Stepping-table gadolinium-enhanced digital subtraction MR angiography of the aorta and lower extremity arteries: preliminary experience.
OBJECTIVE
To compare stepping-table digital subtraction gadolinium-enhanced magnetic resonance (MR) angiography of the distal aorta and lower extremity arteries with conventional catheter digital subtraction x-ray angiography in patients with arterio-occlusive disease.


METHODS
Twenty patients underwent both conventional catheter angiography and fast three-dimensional gadolinium-enhanced MR angiography of the aorta and outflow vessels at 1.5 T; the images were acquired in three consecutive imaging locations during a single infusion of a gadolinium chelate.


RESULTS
Compared with catheter angiography, according to the findings of two blinded independent reviewers, MR angiography had sensitivities of 81% and 89% and specificities of 91% and 95%, respectively, for demonstration of insignificant (< or = 50%) stenosis versus significant (51%-100%) stenosis. For demonstration of occlusion, the sensitivity and specificity were 94% and 97%, respectively, by consensus. There was good interobserver correlation between the two readers overall (kappa = 0.65 for reporting the degree of narrowing in all lesions; 0.86, for reporting of insignificant versus significant stenoses; and 0.928, for reporting of occluded versus patient segments).


CONCLUSIONS
Stepping-table digital subtraction contrast material-enhanced MR angiography has high accuracy compared with catheter angiography in patients with arterio-occlusive disease of the aorta and outflow vessels. These preliminary study results suggest that this technique may ultimately provide a safe, noninvasive, and cost-effective alternative to catheter angiography.
Meaney
J F
JF
Dept of Magnetic Resonance Imaging, Leeds General Infirmary, United Kingdom.
Ridgway
J P
JP
Chakraverty
S
S
Robertson
I
I
Kessel
D
D
Radjenovic
A
A
Kouwenhoven
M
M
Kassner
A
A
Smith
M A
MA
D000368:Aged; D015901:Angiography, Digital Subtraction; D001012:Aorta, Abdominal; D001018:Aortic Diseases / Q000175:diagnosis*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007866:Leg / Q000098:blood supply; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D015588:Observer Variation; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013382:Subtraction Technique
D003287:Contrast Media; D019786:Gadolinium DTPA