Krinsky G, Maya M, Rofsky N, Lebowitz J, Nelson P K, Ambrosino M, Kaminer E, Earls J, Masters L, Giangola G, Litt A, Weinreb J
Department of Radiology, New York University Medical Center, NY 10017, USA.
J Comput Assist Tomogr. 1998 Mar-Apr;22(2):167-78. doi: 10.1097/00004728-199803000-00003.
Our goal was to evaluate non-breath-hold Gd-enhanced 3D MR angiography (MRA) for the detection of atherosclerotic occlusive disease of the aortic arch vessels and to compare image quality with two breath-hold techniques.
One hundred sixty consecutive patients with known or clinically suspected atherosclerotic cerebrovascular occlusive disease underwent Gd-enhanced 3D MRA of the aortic arch and great vessels. One hundred twenty-six examinations were performed with the body coil after infusion of 40 ml of Gd-DTPA; 89 of these were performed without breath-holding and 37 were acquired during suspended respiration. Thirty-four examinations were performed in a body phased-array coil with breath-holding, a timing examination, and 20 ml of contrast agent by manual (n = 17) or power (n = 17) injection. Images were evaluated for the presence of blurring and ghosting artifacts and venous enhancement. Of the 27 patients who underwent non-breath-hold MRI and digital subtraction angiography (DSA), two readers blinded to the DSA results retrospectively evaluated the MRA examinations for the presence of occlusive disease of the innominate, carotid, subclavian, and vertebral arteries. DSA correlation was not evaluated for the 71 breath-hold studies.
Sensitivity and specificity for arch vessel occlusive disease with non-breath-hold MRA were 38 and 94% for Reader A and 38 and 95% for Reader B. Breath-holding significantly reduced blurring and ghosting artifacts (p < 0.001) when compared with non-breath-hold imaging, and use of 20 ml of contrast medium, with a timing examination, resulted in significantly less venous enhancement than seen with 40 ml (p < 0.001).
Non-breath-hold Gd-enhanced 3D MRA is insensitive for detecting arch vessel occlusive disease. Breath-hold imaging, in conjunction with a timing examination and a lower dose of contrast agent, improves image quality, but further studies are needed to assess diagnostic accuracy.
我们的目标是评估非屏气钆增强三维磁共振血管造影（MRA）用于检测主动脉弓血管动脉粥样硬化闭塞性疾病，并将图像质量与两种屏气技术进行比较。
160例已知或临床怀疑患有动脉粥样硬化性脑血管闭塞性疾病的连续患者接受了主动脉弓和大血管的钆增强三维MRA检查。在注入40ml钆喷酸葡胺后，使用体线圈进行了126次检查；其中89次检查未屏气，37次检查在呼吸暂停期间采集。34次检查在体相控阵线圈中进行，屏气、进行定时检查，并通过手动（n = 17）或动力（n = 17）注射20ml造影剂。评估图像是否存在模糊和鬼影伪影以及静脉强化。在27例接受非屏气MRI和数字减影血管造影（DSA）的患者中，两名对DSA结果不知情的读者回顾性评估了MRA检查中无名动脉、颈动脉、锁骨下动脉和椎动脉闭塞性疾病的存在情况。对于71次屏气研究，未评估与DSA的相关性。
读者A对非屏气MRA检测弓血管闭塞性疾病的敏感性和特异性分别为38%和94%，读者B为38%和95%。与非屏气成像相比，屏气显著减少了模糊和鬼影伪影（p < 0.001），并且使用20ml造影剂并进行定时检查导致静脉强化明显少于使用40ml造影剂时（p < 0.001）。
非屏气钆增强三维MRA对检测弓血管闭塞性疾病不敏感。屏气成像结合定时检查和较低剂量的造影剂可提高图像质量，但需要进一步研究来评估诊断准确性。
