Osmanodja Filiz, Rösch Julie, Knott Michael, Doerfler Arnd, Grodzki David, Uder Michael, Heiss Rafael
From the Department of Neuroradiology, Friedrich-Alexander-Universität Erlangen-Nürnberg.
Magnetic Resonance Division, Siemens Healthcare GmbH.
Invest Radiol. 2023 Feb 1;58(2):121-125. doi: 10.1097/RLI.0000000000000918. Epub 2022 Sep 2.
Intracranial aneurysm (IA) is the main cause of subarachnoid hemorrhages. Time-of-flight (TOF) magnetic resonance angiography (MRA) at 1.5 T or 3 T magnetic resonance imaging (MRI) is a well-established method for the diagnosis of IA. The aim of this prospective study was to evaluate the performance of a modern 0.55 T MRI in the diagnosis of IAs in comparison to digital subtraction angiography (DSA) as a standard of reference.
Seventeen patients with suspicion of single or multiple IAs underwent TOF MRA at 0.55 T MRI 1 day before DSA. Two neuroradiologists independently measured the aneurysm neck, width, and height on 0.55 T, 1.5 T, and 3 T 3D-TOF MRA source images and 2D/3D rotational angiography. The main analysis assessed the intermodality agreement between 0.55 T TOF MRA and DSA using Bland-Altman plots, a Wilcoxon test, and the intraclass correlation coefficient (ICC). In a secondary analysis, aneurysm dimensions were compared between 0.55 T TOF MRA and 1.5/3 T TOF MRA. Interreader agreement was evaluated by ICC. A third neuroradiologist blinded to patient history screened 0.55 T TOF MRA data sets of the aforementioned 17 patients and 15 additional healthy patients for the presence and location of aneurysms.
A total of 19 aneurysms in 16 patients were identified in both 0.55 T MRA and DSA. Measurements of the 2 nonblinded readers showed no significant differences between 0.55 T TOF MRA and DSA in the overall aneurysm size (calculated as the mean from height/width/neck) ( P = 0.178), as well as in the mean width ( P = 0.778) and neck values ( P = 0.190). The mean height was significantly larger in 0.55 T TOF MRA in comparison to DSA ( P = 0.020). Intermodality (1.5/3 T TOF MRA) and interrater agreement were excellent (ICC > 0.94). Of the 32 data sets of patients with and without IA, the blinded reader detected all aneurysms correctly by using 0.55 T images.
TOF-MRA acquired with a modern 0.55 T MRI is a reliable tool for the detection and initial assessment of IAs.
颅内动脉瘤（IA）是蛛网膜下腔出血的主要原因。1.5T或3T磁共振成像（MRI）的时间飞跃（TOF）磁共振血管造影（MRA）是诊断IA的成熟方法。本前瞻性研究的目的是评估现代0.55T MRI在诊断IA方面的性能，并与作为参考标准的数字减影血管造影（DSA）进行比较。
17例怀疑患有单发或多发IA的患者在DSA前1天接受了0.55T MRI的TOF MRA检查。两名神经放射科医生在0.55T、1.5T和3T的3D-TOF MRA源图像以及2D/3D旋转血管造影上独立测量动脉瘤的颈部、宽度和高度。主要分析使用Bland-Altman图、Wilcoxon检验和组内相关系数（ICC）评估0.55T TOF MRA与DSA之间的模态间一致性。在次要分析中，比较了0.55T TOF MRA与1.5/3T TOF MRA之间的动脉瘤尺寸。读者间一致性通过ICC进行评估。第三位对患者病史不知情的神经放射科医生对上述17例患者和另外15例健康患者的0.55T TOF MRA数据集进行筛查，以确定是否存在动脉瘤及其位置。
在0.55T MRA和DSA中均识别出16例患者中的19个动脉瘤。两位非盲读者的测量结果显示，0.55T TOF MRA与DSA在总体动脉瘤大小（计算为高度/宽度/颈部的平均值）（P = 0.178）、平均宽度（P = 0.778）和颈部值（P = 0.190）方面无显著差异。与DSA相比，0.55T TOF MRA中的平均高度显著更大（P = 0.020）。模态间（1.5/3T TOF MRA）和评分者间一致性极佳（ICC > 0.94）。在有和没有IA的32例患者的数据集中，盲态读者通过使用0.55T图像正确检测出了所有动脉瘤。
采用现代0.55T MRI获取的TOF-MRA是检测和初步评估IA的可靠工具。
