Department of Biomedical Engineering, Northwestern University, Evanston, Illinois.
Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Magn Reson Med. 2019 Jan;81(1):524-532. doi: 10.1002/mrm.27409. Epub 2018 Sep 5.
To develop an accelerated, free-breathing, noncontrast, electrocardiograph-triggered, thoracic MR angiography (NC-MRA) pulse sequence capable of achieving high spatial resolution at clinically acceptable scan time and test whether it produces clinically acceptable image quality in patients with suspected aortic disease.
We modified a "coronary" MRA pulse sequence to use a stack-of-stars k-space sampling pattern and combined it with golden-angle radial sparse parallel (GRASP reconstruction to enable self-navigation of respiratory motion and high data acceleration. The performance of the proposed NC-MRA was evaluated in 13 patients, where clinical standard contrast-enhanced MRA (CE-MRA) was used as control. For visual analysis, two readers graded the conspicuity of vessel lumen, artifacts, and noise level on a 5-point scale (overall score index = sum of three scores). The aortic diameters were measured at seven standardized locations. The mean visual scores, inter-observer variability, and vessel diameters were compared using appropriate statistical tests.
The overall mean visual score index (12.1 ± 1.7 for CE-MRA versus 12.1 ± 1.0 for NC-MRA) scores were not significantly different (P > 0.16). The two readers' scores were significantly different for CE-MRA (P = 0.01) but not for NC-MRA (P = 0.21). The mean vessel diameters were not significantly different, except at the proximal aortic arch (P < 0.03). The mean diameters were strongly correlated (R ≥ 0.96) and in good agreement (absolute mean difference ≤ 0.01 cm and 95% confidence interval ≤ 0.62 cm).
This study shows that the proposed NC-MRA produces clinically acceptable image quality in patients at high spatial resolution (1.5 mm × 1.5 mm × 1.5 mm) and clinically acceptable scan time (~6 min).
开发一种加速、自由呼吸、非对比、心电图触发的胸部磁共振血管造影(NC-MRA)脉冲序列,能够在临床可接受的扫描时间内实现高空间分辨率,并在疑似主动脉疾病患者中验证其是否能产生临床可接受的图像质量。
我们修改了一种“冠状动脉”MRA 脉冲序列,使用星形堆叠的 k 空间采样模式,并将其与黄金角度径向稀疏并行(GRASP)重建相结合,以实现呼吸运动的自我导航和高数据加速。在 13 名患者中评估了所提出的 NC-MRA 的性能,其中临床标准对比增强 MRA(CE-MRA)作为对照。对于视觉分析,两位读者使用 5 分制(总评分指数=三个评分之和)对血管管腔、伪影和噪声水平的显影程度进行分级。在七个标准化位置测量主动脉直径。使用适当的统计检验比较平均视觉评分、观察者间变异性和血管直径。
CE-MRA 的总体平均视觉评分指数(12.1 ± 1.7 分)与 NC-MRA(12.1 ± 1.0 分)的评分无显著差异(P > 0.16)。CE-MRA 两位读者的评分存在显著差异(P = 0.01),但 NC-MRA 无显著差异(P = 0.21)。除近端主动脉弓外(P < 0.03),平均血管直径无显著差异。平均直径高度相关(R ≥ 0.96),且一致性良好(绝对平均差异≤0.01 cm,95%置信区间≤0.62 cm)。
本研究表明,所提出的 NC-MRA 以高空间分辨率(1.5mm×1.5mm×1.5mm)和可接受的临床扫描时间(约 6 分钟)为疑似主动脉疾病患者提供了可接受的图像质量。