Department of Radiology, Ruijin hospital, Shanghai Jiaotong University School of Medicine, No 197 Ruijin ER road, 200025, Shanghai, China.
Department of Radiology and Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, USA.
Abdom Radiol (NY). 2017 Oct;42(10):2479-2487. doi: 10.1007/s00261-017-1161-0.
To assess the capability of inflow inversion recovery (IFIR) magnetic resonance angiography (MRA), compared with contrast-enhanced MRA (CE-MRA) as reference standard, in evaluating renal artery stenosis (RAS).
Seventy-two subjects were examined by IFIR MRA with respiratory-gated, prior to CE-MRA with a 1.5-T scanner. Two readers evaluated the quality of IFIR MRA images and renal artery depiction on artery-by-artery basis. The agreement of two methods to assess RAS was analyzed using the Kappa test. The relationship between image quality of IFIR MRA and respiratory rate was analyzed by ANOVA test.
The visibility of renal artery branch vessels was significantly higher using IFIR MRA than CE-MRA (p < 0.05). A good agreement of two methods in evaluating stenosis grade, and a near-perfect inter-observer agreement for IFIR MRA (Kappa value 0.98) and CE-MRA (Kappa value 0.93), were demonstrated. As RAS ≥50%, the sensitivity and specificity of IFIR MRA were 92 and 98% in reader 1, 93 and 98% in reader 2, respectively. The image quality was significantly better in patients with stable respiration (p < 0.01).
IFIR MRA in patients with stable respiration has higher visibility of renal artery branch vessels than CE-MRA, and a good agreement with CE-MRA in evaluating stenosis grade. It could be used to evaluate RAS for screening, and monitoring treatment.
评估流入反转恢复（IFIR）磁共振血管造影（MRA）与对比增强 MRA（CE-MRA）作为参考标准评估肾动脉狭窄（RAS）的能力。
72 例患者在 1.5T 扫描仪上进行 IFIR MRA 检查，之前进行 CE-MRA 检查。两名读者对 IFIR MRA 图像质量和动脉逐支的肾动脉显示进行评估。采用 Kappa 检验分析两种方法评估 RAS 的一致性。采用方差分析检验 IFIR MRA 图像质量与呼吸率的关系。
IFIR MRA 肾动脉分支血管的显示明显优于 CE-MRA（p<0.05）。两种方法评估狭窄程度具有良好的一致性，IFIR MRA（Kappa 值 0.98）和 CE-MRA（Kappa 值 0.93）观察者间的一致性近乎完美。对于 RAS≥50%，读者 1 的 IFIR MRA 的灵敏度和特异性分别为 92%和 98%，读者 2 的 IFIR MRA 的灵敏度和特异性分别为 93%和 98%。在呼吸稳定的患者中，图像质量明显更好（p<0.01）。
对于呼吸稳定的患者，IFIR MRA 肾动脉分支血管的显示明显优于 CE-MRA，在评估狭窄程度方面与 CE-MRA 具有良好的一致性。它可用于筛查和监测治疗 RAS。
