Buijs P C, Klop R B, Eikelboom B C, Mali W P, Bakker C J, Beek F J, van Gils A P, Dillon E H, Ramos L M
Department of Radiology, Utrecht University Hospital, The Netherlands.
Eur J Vasc Surg. 1993 May;7(3):245-51. doi: 10.1016/s0950-821x(05)80004-0.
to evaluate the clinical usefulness of the two dimensional "Time of Flight" (2D TOF) Magnetic Resonance Angiography technique (MRA) in imaging the carotid bifurcation as compared to conventional angiography and pulsed and colour Doppler ultrasound.
in 19 patients with possible cerebrovascular disease and eight volunteers, contrast angiography was compared with MRA in 21 carotid bifurcations and with Doppler ultrasound in 23 bifurcations by two independent observers. In 19 bifurcations, all three techniques were available for comparison. Internal carotid arteries were graded normal/minimal disease, mild, moderate or severe stenosis, or occluded.
overall agreement between contrast angiography and MRA existed in 62% for one observer and 76% for the other. When MRA and Doppler agreed, agreement between these two investigations and contrast angiography existed in 77-81%. The major problem with MRA was overestimation of moderately stenosed vessels; 50% of the vessels with a moderate stenosis on contrast angiography were judged severely stenosed on MRA. An occlusion was never mistaken for a stenosis by MRA. Evaluating the separate slices, acquired in the 2D TOF MRA investigation, appeared to be essential to avoid this mistake.
at present 2D TOF MRA is not clinically useful for diagnosing the degree of carotid artery stenosis. MRA has a clear tendency to overestimate the degree of stenosis especially moderately severe stenoses. To date, there are no objective methods to correct for this mistake. Technical improvements may make MRA a better diagnostic tool in the future.
与传统血管造影以及脉冲和彩色多普勒超声相比，评估二维“飞行时间”（2D TOF）磁共振血管造影技术（MRA）在颈动脉分叉成像中的临床实用性。
对19例可能患有脑血管疾病的患者和8名志愿者进行研究，由两名独立观察者将21个颈动脉分叉处的对比血管造影与MRA进行比较，并将23个分叉处的MRA与多普勒超声进行比较。在19个分叉处，所有三种技术均可用于比较。颈内动脉被分为正常/轻度病变、轻度、中度或重度狭窄，或闭塞。
一名观察者对比血管造影与MRA的总体一致性为62%，另一名观察者为76%。当MRA和多普勒结果一致时，这两项检查与对比血管造影的一致性为77%-81%。MRA的主要问题是对中度狭窄血管的高估；对比血管造影显示为中度狭窄的血管中，50%在MRA上被判定为重度狭窄。MRA从未将闭塞误诊为狭窄。评估在2D TOF MRA检查中获取的单独切片似乎对于避免此错误至关重要。
目前2D TOF MRA在诊断颈动脉狭窄程度方面临床实用性不强。MRA明显倾向于高估狭窄程度，尤其是中度至重度狭窄。迄今为止，尚无客观方法纠正此错误。技术改进可能会使MRA在未来成为更好的诊断工具。
