利用铁羧麦芽糖增强磁共振胸部静脉造影评估肾功能损害患者的中央静脉狭窄和闭塞情况
Ferumoxytol-enhanced MR Venography of the Central Veins of the Thorax for the Evaluation of Stenosis and Occlusion in Patients with Renal Impairment.
作者信息
Gallo Christopher J R, Mammarappallil Joseph G, Johnson David Y, Chalian Hamid, Ronald James, Bashir Mustafa R, Kim Charles Y
机构信息
Division of Vascular and Interventional Radiology (C.J.R.G., D.Y.J., J.R., C.Y.K.), Division of Cardiothoracic Imaging (J.G.M., D.Y.J., H.C.), Division of Abdominal Imaging, Department of Radiology (M.R.B.), Center for Advanced Magnetic Resonance Development (M.R.B.), and Division of Hepatology, Department of Medicine (M.R.B.), Duke University Medical Center, Box 3808, 2301 Erwin Rd, Durham, NC 27710.
出版信息
Radiol Cardiothorac Imaging. 2020 Nov 19;2(6):e200339. doi: 10.1148/ryct.2020200339. eCollection 2020 Dec.
PURPOSE
To assess the diagnostic performance of ferumoxytol-enhanced MR venography for the detection of thoracic central vein stenosis or occlusion with conventional venography as the reference standard.
MATERIALS AND METHODS
In this retrospective study, consecutive patients from May 2012 to December 2018 underwent dedicated ferumoxytol-enhanced MR venography of the thoracic central veins and conventional venography within 6 months for detecting central venous stenosis. The central veins were divided into seven segments for evaluation. MR venography images were evaluated by three radiologists for presence of stenosis or occlusion. Interobserver agreement was assessed using Fleiss κ.
RESULTS
A total of 35 patients were included (mean age, 49 years; age range, 12-75 years; 18 females). Of the 122 total venous segments with corresponding conventional venography, 73 were stenotic or occluded. The sensitivity and specificity for detection of stenosis or occlusion was 99% and 98%, respectively. The sensitivity and specificity for detecting occlusion alone was 96% and 98%, respectively. MR venography readers demonstrated moderate agreement in their ability to grade stenosis or occlusion (κ = 0.59). There were no adverse events related to contrast agent administration.
CONCLUSION
Ferumoxytol-enhanced MR venography demonstrated excellent sensitivity and specificity for detection of thoracic central vein stenosis or occlusion.© RSNA, 2020See also the commentary by Finn in this issue.
目的
以传统静脉造影为参考标准，评估 ferumoxytol 增强磁共振静脉造影对检测胸段中心静脉狭窄或闭塞的诊断性能。
材料与方法
在这项回顾性研究中，2012 年 5 月至 2018 年 12 月期间连续纳入的患者在 6 个月内接受了胸段中心静脉的专用 ferumoxytol 增强磁共振静脉造影和传统静脉造影，以检测中心静脉狭窄。中心静脉分为七个节段进行评估。三名放射科医生对磁共振静脉造影图像进行评估，以确定是否存在狭窄或闭塞。使用 Fleiss κ评估观察者间的一致性。
结果
共纳入 35 例患者（平均年龄 49 岁；年龄范围 12 - 75 岁；女性 18 例）。在 122 个有相应传统静脉造影的总静脉节段中，73 个存在狭窄或闭塞。检测狭窄或闭塞的敏感性和特异性分别为 99%和 98%。单独检测闭塞的敏感性和特异性分别为 96%和 98%。磁共振静脉造影阅片者在对狭窄或闭塞进行分级的能力上表现出中度一致性（κ = 0.59）。没有与造影剂注射相关的不良事件。
结论
Ferumoxytol 增强磁共振静脉造影在检测胸段中心静脉狭窄或闭塞方面表现出优异的敏感性和特异性。© RSNA，2020 另见本期 Finn 的评论。
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