Premium
Ungated nonenhanced radial quiescent interval slice‐selective (QISS) magnetic resonance angiography of the neck: Evaluation of image quality
Author(s) -
Koktzoglou Ioannis,
Aherne Emily A.,
Walker Matthew T.,
Meyer Joel R.,
Edelman Robert R.
Publication year - 2019
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.26781
Subject(s) - medicine , nuclear medicine , magnetic resonance angiography , image quality , magnetic resonance imaging , angiography , radiology , stenosis , artificial intelligence , computer science , image (mathematics)
Background Standard‐of‐care time‐of‐flight (TOF) techniques for nonenhanced magnetic resonance angiography (NEMRA) of the carotid bifurcation and other cervical arteries often provide nondiagnostic image quality due to motion and flow artifacts. Purpose To perform an initial evaluation of an ungated radial quiescent‐interval slice‐selective (QISS) technique for NEMRA of the neck, in comparison with 2D TOF and contrast‐enhanced magnetic resonance angiography (CEMRA). Study Type Retrospective. Population Sixty patients referred for neck MR angiography. Field Strength/Sequence Ungated radial QISS at 3T. Assessment Three radiologists scored image quality of 18 arterial segments using a 4‐point scale (1, nondiagnostic; 2, fair; 3, good; 4, excellent), and two radiologists graded proximal internal carotid stenosis using five categories (<50%, 50–69%, 70–99%, occlusion, nondiagnostic). Statistical Tests Friedman tests with post‐hoc Wilcoxon signed‐rank tests; unweighted Gwet's AC1 statistic; tests for equality of proportions. Results Ungated radial QISS provided image quality that significantly exceeded 2D TOF (mean scores of 2.7 vs. 2.0, 2.7 vs. 2.2, and 2.9 vs. 2.3; P < 0.001, all comparisons), while CEMRA provided the best image quality (mean scores of 3.6, 3.7, and 3.5 for the three reviewers). Interrater agreement of image quality scores was substantial for CEMRA (AC1 = 0.70, P < 0.001), and moderate for QISS (AC1 = 0.43, P < 0.001) and TOF (AC1 = 0.41, P < 0.001). Compared with TOF, QISS NEMRA provided a significantly higher percentage of diagnostic segments for all three reviewers (91.0% vs. 71.7%, 93.5% vs. 72.9%, 95.5% vs. 85.2%; P < 0.0001) and demonstrated better agreement with CEMRA for grading of proximal internal carotid stenosis (AC1 = 0.94 vs. 0.73 for reviewer 1, P < 0.05; AC1 = 0.89 vs. 0.68 for reviewer 2, P < 0.05). Data Conclusion In this initial study, ungated radial QISS significantly outperformed 2D TOF for the evaluation of the neck arteries, with overall better image quality and more diagnostic arterial segments, and improved agreement with CEMRA for grading stenosis of the proximal internal carotid artery. Level of Evidence: 3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:1798–1807.