用于主动脉血管内修复术后内漏评估的金角径向稀疏平行(GRASP)磁共振血管成像(MRA):与传统时间分辨 MRA 的前瞻性比较。

IF 2.9 2区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Quantitative Imaging in Medicine and Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-26 DOI:10.21037/qims-24-1130
Haidara Almansour, Migdat Mustafi, Mario Lescan, Ulrich Grosse, Mateja Andic, Jörg Schmehl, Christoph Artzner, Gerd Grözinger, Sven S Walter
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引用次数: 0

摘要

背景:具有交错随机轨迹的时间分辨血管造影(TWIST)磁共振血管造影(MRA)可能会遮挡较小的血管,而且极易受运动伪影的影响,可能会降低血管内主动脉修复术(EVAR)后内漏检测的准确性。新颖的黄金角径向稀疏平行(GRASP)序列通过连续、运动稳定的数据集提高了空间和时间分辨率,显示了EVAR术后准确检测内漏的前景。本研究旨在比较对比增强压缩传感径向GRASP-容积插值屏气检查(VIBE)序列与标准对比增强动态TWIST-VIBE序列对EVAR术后内漏检查结果不确定的计算机断层扫描血管造影(CTA)患者的诊断效果:这项单中心前瞻性研究连续招募了在腹主动脉瘤 EVAR 术后多相 CTA 检查中对内漏的存在或类型有不确定结论的成人。参与者接受造影剂增强 MRA 检查,获取动态 TWIST-VIBE 和 GRASP-VIBE 序列。两位独立的放射科医生对数据集的图像质量、诊断可信度以及内漏的存在和类型进行了评估。此外,还进行了信噪比(SNR)和对比度-信噪比(CNR)的定量评估。统计分析包括研究者之间和方法之间的一致性以及诊断性能测试:共纳入 20 名参与者(平均年龄为 72±9 岁;13 名男性)。GRASP-VIBE的图像质量优于TWIST-VIBE序列,主要无运动伪影,诊断信心增强(所有Pvs均为0.73;P=0.04]。GRASP-VIBE在整体(AUC:0.94 vs. 0.79)和I型内漏检测(AUC:1.0 vs. 0.90)方面的诊断准确性有所提高,但并不显著(P≥0.05)。TWIST-VIBE 序列在测量凝血动脉瘤囊时显示出明显更高的 SNR(P=0.01)。在对比的成像序列中,主动脉和任何动脉瘤囊的 CNR 均无明显差异:结论:压缩传感动态 GRASP-VIBE 序列在图像质量、诊断信心和性能方面均优于标准 TWIST-VIBE 序列,可作为不确定内漏病例的首选。
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Golden-angle radial sparse parallel (GRASP) magnetic resonance angiography (MRA) for endoleak evaluation after endovascular repair of the aorta: a prospective comparison to conventional time-resolved MRA.

Background: Time-resolved angiography with interleaved stochastic trajectories (TWIST) magnetic resonance angiography (MRA) may obscure smaller vessels and is highly susceptibility to motion artifacts, potentially reducing endoleak detection accuracy after endovascular aortic repair (EVAR). The novel golden-angle radial sparse parallel (GRASP) sequence enhances spatial and temporal resolution with continuous, motion-robust datasets, showing promise for accurate endoleak detection post-EVAR. This study aimed to compare the diagnostic effectiveness of contrast-enhanced compressed-sensing radial GRASP-volume interpolated breath-hold examination (VIBE) sequence with standard contrast-enhanced dynamic TWIST-VIBE sequence in patients with inconclusive computed tomography angiography (CTA) findings regarding endoleak after EVAR.

Methods: This single-center prospective study consecutively enrolled adults with inconclusive findings regarding the presence or type of endoleak in multiphasic CTA following EVAR for abdominal aortic aneurysms. Participants underwent contrast-enhanced MRA, acquiring dynamic TWIST-VIBE and GRASP-VIBE sequences. Two independent radiologists assessed the datasets for image quality, diagnostic confidence, and the presence and type of endoleak. Additionally, quantitative assessments with signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) were performed. Statistical analyses included interrater and intermethod agreement, and diagnostic performance testing.

Results: Twenty participants (mean age, 72±9 years; 13 males) were included. GRASP-VIBE demonstrated superior image quality over TWIST-VIBE sequence with predominantly absent motion artifacts and increased diagnostic confidence (all P<0.001). Diagnostic performance significantly improved for detecting type II endoleaks in GRASP-VIBE compared to TWIST-VIBE scans [area under the curve (AUC): 0.96 vs. 0.73; P=0.04]. Diagnostic accuracy improved with GRASP-VIBE for overall (AUC: 0.94 vs. 0.79) and endoleak type I detection (AUC: 1.0 vs. 0.90), however, not significantly (P≥0.05). TWIST-VIBE sequences demonstrated significantly higher SNR for measurements in the clotted aneurysm sac (P=0.01). No significant differences were observed in CNR for the aorta and any aneurysm sacs across the compared imaging sequences.

Conclusions: Compressed-sensing dynamic GRASP-VIBE sequence, with its superior image quality, diagnostic confidence, and performance, may be preferred over standard TWIST-VIBE sequence in inconclusive endoleak cases.

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来源期刊
Quantitative Imaging in Medicine and Surgery
Quantitative Imaging in Medicine and Surgery Medicine-Radiology, Nuclear Medicine and Imaging
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4.20
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17.90%
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252
期刊介绍: Information not localized
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