Mobile spoiled - fresh blood imaging in the clinical application of lower extremity arterial disease

　　Title: Mobile spoiled - fresh blood imaging in the clinical application of lower extremity arterial disease
　　Author: Jing Xian Peng
　　Degree awarded: China Union Medical University
　　Keywords: mobile spoiled - fresh blood imaging;; lower extremity arterial; mobile spoiled - fresh blood imaging;; CT angiography;; lower extremity arterial disease; mobile spoiled - fresh blood imaging;; dorsal artery;; plantar artery bow
　　Abstract:
　　The first part of the mobile spoiled - fresh Rare earth magnets blood imaging with three-stage automatic moving bed technology in a preliminary study of lower extremity arterial
　　Objective: This study aimed to evaluate mobile spoiled - fresh blood imaging (FS-FBI) with automatic three-stage moving bed technology in the feasibility of lower extremity arteries. Materials and Methods: 1.5T MRI on the use of FS-FBI series of 15 healthy volunteers scanned. Scan range from the lower abdominal aorta to the dorsal renal artery, is divided into pelvic, thigh, calf segment scan, which carry out the phase of pelvic blood flow in the direction parallel to the direction and the direction perpendicular to the direction of blood flow phase of the two scans. Two radiologists to evaluate the readability of images, records and the emergence of severe deformation of the parts of the artifacts, and to reach agreement on image quality. Image quality is divided into four grades. Results: 15 cases of pelvic section of volunteers, the thigh segment, leg section to read three paragraphs scanning direction parallel to the direction of blood flow and to flow spoiled gradient pulse, were successfully shown to the dorsal abdominal aorta from the renal artery 27 blood vessels. One section of the pelvic score of 4 points were 9 cases (9 / 15, 60%), six cases of iliac artery lumen signal reduction, but blood vessels clear boundary, does not affect the diagnosis. Thigh segment score of 4 points were 14 cases (14/15, 93.3%), leg segment score of 4 the number of cases is 15 cases (15/15, 100%). Pelvic segment parallel to the direction of blood flow to the phase direction, and 15 volunteers in 9 patients failed to show volunteers the right iliac artery, score 1; 2 cases of right iliac artery stenosis, a score of 2. Conclusion: Mobile spoiled - fresh blood imaging with three-stage automatic moving bed technology in lower limb arteries is feasible, can be complete and clear display http://www.chinamagnets.biz/ of all lower extremity arterial tree, can be used to carry out clinical research. Three sections in the pelvic segment artery flow velocity changes, the relative image quality as good as the thigh and calf segment stability should be used to read out the direction parallel to the direction of blood flow.
　　The second part of the mobile spoiled - fresh blood imaging in the initial application of lower extremity arterial disease: in contrast with the CTA
　　Objective: This study aimed to evaluate mobile spoiled - fresh blood imaging (FS-FBI) diagnostic value of lower limb arterial stenosis. Materials and Methods: 39 cases of suspected lower extremity arterial disease in patients with FS-FBI checks, of which 33 patients underwent CT angiography (CTA) examination control. Mobile spoiled - fresh blood imaging, including pelvic, thigh, calf station without contrast-enhanced magnetic resonance angiography. Two blinded radiologists read films, respectively, of the original image and MIP images. Image quality evaluation is divided into five grades. And lower extremity arterial anatomy is divided into 37 segments for analysis. Vascular segments of the state is divided into four categories: normal or luminal irregularity, stenosis <10%; stenosis of 10-49%; stenosis of 50-99%; occlusion. CTA as the standard to calculate the FS-FBI diagnosis of vascular stenosis greater than 50% sensitivity, specificity, positive predictive value and negative predictive value. Between observers and the diagnostic methods and diagnostic results of the consistency between the evaluation. Results: The pelvic segment, the thigh segment, leg segments, respectively, the image quality score of 4.27 ± 1.07,4.60 ± 1.11,4.18 ± 1.42. During the CTA and FS-FBI check of 33 control subjects, if only the image quality analysis 3 and above in the section of blood vessel segments 1104, FS-FBI diagnosis of stenosis greater than 50% of sensitivity and specificity and accuracy of film-reading in 1 were 94.3%, 93.9%, 94.0%; in film-reading in 2 were 93.1%, 93.2%, 93.2%. CTA and FS-FBI diagnostic consistency in the diagnosis of stenosis of those who read the piece 1 and 2 of the Kappa values ​​were 0.84,0.82. FS-FBI were on the two film-reading greater than 50% stenosis to determine the consistency of 0.88. Conclusion: Mobile spoiled - fresh blood imaging negative predictive value is high, as lower extremity arterial stenosis screening tool in a successful inspection, the image quality good patient, FS-FBI with high accuracy, as not suitable for CTA or CE-MRA examination of the lower extremity arterial disease in patients with alternative or complementary imaging methods.
　　The third part of the mobile spoiled - fresh blood imaging of blood vessels in the initial application of the foot
　　Objective To evaluate the flow of spoiled - fresh blood imaging (FS-FBI) applied to the foot and explore the feasibility of vascular disease in patients with peripheral arterial vessels in the foot mobile spoiled - fresh blood imaging of abnormal performance. Materials and methods used in 1.5T MRI on the FS-FBI series of 15 healthy volunteers and 12 patients with the exception of peripheral vascular disease, vascular foot scan. Scan range from above the http://www.chinamagnets.biz/ ankle to the foot, feet coronal acquisition, reads the direction of head to tail direction, the mobile spoiled gradient pulse was 35%. Evaluation of the foot vessels in healthy volunteers show rate and readability. Records of patients with peripheral arterial disease and abnormal image quality. Results 14 cases of successful healthy volunteers inspected distal anterior tibial artery, dorsalis pedis and posterior tibial artery distal plantar artery, lateral plantar artery shows 100%, and the image quality scores were 3.5 and more (scoring 4). Deep perforating branches, plantar arterial arch shows 100%, but the plantar arterial arch image quality score was significantly lower than the average dorsal artery. Patients with peripheral arterial disease an average image quality score 3.83 ± 1.33 (5 scoring), foot vessel for the different degrees of anterior circulation or posterior circulation stenosis or occlusion. Conclusion flow spoiled - fresh blood imaging can show a more complete cycle of the foot after the first cycle and the main artery, can be used for clinical research.
　　Degree Year: 2010