优化运动敏感驱动平衡预备的平衡稳态自由进动序列的应用

Initial experience of using improved motion sensitized driven equilibrium prepared balanced steady-state free precession

目的:评价基于非对比增强磁共振血管成像(NCE-MRA)技术的优化运动敏感驱动平衡(iMSDE)预备的平衡稳态自由进动(bSSFP)序列在糖尿病患者下肢血管成像中的应用价值。方法:这项前瞻性研究招募了35例Ⅱ型糖尿病患者并在1.5TMR扫描仪上先后进行NCE-MRA和CE-MRA检查;获得的MIP图像由两位放射学医师进行双盲评分并以CE-MRA为参考标准检测NCE-MRA对血管狭窄的诊断精度;两者间血管诊断价值血管段比率的比较采用χ~2检验。结果:NCE-MRA在盆腔段血管中诊断价值血管段比率较CE-MRA降低。两位医师对NCE-MRA组图像的敏感性、特异性、阳性预测值、阴性预测值以及NCE-MRA准确率分别为95%/87%、96%/95%、57%/72%、99%/99%、96%/95%(κ=0.76)。结论:此项基于NCE-MRA技术的iMSDE预备的bSSFP序列可有效的显示糖尿病患者下肢动脉病变,并且具备不使用造影剂、扫描时间短优点以及大腿及小腿段血管具备较好的诊断价值。

Objective To assess the application value of NCE?MRA using iMSDE prepared bSSFPsequence in lower limb in patients with diabetes.Methods This prospective study included a total of35patientswith type II diabetes who underwent CE?MRA on the1.5T MR scanner after the NCE?MRA.The obtained MIPimages were independently rated by two radiologist with a four score table and using CE?MRA as a referencestandard to evaluate the diagnostic accuracy of NCE?MRA for the narrowed arteries.The difference of the percentageof diagnostic arterial segments between NCE?MRA and CE?MRA on diabetic patients was evaluated by theχ2test.Results Compared with CE?MRA,the diagnostic?value arterial segment ratio of pelvic arteries on NCE?MRA isdecreased significantly.The sensitivity,specificity,positive predictive value,negative predictive value,andaccuracy of two readers in NCE?MRA were95%/87%,96%/95%,57%/72%,99%/99%,and96%/95%(k=0.76),respectively.Conclusions The NCE?MRA using iMSDE prepared bSSFP sequence is capable of depicting vascu?lar lesions for the lower extremities in diabetic patients with the advantages of contrast agent free,short scan timesand good diagnostic value in the thigh and calves.