Accuracy of semiautomated analysis of 3D contrast-enhanced magnetic resonance angiography for detection and quantification of aortoiliac stenoses.
OBJECTIVE
We sought to compare reproducibility and accuracy of semiautomated stenosis detection and quantification in 3D contrast-enhanced magnetic resonance angiography (CE-MRA) images with conventional evaluation of 3D CE-MRA in patients with peripheral arterial disease (PAD) by using intra-arterial digital subtraction angiography (IA-DSA) as standard of reference.


METHODS
Twenty-five patients with PAD underwent CE-MRA and IA-DSA. Three blinded observers independently evaluated CE-MRA datasets for stenoses in the aortoiliac region using semiautomated computer analysis. Semiautomated measurements were compared with conventional measurements of stenosis on CE-MRA datasets, as measured by 3 other independent observers blinded to all other measurements. Interobserver agreement was quantified using kappa (kappa) and intraclass correlation coefficients (ICCs). Sensitivity and specificity were determined for both semiautomated and conventional measurements.


RESULTS
Semiautomated measurements were successful in 124 of the 125 arterial segments. The sensitivity of semiautomated measurements was 89% for all observers; specificity varied between 87% and 89%. For conventional measurements of CE-MRA, sensitivity varied between 79% and 86%; specificity was between 86% and 96%. There was good interobserver agreement between all readers for semiautomated measurements (combined kappa for all 3 observers together = 0.78; ICC = 0.82), as well as for conventional measurements (combined kappa = 0.70; and ICC = 0.83). Differences between ICCs, combined kappa values, and accuracy of both measurements were not significant (all P > 0.05).


CONCLUSIONS
Semiautomated analysis of aortoiliac 3D CE-MRA has the same high accuracy for detection and quantification of stenoses as conventional readings of CE-MRA.
de Vries
Marianne
M
Department of Radiology, Maastricht University Hospital, Leiden, The Netherlands.
de Koning
Patrick J
PJ
de Haan
Michiel W
MW
Kessels
Alphons G
AG
Nelemans
Patricia J
PJ
Nijenhuis
Robbert J
RJ
Planken
R Nils
RN
Vasbinder
G Boudewijn C
GB
van Engelshoven
Jos M A
JM
van der Geest
Rob J
RJ
Leiner
Tim
T
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001024:Aortic Valve Stenosis / Q000175:diagnosis*; D001331:Automation; D003287:Contrast Media; D005260:Female; D006801:Humans; D007083:Iliac Artery; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis*; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results
D003287:Contrast Media