Koktzoglou Ioannis, Ozturk Onural, Walker Matthew T, Ankenbrandt William J, Ong Archie L, Ares William J, Gil Fulvio R, Bulwa Zachary B, Edelman Robert R
Department of Radiology, Endeavor Health, Evanston, Illinois, USA.
University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.
J Magn Reson Imaging. 2025 Jan;61(1):404-412. doi: 10.1002/jmri.29395. Epub 2024 Apr 25.
Standard Cartesian time-of-flight (TOF) head magnetic resonance angiography (MRA) is routinely used to evaluate the intracranial arteries, but does not provide quantitative hemodynamic information that is useful for patient risk stratification as well as for monitoring treatment and tracking changes in blood flow over time. Quantitative TOF (qTOF) MRA represents a new and efficient method for simultaneous evaluating the intracranial arteries and quantifying blood flow velocity, but it has not yet been evaluated in patients with cerebrovascular disease.
To evaluate qTOF for simultaneously evaluating the intracranial arteries and quantifying intracranial blood flow velocity in patients with cerebrovascular disease, without the need for a phase contrast (PC) scan.
Prospective.
Twenty-four patients (18 female, 6 male) with cerebrovascular disease.
FIELD STRENGTH/SEQUENCES: Head MRA at 3 T using gradient-echo 3D qTOF, standard Cartesian TOF, and PC protocols.
Three independent readers assessed arterial image quality using a 4-point scale (1: non-diagnostic, 4: excellent) and artifact presence. Total and component flow velocities obtained with qTOF and PC were measured.
Wilcoxon signed-rank tests, Gwet's AC2, intraclass correlation coefficients (ICC) for absolute agreement, Bland-Altman analyses, tests of equal proportions. P values <0.05 were considered statistically significant.
Averaged across readers and compared to standard Cartesian TOF, qTOF significantly improved overall arterial image quality (3.8 ± 0.2 vs. 3.6 ± 0.5), image quality at locations of pathology (3.7 ± 0.5 vs. 3.4 ± 0.7), and increased the proportion of evaluations rated without artifacts (63.9% [46/72] vs. 37.5% [27/72]). qTOF significantly agreed with PC for total flow velocity (ICC = 0.71) and component flow velocity (ICC = 0.89).
qTOF angiography of the head matched or improved upon the image quality of standard Cartesian TOF, reduced image artifacts, and provided quantitative hemodynamic data, without the need for a PC scan.
2 TECHNICAL EFFICACY: Stage 2.
标准笛卡尔时间飞跃（TOF）头磁共振血管造影（MRA）常用于评估颅内动脉，但无法提供有助于患者风险分层以及监测治疗和追踪血流随时间变化的定量血流动力学信息。定量TOF（qTOF）MRA是一种同时评估颅内动脉和量化血流速度的新的有效方法，但尚未在脑血管疾病患者中进行评估。
评估qTOF在无需相位对比（PC）扫描的情况下，对脑血管疾病患者同时评估颅内动脉和量化颅内血流速度的能力。
前瞻性研究。
24例脑血管疾病患者（18例女性，6例男性）。
场强/序列：采用梯度回波3D qTOF、标准笛卡尔TOF和PC协议在3T下进行头MRA检查。
三位独立的阅片者使用4分制（1分：非诊断性，4分：优秀）评估动脉图像质量和伪影情况。测量qTOF和PC获得的总血流速度和各成分血流速度。
Wilcoxon符号秩检验、Gwet's AC2、绝对一致性的组内相关系数（ICC）、Bland-Altman分析、等比例检验。P值<0.05被认为具有统计学意义。
在阅片者之间进行平均并与标准笛卡尔TOF相比，qTOF显著提高了总体动脉图像质量（3.8±0.2对3.6±0.5）、病变部位的图像质量（3.7±0.5对3.4±0.7），并增加了无伪影评级的评估比例（63.9%[46/72]对37.5%[27/72]）。qTOF在总血流速度（ICC = 0.71）和各成分血流速度（ICC = 0.89）方面与PC显著一致。
头部qTOF血管造影在图像质量上与标准笛卡尔TOF相当或有所提高，减少了图像伪影，并提供了定量血流动力学数据，无需进行PC扫描。
2级 技术效能：2级
