Time-resolved MR angiography in the evaluation of central thoracic venous occlusive disease

Kambiz Nael, Mayil Krishnam, Stefan G. Ruehm, Henrik J. Michaely, Gerhard Laub, J. Paul Finn

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

OBJECTIVE. The objective of our study was to assess the feasibility and diagnostic performance of time-resolved MR angiography (MRA) in the evaluation of central thoracic venous occlusive disease and to compare time-resolved MRA with conventional MRA and catheter angiography. MATERIALS AND METHODS. Twenty patients (eight women and 12 men; age range, 19-74 years) with suspected central thoracic venous occlusive disease underwent time-resolved MRA using time-resolved angiography with interleaved stochastic trajectories (TWIST) and parallel acquisition, followed by conventional MRA. Catheter angiography was performed within 1-14 days after MRA and was available for a total of 60 segments for correlation. Time-resolved and conventional MRA images were evaluated in separate reading sessions by two independent radiologists for image quality and level of confidence and degree of venoocclusive disease. The interobserver and intermodality agreement, sensitivity, and specificity were calculated using catheter angiography as the standard of reference. RESULTS. Time-resolved MRA resulted in diagnostic-quality images that did not differ significantly in quality compared with conventional MRA. Thirty-one segmental venous stenoses were identified. The kappa coefficient revealed moderate intermodality agreement (κ = 0.54; 95% CI, 0.32-0.76) between time-resolved MRA and conventional MRA. When compared with catheter angiography, the sensitivity and specificity for the diagnosis of significant stenosis (≥ 70%) were 87.5% and 68% for time-resolved MRA and 90% and 90% for conventional MRA, respectively. CONCLUSION. Time-resolved MRA, as described in this study, has the potential to be used as an initial and screening diagnostic tool obviating conventional MRA and its associated higher contrast dose in normal and near-normal examinations. However, because of its relatively lower specificity, adjunct use of conventional MRA is still required for accurate grading of venous occlusive disease.

Original languageEnglish (US)
Pages (from-to)1731-1738
Number of pages8
JournalAmerican Journal of Roentgenology
Volume192
Issue number6
DOIs
StatePublished - Jun 2009
Externally publishedYes

Fingerprint

Angiography
Thorax
Catheters
Pathologic Constriction
Sensitivity and Specificity

Keywords

  • Central thoracic veins
  • Hemodynamics
  • Low contrast dose
  • Nephrogenic systemic fibrosis
  • Time-resolved MR angiography
  • TWIST

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Time-resolved MR angiography in the evaluation of central thoracic venous occlusive disease. / Nael, Kambiz; Krishnam, Mayil; Ruehm, Stefan G.; Michaely, Henrik J.; Laub, Gerhard; Finn, J. Paul.

In: American Journal of Roentgenology, Vol. 192, No. 6, 06.2009, p. 1731-1738.

Research output: Contribution to journalArticle

Nael, Kambiz ; Krishnam, Mayil ; Ruehm, Stefan G. ; Michaely, Henrik J. ; Laub, Gerhard ; Finn, J. Paul. / Time-resolved MR angiography in the evaluation of central thoracic venous occlusive disease. In: American Journal of Roentgenology. 2009 ; Vol. 192, No. 6. pp. 1731-1738.
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abstract = "OBJECTIVE. The objective of our study was to assess the feasibility and diagnostic performance of time-resolved MR angiography (MRA) in the evaluation of central thoracic venous occlusive disease and to compare time-resolved MRA with conventional MRA and catheter angiography. MATERIALS AND METHODS. Twenty patients (eight women and 12 men; age range, 19-74 years) with suspected central thoracic venous occlusive disease underwent time-resolved MRA using time-resolved angiography with interleaved stochastic trajectories (TWIST) and parallel acquisition, followed by conventional MRA. Catheter angiography was performed within 1-14 days after MRA and was available for a total of 60 segments for correlation. Time-resolved and conventional MRA images were evaluated in separate reading sessions by two independent radiologists for image quality and level of confidence and degree of venoocclusive disease. The interobserver and intermodality agreement, sensitivity, and specificity were calculated using catheter angiography as the standard of reference. RESULTS. Time-resolved MRA resulted in diagnostic-quality images that did not differ significantly in quality compared with conventional MRA. Thirty-one segmental venous stenoses were identified. The kappa coefficient revealed moderate intermodality agreement (κ = 0.54; 95{\%} CI, 0.32-0.76) between time-resolved MRA and conventional MRA. When compared with catheter angiography, the sensitivity and specificity for the diagnosis of significant stenosis (≥ 70{\%}) were 87.5{\%} and 68{\%} for time-resolved MRA and 90{\%} and 90{\%} for conventional MRA, respectively. CONCLUSION. Time-resolved MRA, as described in this study, has the potential to be used as an initial and screening diagnostic tool obviating conventional MRA and its associated higher contrast dose in normal and near-normal examinations. However, because of its relatively lower specificity, adjunct use of conventional MRA is still required for accurate grading of venous occlusive disease.",
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N2 - OBJECTIVE. The objective of our study was to assess the feasibility and diagnostic performance of time-resolved MR angiography (MRA) in the evaluation of central thoracic venous occlusive disease and to compare time-resolved MRA with conventional MRA and catheter angiography. MATERIALS AND METHODS. Twenty patients (eight women and 12 men; age range, 19-74 years) with suspected central thoracic venous occlusive disease underwent time-resolved MRA using time-resolved angiography with interleaved stochastic trajectories (TWIST) and parallel acquisition, followed by conventional MRA. Catheter angiography was performed within 1-14 days after MRA and was available for a total of 60 segments for correlation. Time-resolved and conventional MRA images were evaluated in separate reading sessions by two independent radiologists for image quality and level of confidence and degree of venoocclusive disease. The interobserver and intermodality agreement, sensitivity, and specificity were calculated using catheter angiography as the standard of reference. RESULTS. Time-resolved MRA resulted in diagnostic-quality images that did not differ significantly in quality compared with conventional MRA. Thirty-one segmental venous stenoses were identified. The kappa coefficient revealed moderate intermodality agreement (κ = 0.54; 95% CI, 0.32-0.76) between time-resolved MRA and conventional MRA. When compared with catheter angiography, the sensitivity and specificity for the diagnosis of significant stenosis (≥ 70%) were 87.5% and 68% for time-resolved MRA and 90% and 90% for conventional MRA, respectively. CONCLUSION. Time-resolved MRA, as described in this study, has the potential to be used as an initial and screening diagnostic tool obviating conventional MRA and its associated higher contrast dose in normal and near-normal examinations. However, because of its relatively lower specificity, adjunct use of conventional MRA is still required for accurate grading of venous occlusive disease.

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KW - Hemodynamics

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KW - Nephrogenic systemic fibrosis

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KW - TWIST

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