Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA.
Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.
J Magn Reson Imaging. 2022 Jan;55(1):246-254. doi: 10.1002/jmri.27864. Epub 2021 Jul 29.
Quiescent-interval slice-selective (QISS) magnetic resonance angiography (MRA) is a non-contrast alternative for the pre-procedural assessment of patients with peripheral artery disease (PAD). However, the feasibility of pre-procedural stent size estimation using QISS MRA would merit investigation.
To evaluate the feasibility of QISS MRA for pre-procedural stent size estimation in PAD patients compared to computed tomography angiography (CTA).
Retrospective.
Thirty-three PAD patients (68 ± 9 years, 18 men, 15 women).
FIELD STRENGTH/SEQUENCE: Two-dimensional balanced steady-state free precession QISS MRA at 1.5 T and 3 T.
All patients received QISS MRA and CTA of the lower extremity run-off followed by interventional digital subtraction angiography (DSA). Stenotic lesion length and diameter were quantified (AMF and AVS with 3 and 13 years of experience in cardiovascular imaging, respectively) to estimate the dimensions of the stent necessary to restore blood flow in the treated arteries. Measured dimensions were adjusted to the closest stent size available.
The Friedman test with subsequent pairwise Wilcoxon signed-rank test was used to compare the estimated stent dimensions between QISS MRA, CTA, and the physical stent size used for intervention. Intra-class correlation (ICC) analysis was performed to assess inter-reader agreement. Significant differences were considered at P < 0.05.
No significant difference was observed between estimated stent diameter by QISS MRA or CTA compared to physical stent diameter (8.9 ± 2.9 mm, 8.8 ± 3.0 mm, and 8.8 ± 3.8 mm, respectively; χ = 1.45, P = 0.483). There was a significant underestimation of stent length for both QISS MRA and CTA, compared to physical stent length (45.8 ± 27.8 mm, 46.4 ± 29.3 mm, and 50.4 ± 34.0 mm, respectively; χ = 11.96) which could be corrected when measurements were adjusted to the next available stent length (χ = 2.38, P = 0.303). Inter-reader assessment showed good to excellent agreement between the readers (all ICC ≥0.81).
QISS MRA represents a reliable method for pre-procedural lesion assessment and stent diameter and length estimation in PAD patients.
3 TECHNICAL EFFICACY: Stage 2.
间歇期层选磁共振血管造影术（QISS MRA）是一种非对比性的外周血管疾病（PAD）患者术前评估方法。然而，使用 QISS MRA 术前评估支架大小的可行性值得研究。
评估 QISS MRA 在 PAD 患者中的可行性，用于术前评估支架大小，与计算机断层血管造影术（CTA）相比。
回顾性。
33 名 PAD 患者（68±9 岁，18 名男性，15 名女性）。
磁场强度/序列：二维平衡稳态自由进动 QISS MRA，场强 1.5T 和 3T。
所有患者均接受下肢流出道 QISS MRA 和 CTA 检查，随后进行介入性数字减影血管造影（DSA）。狭窄病变长度和直径用（AMF 和 AVS 分别用 3 年和 13 年心血管成像经验）进行量化，以估计治疗动脉中恢复血流所需的支架尺寸。测量的尺寸调整到最接近的支架尺寸。
采用 Friedman 检验，随后进行两两 Wilcoxon 符号秩检验，比较 QISS MRA、CTA 和用于干预的物理支架尺寸之间的估计支架尺寸。采用组内相关系数（ICC）分析评估读者间的一致性。认为 P<0.05 有统计学差异。
QISS MRA 或 CTA 估计的支架直径与物理支架直径无显著差异（8.9±2.9mm、8.8±3.0mm 和 8.8±3.8mm，χ 2 =1.45，P=0.483）。与物理支架长度相比，QISS MRA 和 CTA 均显著低估了支架长度（45.8±27.8mm、46.4±29.3mm 和 50.4±34.0mm，χ 2 =11.96），当测量值调整到下一个可用的支架长度时，可以进行校正（χ 2 =2.38，P=0.303）。读者间评估显示，读者间具有良好到极好的一致性（所有 ICC≥0.81）。
QISS MRA 是 PAD 患者术前病变评估和支架直径及长度估计的可靠方法。
3 级 技术功效：2 级。
