Vascular calcification is an independent predictor of cardiovascular disease in patients with chronic kidney disease. Computed tomography (CT) is the gold-standard for detecting vascular calcification. Radial volumetric-interpolated breath-hold examination (radial-VIBE), a free-breathing gradient-echo cardiovascular magnetic resonance (CMR) sequence, has advantages over CT as it is ionising radiation-free. However, its capability in detecting thoracic aortic calcification (TAC) has not been investigated. This study aims to compare radial-VIBE to CT for the detection of TAC in the descending aorta of patients with end-stage renal disease (ESRD) using semi-automated methods, and to investigate the association between TAC and coronary artery calcification (CAC). Paired cardiac CT and radial-VIBE CMR scans from ESRD patients participating in 2 prospective studies were obtained. Calcification volume was quantified using semi-automated methods in a 9 cm segment of the thoracic aorta. Correlation and agreement between TAC volume measured on CMR and CT were assessed with Spearman’s correlation coefficient (ρ), linear regression, Bland–Altman plots and intraclass correlation coefficient (ICC). Association between CAC Agatston score and TAC volume determined by CT and CMR was measured with Spearman’s correlation coefficient. Scans from 96 participants were analysed. Positive correlation was found between CMR and CT calcification volume [ρ = 0.61, 95% confidence interval (CI) 0.45–0.73]. ICC for consistency was 0.537 (95% CI 0.378–0.665). Bland–Altman plot revealed that compared to CT, CMR volumes were systematically higher at low calcification volume, and lower at high calcification volume. CT did not detect calcification in 41.7% of participants, while radial-VIBE CMR detected signal which the semi-quantitative algorithm reported as calcification in all of those individuals. Instances of suboptimal radial-VIBE CMR image quality were deemed to be the major contributors to the discrepancy. Correlations between CAC Agatston score and TAC volume measured by CT and CMR were ρ = 0.404 (95% CI 0.214–0.565) and ρ = 0.211 (95% CI 0.008–0.396), respectively. Radial-VIBE CMR can detect TAC with strong positive association to CT, albeit with the presence of proportional bias. Quantification of vascular calcification by radial-VIBE remains a promising area for future research, but improvements in image quality are necessary.

中文翻译：

---

心血管磁共振检测终末期肾病患者胸降主动脉钙化


血管钙化是慢性肾病患者心血管疾病的独立预测因素。计算机断层扫描 (CT) 是检测血管钙化的金标准。径向容积插值屏气检查 (radial-VIBE) 是一种自由呼吸梯度回波心血管磁共振 (CMR) 序列，与 CT 相比具有优势，因为它无电离辐射。然而，其检测胸主动脉钙化（TAC）的能力尚未得到研究。本研究旨在使用半自动方法比较放射状 VIBE 与 CT 对终末期肾病 (ESRD) 患者降主动脉 TAC 的检测，并探讨 TAC 与冠状动脉钙化 (CAC) 之间的关联。获得了参加 2 项前瞻性研究的 ESRD 患者的配对心脏 CT 和径向 VIBE CMR 扫描。使用半自动方法对胸主动脉 9 cm 段的钙化体积进行量化。使用 Spearman 相关系数 (ρ)、线性回归、Bland-Altman 图和组内相关系数 (ICC) 评估 CMR 和 CT 测量的 TAC 体积之间的相关性和一致性。使用 Spearman 相关系数测量 CAC Agatston 评分与 CT 和 CMR 确定的 TAC 体积之间的关联。对 96 名参与者的扫描进行了分析。 CMR 和 CT 钙化体积之间存在正相关性 [ρ = 0.61，95% 置信区间 (CI) 0.45–0.73]。一致性 ICC 为 0.537 (95% CI 0.378–0.665)。 Bland-Altman 图显示，与 CT 相比，低钙化体积时 CMR 体积系统性较高，而高钙化体积时 CMR 体积较低。 CT 未发现 41 例钙化。7% 的参与者，而径向 VIBE CMR 检测到信号，半定量算法将其报告为所有这些个体的钙化。径向 VIBE CMR 图像质量不理想的情况被认为是造成差异的主要原因。 CAC Agatston 评分与 CT 和 CMR 测量的 TAC 体积之间的相关性分别为 ρ = 0.404 (95% CI 0.214–0.565) 和 ρ = 0.211 (95% CI 0.008–0.396)。 Radial-VIBE CMR 可以检测与 CT 呈强正相关的 TAC，尽管存在比例偏差。通过径向 VIBE 量化血管钙化仍然是未来研究的一个有前景的领域，但图像质量的改进是必要的。