$B2<;h#M#R(Jangiography$B$K$h$kIA=PG=$N8!F$(J
$B!A7l4IB$1F!J#D#S#A!K$H$NHf3S$+$i!A(J
Evaluation of the indicative quality of lower extremity MR angiography
$B!](Jcompared with MRA and DSA$B!](J
$BBS9-8|@8IB1!!!!!J|
$B?ALnFX;K!!;3:jCN9n!!2f:JIp;N(J
$B2<@nNIH~!!BgLnN50l(J
SUMMARY
The two-dimensional time of flight method in magnetic resonance angiography (2D-TOF MRA) is said to overestimate the actual area of stenosis.
$B!!!!(JWe made stenosed mimic blood vessels and examined the result (the rate and length of stenosis) bymeasuring with MRA and DSA. Changing flip angles, we executed 2D-TOF MRA of the lower limbs and obtained the most suitable flip angle for it.
( Results )
- The most suitable flip angle was 50 degrees for the veins, and 40 degrees for the arteries.
- As the area of the mimic stenosis became larger, the rate and length of stenosis measured with MRA was overestimated.
- The segmented part of stenosis shown by angiography could be detected equally by MRA.
- In clinical cases, we found that the stenosis rate of 2D-TOF MRA was higher than that of angiography, and its length had no regularity in either case.
$B=o!!8@(J
$B!!(JMagnetic Resonance Imaging$B!J0J2<(J $B#M#R(JI$B!K$N1~MQ5;=Q$N0l$D$H$7$F(J Magnetic Resonance angiography$B!J(J $B0J2<(J $B#M#R#A(J $B!K$,$"$j!"$3$N?tG/F,38Fb7l4I$NIA=P$rCf?4$KH/C#$7$F$-$?$,!"6aG/6;It!"J"It!";M;h$J$IA4?H$N7l4I$K1~MQ$5$l$k$h$&$K$J$C$F$-$?(J1)$B!#(J
$B!!#M#R#A(J $B$N:GBg$ND9=j$O!"B$1F:^$d%+%F!<%F%k$r;HMQ$;$:L5?/=1E*$K7l4I$rIA=P$G$-$k;v$G$"$j(J2)$B!"Ev;\@_$K$*$$$F!":#8e$^$9$^$9A}$($F$$$/8!::$G$"$k$H9M$($i$l$k!#(J
$B!!#M#R(JI$B$G$O!"N.B.$r$b$DJ*BN$,$5$^$6$^$J?.9f6/EY$r<($9$,!"A*BrE*$K7lN.$N$_$r2hA|2=$9$k
$B!!2<;h(J $B#M#R#A(J $B$N8=CJ3,$K$*$1$kM-MQ@-$K$D$$$F!"#M#R#A$H7l4IB$1F!J#D#S#A(J : Digital Subtra-ction Angiography $B!K$rHf3S8!F$$7$?!#(J
$BL\!!E*(J
$B!!Ev1!$G$O!"(J1994$BG/(J $B#37n$K(JGE$B@=(J Signa Adva-ntage$B$,F3F~$5$l(J 7$B7n$^$G$N(J 4‹$Bl;jGb)áA(J663$B7o$N8!::$,9T$J$o$l!"$=$N$&$A2<;h(J $B#M#R#A(J $B$,(J 20$B7o9T$J$o$l$?!#(J
$B!!2<;h(J MRA$B$K$O!"
- $B%9%i%$%9LL$KJ?9T$J7lN.$ODc46EY$G$"$k!#(J
- $B69:u$r2aBgI>2A$9$k2DG=@-$,$"$k!#(J
- $BKv>?7l4I$NIA=PG=$,0-$$!#(J
- $BBNF0$K$h$j7lN.It$NO"B3@-$,<:$o$l$k!#(J
$B$J$I$N7gE@$,$"$j!":#2s!"2f!9$O(J $B#M#R#A$,69:uIt0L$r2aBgI>2A$9$k$H8@$&LdBjE@$KBP$7$F!"69:uN($H69:uIt$ND9$5$K$D$$$F(J $B#D#S#A$HHf3S8!F$$7$?!#(J
$B$^$?!"2<;h$NF0L.$H@EL.$K$*$$$F:GE,;#1F>r7o!"FC$K!!(JFlip angle $B$K$D$$$F$N8!F$$r9T$C$?!#(J
$B;HMQ5!4o(J
- GE$B$BEl$B;HMQ%3%$%k!'(JBody coil
- $BLO5<69:u%U%!%s%H%`!J;n:n!K(J
$BJ}!!!!K!(J
$B!!;#1F%7!<%1%s%9$O!"(JSPGR (Spoiled Grass)$B$N(J 2D-TOF$BK!$rMQ$$$?!#(J
$B!!;HMQ$7$?(JScan Parameters$B$r(JTable 1$B$K<($9!#>INc$K$*$$$F$O!"F0L.$N$_$r;#1F$9$k>l9g!"%9%i%$%9$NHxJ}8~$K3F%9%i%$%9$4$H$K(J SAT (Saturation)$B$r@_$1$k$3$H$K$h$j!"8!=P$9$k7lN.$NJ}8~$rF,HxJ}8~$N$_$H$7!"@EL.?.9f$N>C5n$r9T$J$$F0L.$N$_$rIA=P$7$?8e!":GBg51EYEj1FK!(J (MIP : Maximun Intensity Proje-ction)$BK!$G=hM}$r9T$J$$#3
Table 1 Scan Parameters of Method
| Method 1 | Method 2 | Method 3
|
|---|
| Scanning Plane | Axial | Axial | Axial
|
|---|
| Flip Angle (deg) | 10-90 | 40 | 40
|
|---|
| TR (ms) | 33 | 33 | 33-45
|
|---|
| TE (ms) | 6.9 | 6.9 | 6.9-14
|
|---|
| FOV (cm) | 20x20, 32x24 | 20x20 | 32x32-24
|
|---|
| Matrix | 256x256 | 256x256 | 256x192-256
|
|---|
| Slice Thick. (mm) | 2.9 | 2.9 | 1.5-2.9
|
|---|
| NEX | 1 | 1 | 1
|
|---|
$B#1!%(J Flip angle$B$NJQ2=$K$D$$$F(J
- (1) Flow Phantom$B$rMQ$$$?$H$-(J
- Fig.1 $B$K<($9MM$K!"Fb7B&U(J8mm$B$N(J tube$B$r2>A[L.4I$H$7$F(J Flow Phantom $B$r:n$j!"Dj>oN.$rMQ$$$F4pACE*
- (2) $B2<;hF0L.$H@EL.$N:GE,$J(JFlip angle
- $B!!@5>o%\%i%s%F%#%"!J(J $B#5Nc!K$K$h$j!"(J2D-TOF$BK!$N;#1F$rBgB\9|F,%l%Y%k$G(J axial scan$B$r9T$J$$!"AmD29|F0L.$HAmD29|@EL.$K$D$$$F!"$=$l$>$l;#1F$r9T$J$C$?!#(J
- $B!!%9%-%c%s%Q%i%a!<%?(J $B$O(J TR (time of repetition ), TE (time of echo ), Slice Thickness $B$r8GDj$7(J Flip angle $B$rJQ2=$5$;!"7lN.$N?.9f$N6/$5$rB,Dj$7:GE,$J(J Flip angle $B$r5a$a$?!#(J
$B#2!%69:u(J Phantom$B$rMQ$$$?!"#M#R#A$H#D#S#A$NHf3S(J
- $B!!(JFig.2$B$K<($9MM$K!"Fb7B(J $B&U(J8mm$B$N(J tube$B$K69:u$N0c$&(J $B#3A[L.4I$H$7$F4pACE*/$J$/$9$k$?$aBf7A7?$K$7$?!#$=$7$F3F(J Phantom $B$KKhIC(J 20cm$B$NDj>oN.$GB$1F:^!J(JIopamiron370$B$rLs(J 5$BG\$K4u
fig. 2 $BLO5<69:u(J Phantom
$B#3!%>INc$K$*$1$k69:uN($H69:uHO0O$K$D$$$F(J
- $B!!BP>]$O(J 1995$BG/#37n$+$i#77n$^$G$K!"#M#R#A$H7l4IB$1F(J $B!J#D#S#A!K$r;\9T$7$?!"2<;hF0L.$NJD:I@-F0L.9E2=>I!J(JASO : Arteriosclerosis Ob-literans) $B$N(J $B#4>INc$K$D$$$F!"(JPTA ( percu-taneous transluminal angioplasty )$BA08e$K$*$1$k69:uIBJQ$N69:uN($H!"69:uHO0O$NIA=PG=$rHf3S8!F$$7$?!#(J
$B7k!!2L(J
$B#1!%(J Flip angle$B$NJQ2=(J
- (1) Flow Phantom$B$rMQ$$$?$H$-(J
- $B!!(JFig.3$B$K<($9MM$K!"(JFlip angle $B$,Bg$-$/$J$k$K$D$l$F?.9f6/EY$O!"A}2C798~$r<($7$?!#KhIC(J 80cm$B$h$jKhIC(J 20cm$B$NJ}$,?.9f6/EY$O6/$+$C$?!#(J
- (2) $B2<;hF0L.$H@EL.$N:GE,$J(JFlip angle
- $B!!8!F$$7$?852hA|$r(J Photo.1$B$K<($9!#?.9f6/EY$N7WB,$O!"L\E*7l4I$K4X?4NN0h$r@_Dj$7F0L.$H@EL.$N7lN.?.9f6/EY$rB,Dj$7$?!#(J $B#5Nc$NF0L.$H@EL.$N7lN.?.9f$KBP$7$FAjBP?.9f6/EY$r5a$a$?(J ( Fig.4 )$B!#F0L.$G$O(J 40$B!k!A(J 50$B!,$G%T!<%/$KC#$7!"$=$l0J9_$G$O%W%i%H!<$K$J$C$?!#@EL.$G$O(J 50$B!k!A(J 60$B!,$G%T!<%/$KC#$7!"$=$l0J9_$G$O%W%i%H!<$K$J$C$?!#852hA|$HHf$Y$k$H(J Flip angle $B$,Bg$-$/$J$k$K$D$l!"0LAj%(%s%3!<%IJ}8~$N(J artifact $B$,L\N)$D$h$&$K$J$k$N$G!"(Jartifact$B$,>/$J$/?.9f6/EY$,6/$$(JFlip angle $B$O!"F0L.$N$H$-(J 40$B!k!"@EL.$N$H$-$O(J 50$B!k$,:GE,$J!!(JFlip angle $B$H9M$($i$l$?!#(J
fig. 3 Flow Phantom $B$K$*$1$k(J Flip Angle $B$NJQ2=(J
fig. 4 $BF0L.$H@EL.$K$*$1$k(J Flip Angle $B$NJQ2=(J
Photo 1 Filp Angle (a) 10, (b) 40, (c) 45, (d) 90
$B#2!%69:u(J Phantom$B$rMQ$$$?!"#M#R#A$H#D#S#A$NHf3S(J
- $B!!(J3$BPhoto 2 $B69:u(J Phantom $B$K$h$k(J MRA, DSA $B$NHf3S(J
- (1) $B69:uN($K$D$$$F(J
- $B!!69:uN($NI>2A$O!"
- $B!!!!!!!!#S#L!a!J#L#n!]#L#s!K!?#L#n!K!_(J 100$B!!!D!D!D(J (1)
- $B!!!!!!!!!!!!!!#S#L!'(JLength$BK!$K$h$k69:uN((J
- $B!!!!!!!!!!!!!!#L#n!'@5>oIt$N7l4I$NI}(J
- $B!!!!!!!!!!!!!!#L#s!'69:uIt$N7l4I$NI}(J
- $B!!
Table 2 $B69:u(J Phantom $B$K$h$k(J Rate of Stenosis (in % unit)
| | $B!!(JDSA$B!!(J | $B!!(JMRA$B!!(J | Phantom
|
|---|
| Model-1 | 54.3 | 85.5 | 52.5
|
|---|
| Model-2 | 61.3 | 70.0 | 60.0
|
|---|
| Model-3 | 80.0 | 100 | 81.0
|
|---|
- (2) $B69:u$NHO0O!JD9$5!K$K$D$$$F(J
- $B!!(JPhantom $B69:uIt$N
Table 3 $B69:u(J Phantom $B$K$h$k(J Length of Stenosis (in mm unit)
| | $B!!(JDSA$B!!(J | $B!!(JMRA$B!!(J | Phantom
|
|---|
| Model-1 | 14.7 | 17.0 | 14.0
|
|---|
| Model-2 | 16.2 | 25.0 | 16.0
|
|---|
| Model-3 | 10.8 | 19.0 | 11.0
|
|---|
$B#3!%>INc$K$*$1$k69:uN($H69:uHO0O$K$D$$$F(J
- (1) $B69:uN($K$D$$$F(J
- $B!!69:uN($NI>2A$O(J(1)$B!]<0$N(JLength$BK!$rMQ$$$F9T$J$C$?!#69:uN($O(J angiography$B$HHf3S$7$F#M#R#A(J $B$NJ}$,F1Ey$+9bCM$r<($7$?(J (Table4)$B!#(J
Table 4 $B>INc$K$*$1$k(J Rate of Stenosis (in % unit)
| Pre PTA | Pre POST
|
|---|
| Angio | DSA$B!!(J | Angio | DSA$B!!(J
|
|---|
| Lesion 1 | 100 | 100 | 50 | 75
|
|---|
| Lesion 2 | 33 | 100 | 33 | 50
|
|---|
| Lesion 3 | 60 | 60 | 20 | 37
|
|---|
| Lesion 4 | 100 | 100 | 43 | 37
|
|---|
- (2) $B69:u$NHO0O!JD9$5!K$K$D$$$F(J
- $B!!69:u$ND9$5$O!"(J angiography $B$HHf3S$7$F(J $B#M#R#A(J $B$O!">INc$K$h$C$F!"$P$i$D$-$N$"$kCM$r<($7$?(J (Table5)$B!#(J
Table 5 $B>INc$K$*$1$k(J Length of Stenosis (in mm unit)
| Pre PTA | Pre POST
|
|---|
| Angio | DSA$B!!(J | Angio | DSA$B!!(J
|
|---|
| Lesion 1 | 180 | 132 | 35 | 45
|
|---|
| Lesion 2 | 11 | 8 | 11 | 15
|
|---|
| Lesion 3 | 17 | 15 | 17 | 15
|
|---|
| Lesion 4 | 114 | 82 | 114 | 110
|
|---|
$B9M!!;!(J
$B!!#M#R#A$K$O!"7lN.$N(J inflow $B8z2L$rMxMQ$7$?(J Time of flight $BK!$H(J phase shift$B8z2L$rMxMQ$7$?(J Phase contrast $BK!$,
$B!!#T#O#F8z2L$K$O!"(Jinflow$B!JN.F~!K8z2L$H(J out-flow$B!JN.=P!K8z2L$,$"$j!"$3$N(Jinflow$B8z2L$K$h$k?.9f6/EY$KBg$-$/1F6A$9$k0x;R$H$7$F7lN.B.EY(J(v),$B7+$jJV$7;~4V(J(TR),$B%(%3!<;~4V(J(TE),$B%9%i%$%9I}$,$"$k!#$^$?!"(JSPGR$BK!$G$O(J Flip angle $B$N1F6A$,Bg$-$$$H8@$o$l$F$$$k!#(J
$B#1!%;#1F(J sequence$B$N8!F$(J
- (1) Flip angle$B$K$D$$$F(J
- $B!!:#2s!"(JPhantom $Be$K$J$k$H(Jartifact $B$,H/@8$9$k$?$a!"7lN.?.9f$ODc2<$9$k$3$H$,2r$C$?!#$3$l$O(J Phantom $Bl9g!"?e$NN.$l$,Dj>oN.$N$?$a0LAjJ}8~$X(J artifact$B$,H/@8$7$F$bB.EYJd@5K!!J0J2<(J FC:Flow Compensation)$B$rMQ$$$k;v$K$h$j0LAj$,B7$C$?>uBV$KLa$9$3$H$,$G$-$k$,!"?MBN7l1U$N>l9g$O?4B!$K$h$kGoF0N.$N$?$a2CB.$H8:B.$,$"$j(J FC$BK!$rMQ$$$F$b0LAj$,B7$o$J$$$?$a$G$"$k!#@EL.$NJ}$,F0L.$h$jDj>oN.$K6a$$>uBV$K$"$k$?$a!"%W%i%H!<$N0LCV$,>/$79b$$CM$K$J$k$H9M$($i$l$k!#(J
- (2) TE,TR,Slice Thickness$B$K$D$$$F(J
- $B!!(JTE$B$O!"0lHLE*$KC;$$$[$INI$$7lN.2hA|$,F@$i$l$k$,?e$H;iKC?.9f$rM^@)$9$k(J Out$B+~(JPhase$B!J(J1.5$B&?Mb7b+b(JTE$B!'(J6.9ms$B!K$rMQ$$$?J}$,7lN.0J30$N?.9f$,Dc2<$9$k$?$a!"7lN.$N?.9f$r6/D4$5$;$k$3$H$,$G$-$k!#(JTR$B$O!"C;$$$[$I6/$$?.9f6/EY$r<($9$,!"C;$9$.$k$H(J S/N$B$,Nt2=$9$k$*$=$l$,$"$k!#(J
- $B!!%9%i%$%98|$O(Jsigna$B$N>l9g(J 1.5$B!A(J2.9mm$B$N4V$G$O!">/$7%*!<%P!<%i%C%W$7$F;#1F$9$kMM$K$J$C$F$$$k!#(J3mm $B0J>e$K$J$k$H(JTE,TR$B$NCM$,Bg$-$/$J$k$?$a(J 1.5$B!A(J2.9mm$B$N4V$G;HMQ$9$kJ}$,NI$$!#(J
- $B!!%9%i%$%98|$O!"Gv$$$[$I%9%i%$%9J}8~$N6u4VJ,2rG=$OM%$l$F$$$k$,!"BgF0L.$J$I$NB.$$7lN.$N>l9g!"Gv$$%9%i%$%9$r;HMQ$9$k$H7lN.?.9f$,Dc2<$9$k$3$H$,$"$j!";#1F$9$kIt0L$N7lN.$NB.EY$r==J,$K9MN8$7$F@_Dj$9$kI,MW@-$,$"$k!#(J
$B#2!%7lN.?.9f$rDc2<$5$;$k0x;R(J
- $B!!#M#R#A(J $B$O7lN.$NN.$l$N?.9f$rIA=P$7$F$$$k$?$a!"69:uIt0L$K$h$C$F$*$3$kB.$$N.B.!"MpN.!"12N.$J$I$,7lN.?.9f$rDc2<$5$;$k!#(J
- (1) $BB.$$N.B.$K$h$k?.9fDc2<(J
- $B!!(JPhantom$B2A$7$F$$$k$3$H$,2r$C$?!#$3$l$O69:u$,$"$k$H69:uItJ,$KHf3SE*N.$l$NB.$$NN0h$,$G$-$k$?$a$G$"$j!"69:uN($,Bg$-$$$[$IB.$$N.B.$K$J$j(Jout flow$B8z2L$G$"$k?.9f6/EY$,Dc2<$9$k$?$a$G$"$k$H9M$($i$l$k!#$^$?!"(J80$B!s69:u$N$H$-(J $B#M#R#A(J $B$G$O(J100$B!s$r<($7$?$N$O9bN.B.$N$?$a!"(JRF$B%Q%k%9$re$K0\F0$7$?0Y$KL5?.9f$r<($7$?$H9M$($i$l$k!#(J
- $B!!:#2s$N>INc$K$*$$$F(J MRA$B$G$O!"7l4IB$1F$G8!=P$5$l$?A4$F$N69:uIBJQ$rIA=P$7!"B8:_?GCG$N(J Sensitivity$B$O(J 100$B!s$G$"$C$?!#(J
- (2) $BMpN.$H12N.$K$h$k?.9fDc2<(J
- $B!!(JPhantom $B8e$KCY$$12N.$HMpN.$,@8$8$k$?$a!"?.9f6/EY$,Dc2<$769:uIt$,D9$/$J$C$?$H9M$($i$l$k!#(J
- $B!!>INc$K$*$$$F!"(Jangiography$B$NCM$HHf3S$7$F(J $B#M#R#A$NCM$,$P$i$D$-$,B?$+$C$?$N$O!"?M4V$N7l4I$,F0L.9E2=>I$K$h$jJIIT@0!"J,;^7A@.!"GoF0$K$h$k7lN.$N2CB.$*$h$S8:B.$J$I$NMW0x$,$"$k$?$a$H9M$($i$l$k!#(J
Photo 3 $B>INc(J-1 50$B:P!!CK@-!!:8AmD29|F0L.69:u(J
Photo 4 $B>INc(J-2 66$B:P!!CK@-!!1&@uBgB\F0L.JD:I(J
$B7k!!8l(J
$B!!2<;h(J $B#M#R#A$N:GBg$ND9=j$O!"B$1F:^$d%+%F!<%F%k$r;HMQ$;$:L5?/=1E*$K7l4I$rIA=P$G$-$kE@$G$"$j!";#1F$KMW$9$k;~4V$b==?tJ,$HC;$/!"$7$+$bF@$i$l$?;0
$B!!69:uIt$K$*$1$k(J $B#M#R#A$N7gE@$O!"#D#S#A$HHf3S$7$F6u4VJ,2rG=$,Nt$kE@!"5Z$SB.$$N.B.$d12N.(J, $BMpN.$,B8:_$9$kIt0L$G?.9f$NDc2<$,5/$3$j!"7l4I69:uIt$,2aBgI>2A$7$d$9$$E@$G$"$k!#(J
$B!!:#2s!"69:uIt$N69:uN($HD9$5!"5Z$S2<;hF0L.$H@EL.$N(JFlip angle$B$K$D$$$F8!F$$r9T$J$$!"$=$N7k2L!"(J Flip angle$B$O2<;hF0L.$G$O(J 40$B!k!"2<;h@EL.$G$O(J 50$B!k$,:GE,$G$"$C$?!#(J
$B!!(JMRA$B$N69:uN($O!"(JPhantom$B69:uN($,Bg$-$$$[$I2aBgI>2A$9$k798~$r<($7!"(JMRA$B$N69:uIt$ND9$5$O!"(JPhantom$BCM$h$j9bCM$r<($7$?!#(J
$B!!>INc$K$*$$$F!"7l4IB$1F$G69:uIt$,8!=P$5$l$?IBJQ$O!"(JMRA$B$G$9$Y$FIA=P$5$l$?!#(JMRA$B$N69:uN($O7l4IB$1F$h$j9bCM$r<($7!"69:u$ND9$5$K$D$$$F$O>INc$4$H$K5,B'@-$O$J$+$C$?!#(J
$B!!:#8e!"2<;h(J $B#M#R#A$O(J $B#P#T#A$d%P%$%Q%9=Q8e$N3+B8@-$NI>2A$J$I!"<#NE8e$N%U%)%m!<%"%C%W$K$ONI$$E,1~$H9M$($i$l$k$,!"$3$l$i$N(J $B#M#R#A$NFC@-$r==J,$KM}2r$7!"2<;h(J $B#M#R#A$N;#1F$r9T$J$&I,MW@-$,$"$k$H;W$o$l$k!#(J
$BJ8!!8%(J
- $B5\:j=S9,!(J"It$N(JMRAngiography, $BCGAX1GA|8&5f2q;(;o(J 18, (1992)
- $B66K\!!E}!!B>!(JD:I@-F0L.9E2=>I$KBP$9$k(J DSA$B$H(JMRA, $BF0L.9E2=$N2hA|?GCG(J, Vol.33,No1$B!!(J195,(1993)
- $BBgFbIR90!!B>!(7lN.$K$h$k?.9f$NJQ2=$H(J MR$B%"%s%.%*!%NW>20e$N$?$a$N(JMRI$B$N4pAC(J, $BNW>22hA|!!(JVol.7,No1$B!!(J563,(1991)
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- $BD9C+@n?J0l!!B>!(;M;h$N(JMR$B%"%s%.%*%0%i%U%#(J, INNERVISION Vol.8,No6 36-42,(1993)
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- $BLgED!!6/(J, $B9uEDCN=c!((J MRI$B$N(JArtifact, MRI$BFI1F$N4pAC(J, $B2hA|?GCG!!(JVol.13,No1, (1993)
- Patrick Turski,M.D.$B!(
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