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Nonenhanced MR angiography of the hand with flow-sensitive dephasing-prepared balanced SSFP sequence: initial
John J Sheehan1, Zhaoyang Fan, Amir H Davarpanah
1Division of Cardiovascular Imaging, Northwestern Memorial Hospital, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611, USA. jsheehan@hermitageclinic.ie
Insights
Nonenhanced flow-sensitive dephasing (FSD) magnetic resonance (MR) angiography offers improved image quality and reduced assessment of digital artery stenosis compared to contrast-enhanced techniques for evaluating hand vasculature in systemic sclerosis patients.
Area of Science:
- Radiology
- Medical Imaging
- Vascular Imaging
Background:
- Systemic sclerosis can cause vasospastic disorders affecting hand vasculature.
- Accurate imaging of hand arteries is crucial for diagnosis and management.
- Contrast-enhanced MR angiography is a common technique, but noninvasive alternatives are desirable.
Purpose of the Study:
- To compare the image quality and degree of vessel narrowing using flow-sensitive dephasing (FSD) magnetic resonance (MR) angiography versus contrast-enhanced MR angiography in the hands.
- To evaluate these techniques in both healthy volunteers and patients with systemic sclerosis.
Main Methods:
- A single-center study involving 6 healthy volunteers and 6 patients with systemic sclerosis.
- 1.5-T nonenhanced FSD MR angiography was performed, followed by contrast-enhanced MR angiography.
- Sixteen vascular segments were assessed for image quality and stenosis degree using Likert scales.
Main Results:
- FSD MR angiography demonstrated improved image quality compared to time-resolved and high-spatial-resolution MR angiography in both control and patient groups.
- In healthy subjects, FSD angiography showed less severe digital artery stenosis (mean grade, 0.7) than other techniques.
- In patients, FSD angiography revealed lower degrees of stenosis (mean grade, 1.3) compared to contrast-enhanced methods.
Conclusions:
- Nonenhanced FSD MR angiography appears to be an improvement over contrast-enhanced techniques for evaluating hand vasculature in vasospastic disorders.
- Further technical advancements and clinical studies are recommended to validate these preliminary findings.
Purpose:
To compare the image quality and degree of vessel narrowing at flow-sensitive dephasing (FSD) magnetic resonance (MR) angiography of the hands with those at contrast material-enhanced MR angiography of the hands in patients with systemic sclerosis.
Materials And Methods:
In a single-center study with institutional review board approval and HIPAA compliance, six healthy volunteers and six patients with systemic sclerosis were imaged at 1.5-T nonenhanced FSD MR angiography followed by contrast-enhanced MR angiography. Sixteen vascular segments in four vessel groups were evaluated for image quality and assessed semiquantitatively for stenosis degree by using Likert scales. The nonparametric Wilcoxon signed rank test was used to perform pairwise comparisons of the MR angiographic techniques. P < .05 indicated statistical significance.
Results:
Performing FSD MR angiography, as compared with time-resolved MR angiography and high-spatial-resolution MR angiography, improved the image quality for all arterial segments combined in the control (mean score, 2.9 [FSD] vs 3.7 [time-resolved technique] and 3.1 [high-spatial-resolution technique]) and patient (mean score, 4.0 [FSD] vs 4.2 [time-resolved technique] and 4.3 [high-spatial-resolution technique]) groups. In the control subjects, FSD angiography depicted proper digital artery stenosis that was less severe (mean grade, 0.7) than that seen with the time-resolved (mean grade, 1.6) and high-spatial-resolution (mean grade, 1.0) techniques. In the patient group, FSD angiography depicted lower degrees of stenosis, with a lower mean grade for all segments combined (1.3) compared with the corresponding mean grades for time-resolved (1.5) and high-spatial-resolution (1.8) MR angiography.
Conclusion:
Preliminary data indicate that the proposed nonenhanced FSD MR angiographic technique is an improvement over existing contrast-enhanced techniques for evaluation of the hand vasculature in vasospastic disorders of the hand. Further technical improvements and a systematic clinical study are warranted.
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