Purpose : The Carotid Angio inspection including Aortic arch applied to wide area is conducted as the Contrast Enhance MR Angiography(CEA) which is using a contrast medium. However it is a burden not only for someone such as infants, pregnant women and patients suffering from kidney failure but continuous use of contrast medium also can be a burden for patients who has been taken follow up inspection since diagnose lesion already. The purpose of this study is to estimate a usefulness of the Time of Flight (TOF) by comparing with CEA.
Materials and methods : 10 patients with an average age of 58 (from 45 to 75) who had MRA inspection in our hospital were studied using 3.0 Tesla Aachieva (Philips, Netherland) MRI system and Sense Neuro-Vascular 16 Channels Coil. The same patient was inspected both TOF and CEA simultaneously. The TOF inspection included from Aortic arch to Willis Circle by connecting 3 TOF stacks and so did CEA inspection. The quantitative analysis was conducted through signal to noise ratio(SNR) and contrast to noise ratio(CNR) with soft tissue by setting up an area of interest on CCA bifurcatoin, ICA, ECA, MCA and VA concerning obtained image. In case of qualitative analysis, 3 radiological technologists and 1 radiologist evaluated 4 items (1: Visibility of the blood vessel, 2: Image distortion measure, 3: Overlapping measure with vein, 4: Peripheral blood vessel description measure) into five points scale (1: Very bad, 2: Bad, 3: Normal 4: Good, 5: Very good).
Results : Results for the quantitative analysis was obtained by calculating the average of 5 ROIs in case of SNR and CNR separately. Results of SNR, TOF were generally measured higher than CEA (In case of TOF were 166.1, 205.2, 154.39, 172.23, 161.95, and CEA were 92.05, 95.43, 84.76, 73.69, 88.3). But according to the result of CNR, both TOF and CEA were measured similarly as 67.62, 106.71, 55.9, 73.74, 63.46 for TOF and 67.82, 71.19, 60.52, 49.45, 64.07 for CEA. Throughout every results of each ROI, SNR showed statistically meaningful consequence (0.050.05). In case of qualitative analysis the average of each evaluated item was 4.2points and 4.28points in the item1, 2.93points and 4.55points in the item2, 4.6points and 3.13points in the item3, 2.88points and 4.6points in the item4. According to the results TOF was measured higher in the item3 while in the item2 and item4 CEA was higher and in case of the item1, both CEA and TOF were similar. To sum up statistically meaningful results (p<0.05) were shown in the item2, item3 and item4 but not in the item1 (p>0.05).
Conclusions : Both TOF and CEA are complementary because each inspection has pros and cons, but when inspect wide area including Aortic arch normally CEA is conducted. But TOF inspection also can be considered as alternative in terms of patients who has difficulty in the contrast medium such as infants, pregnant women and patients suffering from kidney failure and patients during follow up.
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