001）。
三维BB MR成像是一种非侵入性且准确的量化中度至重度颈动脉粥样硬化疾病的方法。凭借快速采集和大覆盖范围，3D BB MR成像有潜力成为评估动脉粥样硬化严重程度的一种替代成像方法。
