Jin Teng, Wu Gang, Li Xiaoming, Feng Xiaoyuan
1 Department of Radiology, Huashan Hospital, Fudan University, Shanghai, PR China.
2 Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan City, PR China.
Acta Radiol. 2018 May;59(5):586-592. doi: 10.1177/0284185117729185. Epub 2017 Aug 25.
Background Time-resolved angiography with stochastic trajectories (TWIST) sequence makes considerable progress in temporal and spatial resolution, which presents high potential in evaluation of vascular diseases. Purpose To assess magnetic resonance imaging (MRI) using TWIST MR angiography (MRA) sequence in the assessment of vascular invasion for bone and soft-tissue tumors in comparison to computed tomography angiography (CTA) as the reference standard. Material and Methods Thirty-three patients with lower extremity musculoskeletal tumors were imaged with conventional MR and TWIST MRA. CTA was performed 48 h later. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the femoral artery were calculated. Vascular invasion as determined by MRA and CTA was separately analyzed. Vascular invasion by MRA and CTA were analyzed with kappa coefficients to determine agreement between the imaging methods. Results Seven cases of bone and 26 cases of soft tissue tumors were examined. SNR and CNR of the femoral artery were excellent for TWIST MRA (mean ± SD values of 317 ± 80 and 276 ± 76, respectively). Based on the TWIST sequence, the vessels were free of tumor in 16 cases. Vascular displacement was found in 11 cases and vascular stenosis in six cases. The MRA findings conflicted with CTA findings in only one case. The kappa value was 0.953 ( P < 0.01). In five cases, vascular malformations were found with TWIST MRA but not CTA. Conclusion TWIST MRA enables accurate delineation of anatomical structures and tumor arterial involvement, providing reliable preoperative imaging information with respect to lower extremity musculoskeletal tumors.
背景 随机轨迹时间分辨血管造影（TWIST）序列在时间和空间分辨率方面取得了显著进展，在血管疾病评估中具有很高的潜力。目的 与作为参考标准的计算机断层血管造影（CTA）相比，评估使用TWIST磁共振血管造影（MRA）序列的磁共振成像（MRI）在评估骨与软组织肿瘤的血管侵犯情况。材料与方法 对33例下肢肌肉骨骼肿瘤患者进行常规MR和TWIST MRA成像。48小时后进行CTA检查。计算股动脉的信噪比（SNR）和对比噪声比（CNR）。分别分析MRA和CTA确定的血管侵犯情况。用kappa系数分析MRA和CTA的血管侵犯情况，以确定成像方法之间的一致性。结果 检查了7例骨肿瘤和26例软组织肿瘤。TWIST MRA的股动脉SNR和CNR极佳（均值±标准差分别为317±80和276±76）。基于TWIST序列，16例血管未见肿瘤。11例发现血管移位，6例发现血管狭窄。仅1例MRA结果与CTA结果不一致。kappa值为0.953（P＜0.01）。5例中，TWIST MRA发现血管畸形而CTA未发现。结论 TWIST MRA能够准确描绘解剖结构和肿瘤动脉受累情况，为下肢肌肉骨骼肿瘤提供可靠的术前影像学信息。
