Shaida Nadeem, Priest Andrew N, See T C, Winterbottom Andrew P, Graves Martin J, Lomas David J
Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.
Department of Medical Physics, Addenbrooke's Hospital, Cambridge, UK.
J Magn Reson Imaging. 2017 Jun;45(6):1846-1853. doi: 10.1002/jmri.25533. Epub 2016 Nov 30.
To evaluate the diagnostic performance of velocity- and acceleration-sensitized noncontrast-enhanced magnetic resonance angiography (NCE-MRA) of the infrageniculate arteries using contrast-enhanced MRA (CE-MRA) as a reference standard.
Twenty-four patients with symptoms of peripheral arterial disease were recruited. Each patient's infrageniculate arterial tree was examined using a velocity-dependent flow-sensitized dephasing (VEL-FSD) technique, an acceleration-dependent (ACC-FSD) technique, and our conventional CE-MRA technique performed at 1.5T. The images were independently reviewed by two experienced vascular radiologists, who evaluated each vessel segment to assess visibility, diagnostic confidence, venous contamination, and detection of pathology.
In all, 432 segments were evaluated by each of the three techniques by each reader in total. Overall diagnostic confidence was rated as moderate or high in 98.5% of segments with CE-MRA, 92.1% with VEL-FSD, and 79.9% with ACC-FSD. No venous contamination was seen in 96% of segments with CE-MRA, 72.2% with VEL-FSD, and 85.8% with ACC-FSD. Per-segment, per-limb, and per-patient sensitivities for detecting significant stenotic disease were 63.4%, 73%, and 92%, respectively, for ACC-FSD, and 65.3%, 87.2%, and 96% for VEL-FSD, and as such no significant statistical change was detected using McNemar's chi-squared test with P-values of 1.00, 0.13, and 0.77 obtained, respectively.
Flow-dependent NCE-MRA techniques may have a role to play in evaluation of patients with peripheral vascular disease. Increased sensitivity of a velocity-based technique compared to an acceleration-based technique comes at the expense of greater venous contamination.
2J. Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1846-1853.
以对比增强磁共振血管造影（CE-MRA）作为参考标准，评估膝下动脉速度和加速度敏感的非对比增强磁共振血管造影（NCE-MRA）的诊断性能。
招募24例有外周动脉疾病症状的患者。使用速度依赖的血流敏感去相位（VEL-FSD）技术、加速度依赖（ACC-FSD）技术以及我们在1.5T下进行的传统CE-MRA技术对每位患者的膝下动脉树进行检查。图像由两位经验丰富的血管放射科医生独立评估，他们对每个血管段进行评估，以评估可视性、诊断信心、静脉污染以及病变的检测情况。
每位读者总共使用这三种技术对432个血管段进行了评估。总体诊断信心在CE-MRA评估的血管段中98.5%被评为中等或高，VEL-FSD为92.1%，ACC-FSD为79.9%。CE-MRA评估的血管段中96%未见静脉污染，VEL-FSD为72.2%，ACC-FSD为85.8%。ACC-FSD检测显著狭窄疾病的每段、每肢体和每位患者的敏感性分别为63.4%、73%和92%，VEL-FSD分别为65.3%、87.2%和96%，因此使用McNemar卡方检验未检测到显著的统计学变化，P值分别为1.00、0.13和0.77。
血流依赖的NCE-MRA技术在评估外周血管疾病患者中可能发挥作用。基于速度的技术比基于加速度的技术敏感性更高，但代价是静脉污染更严重。
2J。技术效能：2期J。MAGN。RESON。IMAGING 2017；45：1846 - 1853。
