Feasibility of peripheral contrast-enhanced magnetic resonance angiography at 3.0 Tesla with a hybrid technique: comparison with digital subtraction angiography.
OBJECTIVE
To prospectively determine feasibility and diagnostic accuracy of 3D contrast-enhanced MR-angiography (CE-MRA) at 3.0 tesla (T) in patients with peripheral arterial occlusive disease. Digital subtraction angiography (DSA) was used as reference standard.


METHODS
Thirty consecutive patients with suspected peripheral arterial occlusive disease were examined on a 3.0 T MR system by using the integrated whole body coil. A 4-station examination protocol in hybrid technique was chosen, containing 2 gadodiamide injections, the first one for imaging the calf and foot arteries (single-step technique) and the second injection for the visualization of the aortoiliacal and femoral arteries (bolus-chase MRA). All patients underwent DSA within the following 48 hours. The arterial tree of each leg was divided in 15 segments and 4 anatomic regions (iliacal, femoral, popliteal/proximal calf, distal calf/foot). Two radiologists analyzed the MR-images with regard to image quality, grade of stenosis, and venous overlap. DSA-images were analyzed by 2 radiologists in consensus with regard to the stenosis grade.


RESULTS
Eight hundred eighty-five and 884 of 889 arterial segments at CE-MRA were rated with excellent or good diagnostic image quality by observer 1 and observer 2, respectively. In only 3 segments image quality was affected by venous contamination. Sensitivity of CE-MRA for determination of relevant arterial stenoses (50%-99%) and occlusions--as compared with DSA--was 95.3% (both observer) and specificity was 98.5% and 97.8% for observer 1 and observer 2, respectively.


CONCLUSIONS
Peripheral hybrid CE-MRA at 3.0 T is feasible and proved to be reliable at depiction of stenoses and occlusions of the whole pelvic and lower leg arterial system.
Berg
Frank
F
Department of Radiology, University of Cologne, Cologne, Germany. frank.berg@uk-koeln.de
Bangard
Christopher
C
Bovenschulte
Henning
H
Hellmich
Martin
M
Nijenhuis
Marco
M
Lackner
Klaus
K
Gossmann
Axel
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique
D003287:Contrast Media