Diagnosis of perfusion abnormality of the pulmonary artery in Takayasu's arteritis using contrast-enhanced MR perfusion imaging.
To determine the clinical efficacy of contrast-enhanced magnetic resonance (MR) perfusion imaging in the diagnosis of perfusion abnormality in the pulmonary artery (PA) in Takayasu's arteritis (TA). Twenty-one patients were evaluated. Pulmonary MR perfusion images were acquired using a 2-dimensional (2D) fast spoiled gradient echo sequence with single-slice technique (TR/TE, 5.3/1.3; flip angle, 30 degrees; receiver bandwidth, 31.2 kHz/pixel; acquisition time, 0.7 s; and total acquisition time, 49 s). Seventy continuous subtracted MR images were evaluated, and the presence of perfusion abnormality was determined in lobe-based (n=126) and patient-based (n=21) analyses. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) were calculated using perfusion scintigraphy as a standard reference. For lobe-based analysis, sensitivity was 91.7-95.8%, specificity was 92.2-93.7%, and PPV and NPV were 73.3-76.7% and 97.9-99.0%, respectively. For patient-based analyses, sensitivity was 100%, specificity was 72.7%, and PPV and NPV were 76.9% and 100%, respectively. Kappa values for each analysis were between 0.78-1.00. In conclusion, MR perfusion imaging appears to be a valuable, noninvasive method to estimate PA involvement in patients with TA.
Sueyoshi
Eijun
E
Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, 852-8501, Nagasaki, Japan. EijunSueyoshi@aol.com
Sakamoto
Ichiro
I
Ogawa
Yogi
Y
Uetani
Masataka
M
D000328:Adult; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D011651:Pulmonary Artery / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013625:Takayasu Arteritis / Q000175:diagnosis*
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA