title: Evaluation of the iliac arteries: comparison of two-dimensional time of flight magnetic resonance angiography with cardiac compensated fast gradient recalled echo and contrast-enhanced three-dimensional time of flight magnetic resonance angiography.
abstract: We compared dynamic contrast-enhanced three-dimensional time of flight (3DTOF) magnetic resonance angiography (MRA) with two-dimensional time of flight (2DTOF) MRA with cardiac compensated fast gradient recalled echo (C-MON) and conventional angiography (CA) when it was available. C-MON re-orders the normal data acquisition to minimize ghosting artifacts generated by pulsatile flow. The initial phase of the study involved optimization of parameters and comparison C-MON with no C = MON in eight patients and volunteers. The final phase of the study involved 53 patients who were imaged with contrast-enhanced 3DTOF MRA and 2DTOF MRA with C-MON. Thirty of these patients also had CA. In the initial phase, 2DTOF MRA with C-MON was found to be equal (n = 3) or superior (n = 5) to 2DTOF without C-MON. In the final phase, the agreement among all imaging modalities varied from substantial to almost perfect (Cohen's kappa = .6-.83). The lowest agreement was using 2DTOF to evaluate the external iliac segments. The among suggested treatments varied from substantial to almost perfect for all imaging modalities (Cohen's kappa = .73-93). The diagnostic efficacies of 2DTOF with C-MON and contrast-enhanced 3DTOF were high overall, with the lowest value being a specificity of 63% for one reader in the evaluation of an external iliac segment using 2DTOF. In summary, 2DTOF with C-MON helped to eliminate artifacts due to pulsatility in the iliac arterial segments. In our experience, both dynamic contrast-enhanced 3DTOF MRA and 2DTOF MRA with C-MON performed well in the evaluation of the iliac arteries. Both studies have high interobeserver agreement and high diagnostic efficacy. Contrast-enhanced 3DTOF MRA should be reserved for situations in which the iliac vessels are extremely tortuous or occluded or the external iliac segments are poorly seen.
authors.affiliation: Department of Radiology, Legacy Good Samaritan Hospital and Medical Center, Portland, OR 97210, USA.
authors.forename: S F
authors.initials: SF
authors.lastname: Quinn
authors.forename: R C
authors.initials: RC
authors.lastname: Sheley
authors.forename: J
authors.initials: J
authors.lastname: Szumowski
authors.forename: A
authors.initials: A
authors.lastname: Shimakawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D004452:Echocardiography / Q000295:instrumentation / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000473:pathology* / Q000502:physiology; D018810:Magnetic Resonance Angiography / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D016491:Peripheral Vascular Diseases / Q000175:diagnosis*; D011673:Pulsatile Flow; D011856:Radiographic Image Enhancement / Q000379:methods*; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media