Department of Radiology, Tianjin First Central Hospital, 24 Fukang Road, Nankai District, Tianjin, 300192, China.
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, China.
Eur Radiol. 2020 Sep;30(9):5110-5119. doi: 10.1007/s00330-020-06840-7. Epub 2020 Apr 20.
This study aimed to compare the performance of strategically acquired gradient echo (STAGE)-derived MR angiography and time-of-flight MR angiography (TOF-MRA) in visualization of leptomeningeal collaterals (LMCs).
Between May 2018 and January 2020, 75 participants (47 healthy volunteers and 28 intracranial atherosclerotic disease [ICAD] patients) undergoing TOF-MRA and STAGE-MRA were prospectively included. Image quality was scored at the internal carotid artery (ICA) terminus, proximal middle cerebral artery (MCA), and LMCs. Quantitative analysis included calculation of contrast-to-noise ratios (CNRs) in the M1-4 segments and number of LMCs counted in the line signal intensity profiles. Comparisons of image qualitative scores, CNRs, and number of LMCs were calculated using the Wilcoxon rank-sum test.
Image qualitative scores were significantly higher in STAGE-MRA than in TOF-MRA for the ICA terminus, proximal MCA, and LMCs (ps < 0.05) in 75 participants. When referred to digital subtraction angiography (DSA) in 25 ICAD patients, STAGE-MRA showed higher qualitative scores only at LMCs. CNRs in the M1-4 segments were significantly higher in STAGE-MRA than in TOF-MRA (218.7 ± 90.7 vs 176.2 ± 72.6, 195.7 ± 86.0 vs 146.6 ± 71.7, 176.4 ± 71.6 vs 125.8 ± 61.1, 126.2 ± 62.9 vs 78.8 ± 43.6; all ps < 0.001). STAGE-MRA showed more LMCs (11.4 ± 3.4) than TOF-MRA (8.4 ± 3.3) with p < 0.05.
STAGE-MRA might be superior to TOF-MRA in qualitative and quantitative assessment of LMCs in both healthy volunteers and ICAD patients; thus, it may serve as an alternative method in evaluating LMC.
• Strategically acquired gradient echo (STAGE)-derived magnetic resonance angiography is a newly developed sequence with a pair of rephasing/dephasing gradient echoes. • STAGE-MRA enables higher image qualitative score, improves contrast-to-noise ratio, and shows greater number of leptomeningeal collaterals (LMCs) in healthy volunteers and patients with intracranial atherosclerotic disease. • LMC visualization by STAGE-MRA shows good to excellent inter-observer agreement.
本研究旨在比较策略性获取梯度回波（STAGE）衍生磁共振血管成像（MRA）与时间飞越（TOF）MRA 在显示软脑膜侧支（LMCs）方面的性能。
2018 年 5 月至 2020 年 1 月，前瞻性纳入 75 名接受 TOF-MRA 和 STAGE-MRA 检查的参与者（47 名健康志愿者和 28 名颅内动脉粥样硬化性疾病[ICAD]患者）。在颈内动脉（ICA）末端、近端大脑中动脉（MCA）和 LMCs 处对图像质量进行评分。定量分析包括计算 M1-4 段的对比噪声比（CNR）和线信号强度曲线中 LMCs 的数量。使用 Wilcoxon 秩和检验比较图像定性评分、CNR 和 LMCs 数量。
在 75 名参与者中，STAGE-MRA 与 TOF-MRA 相比，ICA 末端、近端 MCA 和 LMCs 的图像定性评分显著更高（p<0.05）。在 25 名 ICAD 患者中与数字减影血管造影（DSA）比较时，STAGE-MRA 仅在 LMCs 处显示出更高的定性评分。M1-4 段的 CNR 在 STAGE-MRA 中明显高于 TOF-MRA（218.7±90.7 比 176.2±72.6，195.7±86.0 比 146.6±71.7，176.4±71.6 比 125.8±61.1，126.2±62.9 比 78.8±43.6；均 p<0.001）。STAGE-MRA 显示的 LMCs（11.4±3.4）比 TOF-MRA（8.4±3.3）更多（p<0.05）。
STAGE-MRA 在健康志愿者和 ICAD 患者的 LMCs 定性和定量评估方面可能优于 TOF-MRA；因此，它可能是评估 LMC 的一种替代方法。
策略性获取梯度回波（STAGE）衍生磁共振血管成像（MRA）是一种具有一对相位重聚/去相位梯度回波的新序列。
STAGE-MRA 可提高图像定性评分、对比噪声比，并在健康志愿者和颅内动脉粥样硬化性疾病患者中显示更多的软脑膜侧支（LMCs）。
STAGE-MRA 显示的 LMCs 可视化具有良好到极好的观察者间一致性。
