Carriero A, Gatta S, Baratto M, Marano R, Aulisa R, Bonomo L
Istituto di Scienze Radiologiche e Formazione dell'Immagine, Università degli Studi, Chieti.
Radiol Med. 1998 Mar;95(3):165-9.
Magnetic Resonance Angiography (MRA) potentials in all vascular districts have been largely applied also to peripheral vessels, where however there is no agreement as to the best type of sequence. We investigated the sensitivity, specificity and diagnostic accuracy of 2D TOF travel-sat MRA in the study of iliac-femoral artery stenoses. The gold standard was digital subtraction angiography (DSA).
Twenty patients (14 men and 6 women, mean age: 65 years with suspected atheromasic disease were examined. Diagnostic MRA and DSA were carried out within 48 hours of each other. A super-conductive 1 T magnet (Siemens Impact) and a body coil were used. 2D TOF travel-sat sequences were carried out with the following parameters: FA 40 degrees, TR 31 ms, ST 10 mm, overlap 1 mm, MA 128 x 512. The images acquired on the axial plane were postprocessed with MIP on the z axis from -15 degrees to 15 degrees. Two different radiologists evaluated MRA and DSA images and graded the stenoses on a multiple choice card: 1) negative, 2) 1-40%, 3) 41-70%, 4) 71-99%, 5) occlusion.
MRA diagnosed 90 positives and 110 negatives: 60 were true positives, 92 true negatives, 30 false positives and 18 false negatives. MRA overestimated 8 cases and underestimated 4 cases. DSA findings were negative in 122 cases and positive in 78 cases: 4 grade 2, 10 grade 3, 28 grade 4 and 36 grade 5. Relative to DSA, MRA sensitivity, specificity and diagnostic accuracy were 72%, 75% and 74%, respectively; MRA diagnostic accuracy, sensitivity and specificity in hemodynamically severe stenoses (> 71%) were 80%, 78% and 71.8%, respectively.
Our study confirms the usefulness of 2D TOF travel-sat MRA in the study of iliac-femoral stenoses.
磁共振血管造影（MRA）在所有血管区域的应用潜力已在很大程度上扩展到外周血管，但对于最佳序列类型尚无定论。我们研究了二维时间飞跃法（2D TOF）移行饱和MRA在髂股动脉狭窄研究中的敏感性、特异性和诊断准确性。金标准为数字减影血管造影（DSA）。
对20例疑似动脉粥样硬化疾病的患者（14例男性和6例女性，平均年龄65岁）进行检查。诊断性MRA和DSA在彼此48小时内进行。使用超导1T磁体（西门子Impact）和体线圈。二维时间飞跃法移行饱和序列采用以下参数进行：翻转角（FA）40度，重复时间（TR）31毫秒，层厚（ST）10毫米，层间重叠1毫米，矩阵（MA）128×512。在轴位平面采集的图像在z轴上从-15度到15度进行最大强度投影（MIP）后处理。两名不同的放射科医生评估MRA和DSA图像，并在多项选择卡上对狭窄程度进行分级：1）阴性，2）1-40%，3）41-70%，4）71-99%，5）闭塞。
MRA诊断出90例阳性和110例阴性：60例为真阳性，92例为真阴性，30例为假阳性，18例为假阴性。MRA高估8例，低估4例。DSA检查结果122例为阴性，78例为阳性：4例为2级，10例为3级，28例为4级，36例为5级。相对于DSA，MRA的敏感性、特异性和诊断准确性分别为72%、75%和74%；MRA在血流动力学严重狭窄（>71%）中的诊断准确性、敏感性和特异性分别为80%、78%和71.8%。
我们的研究证实了二维时间飞跃法移行饱和MRA在髂股动脉狭窄研究中的实用性。
