title: Vessel diameter measurements in gadolinium contrast-enhanced three-dimensional MRA of peripheral arteries.
abstract: In this study, the possibilities for quantification of vessel diameters of peripheral arteries in gadolinium contrast-enhanced magnetic resonance angiography (Gd CE MRA) were evaluated. Absolute vessel diameter measurements were assessed objectively and semi-automatically in maximum intensity projections (MIPs) of contrast-enhanced T1-weighted 3D spoiled gradient-echo datasets, studied with digital subtraction techniques. In vivo, the complete peripheral arterial bed of six patients was studied, from the aorto-iliac bifurcation down to the distal run-off. By measuring the signal intensity (SI) over the lumen of a vessel in the MIP, an SI-plot was obtained. Next, the vessel boundaries were determined using a threshold algorithm; from these boundary points individual diameter values could be obtained along the trajectory of the vessel. In an in vitro study, an optimal threshold value of 30% of the range of SI-values between the background and the maximal SI in the vessel was obtained for accurate diameter measurement in Gd CE MRA (i.e., full-width 30%-maximum). Furthermore, the relationship between the accuracy of these measurements and the scan resolution was investigated. Accuracy was found to be acceptable (i.e., less than 10% over/underestimation) for vessel sizes covering at least 3 pixels. In six patients, diameters were measured in MIPs of the total datasets (i.e., D(T)) as well as in selective MIPs of the clipped datasets (i.e., D(S)) (n = 209). D(T) and D(S) were statistically significantly correlated (p < 0.01) with a Pearson correlation coefficient rP = 0.98. Measurements in the total MIPs yielded statistically significant (p < 0.01) smaller diameter values compared with measurements in selective MIPs, with a mean difference of 0.15 mm. Diameter values from the selective MIPs of the aorto-iliac arteries were also compared with diameter values measured at corresponding anatomic positions in X-ray angiograms of these patients (i.e., D(x)) (n = 70). D(X) and D(S) were statistically significantly correlated (p < 0.01) with a Pearson correlation coefficient rP = 0.92. Diameters measured in the selective MIPs were smaller than those measured in the X-ray angiograms (mean difference 0.49 mm) and this difference was statistically significant (p < 0.01). In conclusion, diameter values can be evaluated accurately in MIPs of vessels with at least 3 pixels in diameter, using the full-width 30%-maximum criterion.
authors.affiliation: Department of Radiology, Leiden University Medical Center, The Netherlands.
authors.forename: J J
authors.initials: JJ
authors.lastname: Westenberg
authors.forename: R J
authors.initials: RJ
authors.lastname: van der Geest
authors.forename: M N
authors.initials: MN
authors.lastname: Wasser
authors.forename: E L
authors.initials: EL
authors.lastname: van der Linden
authors.forename: T
authors.initials: T
authors.lastname: van Walsum
authors.forename: H C
authors.initials: HC
authors.lastname: van Assen
authors.forename: A
authors.initials: A
authors.lastname: de Roos
authors.forename: J
authors.initials: J
authors.lastname: Vanderschoot
authors.forename: J H
authors.initials: JH
authors.lastname: Reiber
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007083:Iliac Artery / Q000473:pathology*; D007091:Image Processing, Computer-Assisted; D007275:Injections, Intravenous; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D016491:Peripheral Vascular Diseases / Q000175:diagnosis*; D019047:Phantoms, Imaging; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA