Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Radiology, Nagasaki University Hospital, Nagasaki, Japan.
J Vasc Res. 2024;61(3):122-128. doi: 10.1159/000538175. Epub 2024 Mar 28.
We aimed to compare conventional vessel wall MR imaging techniques and quantitative susceptibility mapping (QSM) to determine the optimal sequence for detecting carotid artery calcification.
Twenty-two patients who underwent carotid vessel wall MR imaging and neck CT were enrolled. Four slices of 6-mm sections from the bilateral internal carotid bifurcation were subdivided into 4 segments according to clock position (0-3, 3-6, 6-9, and 9-12) and assessed for calcification. Two blinded radiologists independently reviewed a total of 704 segments and scored the likelihood of calcification using a 5-point scale on spin-echo imaging, FLASH, and QSM. The observer performance for detecting calcification was evaluated by a multireader, multiple-case receiver operating characteristic study. Weighted κ statistics were calculated to assess interobserver agreement.
QSM had a mean area under the receiver operating characteristic curve of 0.85, which was significantly higher than that of any other sequence (p < 0.01) and showed substantial interreader agreement (κ = 0.68). A segment with a score of 3-5 was defined as positive, and a segment with a score of 1-2 was defined as negative; the sensitivity and specificity of QSM were 0.75 and 0.87, respectively.
QSM was the most reliable MR sequence for the detection of plaque calcification.
我们旨在比较常规血管壁磁共振成像技术和定量磁化率映射（QSM），以确定检测颈动脉钙化的最佳序列。
共纳入 22 例接受颈动脉血管壁磁共振成像和颈部 CT 检查的患者。双侧颈内动脉分叉处的 6mm 层厚连续 4 个层面，根据时钟位置（0-3、3-6、6-9 和 9-12）分为 4 个节段，评估钙化情况。2 名盲法阅片的放射科医生对总共 704 个节段进行独立评估，使用 5 分制自旋回波成像、FLASH 和 QSM 对钙化的可能性进行评分。采用多读者、多病例的受试者工作特征研究评估检测钙化的观察者性能。计算加权κ统计量评估观察者间的一致性。
QSM 的受试者工作特征曲线下面积的平均值为 0.85，明显高于任何其他序列（p < 0.01），且观察者间一致性较高（κ=0.68）。评分 3-5 的节段定义为阳性，评分 1-2 的节段定义为阴性；QSM 的敏感性和特异性分别为 0.75 和 0.87。
QSM 是检测斑块钙化最可靠的磁共振序列。
