3 T非对比剂增强静态间隔单次激发MRA对下肢动脉硬化的诊断价值

Non-contrast enhanced quiescent interval single shot magnetic resonance angiography at 3T for lower extremity peripheral arterial disease

目的 :与CTA对比,探讨3 T非对比剂增强静态间隔单次激发(QISS)MRA的图像主观评分及其诊断下肢动脉硬化的准确性。方法:选择32例临床怀疑下肢动脉硬化患者行QISS MRA和CTA检查。把全下肢动脉分为19个节段,分别评估MRA和CTA对下肢血管的显示,并使用秩和检验分析两者差异。使用Kappa检验分析MRA和CTA在评估动脉狭窄方面的一致性。结果:QISS MRA的平均图像主观评分为3.71分,显著低于CTA的图像评分3.81分(P<0.001)。但对于显著钙化的动脉节段,QISS MRA的图像评分高于CTA。在评估动脉狭窄方面,MRA与CTA间有很好的一致性(K=0.925±0.012)。结论:在评估下肢动脉硬化方面,QISS能作为CTA的替代检查,尤其是对碘过敏或肾功能不全而无法行CTA者,QISS可作为首选检查方法。

Objective：To compare image subjective score and diagnostic accuracy of non-contrast enhanced Quiescent Interval Single Shot （QISS） magnetic resonance angiography at 3 T versus CT angiography for evaluation of lower extremity peripheral arterial disease （PAD）. Methods：32 consecutive patients （17 male,15 female,age range 41-83 years,average age 63.4 years） with clinically suspected lower extremity PAD underwent QISS MRA and CTA. Image score of MRA was compared with CTA. The Kappa test was used to determine the intermodality agreement between MRA and CTA in stenosis assessment. Results：Mean image score of QISS MRA was 3.71,significantly lower than that of CTA （3.81,P〈0.001）.Intermodality agreement be-tween MRA and CTA was excellent for assessment of stenosis （Kappa=0.925±0.012）. Conclusion：QISS is an alternative to CTA for evaluation of lower extremity PAD,and can serve as a first-line screening examination in patients with contraindications to intravenous contrast administration.