Demirtaş Hakan, Parpar Tuna, Değirmenci Bumin, Kara Mustafa, Çelik Ahmet Orhan, Umul Ayşe, Kayan Mustafa, Yılmaz Ömer
Radiology Department, School of Medicine, Suleyman Demirel University, Isparta, 32260, Turkey.
Radiology Department, Hitit University Training and Research Hospital, Çorum, Turkey.
Radiol Med. 2016 Dec;121(12):916-925. doi: 10.1007/s11547-016-0678-6. Epub 2016 Aug 29.
This study aimed to investigate the feasibility and diagnostic power of unenhanced 3D turbo spin echo MR angiography sequence (a technique based on subtraction of corresponding images acquired in diastole and systole, Syngo Native Space-Siemens healthcare) to identify peripheral artery disease (PAD).
Thirty patients (619 arterial segments in total) suspected with PAD and who were assessed with lower extremity MDCT angiography were examined starting from the level of aortic bifurcation for both lower extremities by 3D native space MR angiography. Two readers assessed the image quality of native space MR angiography and number of lesions, their degrees of stenosis and localizations. The differences and compliance between the readers in the parameters assessed were investigated.
Out of 619 segments; Reader 1 considered 187 segments (30.2 %) and Reader 2 considered 177 segments (28.6 %) to have poor and inadequate MR image quality. When compared to CTA, sensitivity, specificity and diagnostic accuracy of native space MR angiography were calculated as 81.0, 83.1, 82.6 %, respectively, by Reader 1, while the same parameters were calculated as 69.9, 92.6, 84.9 %, respectively, by Reader 2. When the two readers were examined together, sensitivity, specificity, diagnostic accuracy were found to be 76.3, 88.1, 83.7 %, respectively, and the positive predictive value and negative predictive value was 70.3 and 89.9 %, respectively. A significantly better image quality was acquired with the age group below 50 years (p = 0.002).
Native space MR angiography technique can be used as the first-step imaging technique before contrast-enhanced examinations in young and middle age patients with suspected PAD and for patients with the risk of nephrogenic systemic fibrosis in chronic renal failure.
本研究旨在探讨非增强三维快速自旋回波磁共振血管造影序列（一种基于舒张期和收缩期采集的相应图像相减的技术，Syngo Native Space - 西门子医疗）用于识别外周动脉疾病（PAD）的可行性和诊断能力。
对30例疑似PAD且接受下肢MDCT血管造影评估的患者，从主动脉分叉水平开始对双下肢进行三维原始空间磁共振血管造影检查。两名阅片者评估原始空间磁共振血管造影的图像质量、病变数量、狭窄程度及部位。研究阅片者在评估参数方面的差异及一致性。
在619个节段中，阅片者1认为187个节段（30.2%）、阅片者2认为177个节段（28.6%）的磁共振图像质量差或不足。与CTA相比，阅片者1计算的原始空间磁共振血管造影的敏感性、特异性和诊断准确性分别为81.0%、83.1%、82.6%，而阅片者2计算的相同参数分别为69.9%、92.6%、84.9%。当两名阅片者共同评估时，敏感性、特异性、诊断准确性分别为76.3%、88.1%、83.7%，阳性预测值和阴性预测值分别为70.3%和89.9%。50岁以下年龄组获得的图像质量明显更好（p = 0.002）。
原始空间磁共振血管造影技术可作为疑似PAD的中青年患者及慢性肾衰竭有发生肾源性系统性纤维化风险患者在进行对比增强检查前的第一步成像技术。
