title: Whole-body magnetic resonance angiography at 3 tesla using a hybrid protocol in patients with peripheral arterial disease.
abstract: The purpose of this study was to determine the diagnostic performance of 3T whole-body magnetic resonance angiography (WB-MRA) using a hybrid protocol in comparison with a standard protocol in patients with peripheral arterial disease (PAD). In 26 consecutive patients with PAD two different protocols were used for WB-MRA: a standard sequential protocol (n = 13) and a hybrid protocol (n = 13). WB-MRA was performed using a gradient echo sequence, body coil for signal reception, and gadoterate meglumine as contrast agent (0.3 mmol/kg body weight). Two blinded observers evaluated all WB-MRA examinations with regard to presence of stenoses, as well as diagnostic quality and degree of venous contamination in each of the four stations used in WB-MRA. Digital subtraction angiography served as the method of reference. Sensitivity for detecting significant arterial disease (luminal narrowing > or = 50%) using standard-protocol WB-MRA for the two observers was 0.63 (95%CI: 0.51-0.73) and 0.66 (0.58-0.78). Specificities were 0.94 (0.91-0.97) and 0.96 (0.92-0.98), respectively. In the hybrid protocol WB-MRA sensitivities were 0.75 (0.64-0.84) and 0.70 (0.58-0.8), respectively. Specificities were 0.93 (0.88-0.96) and 0.95 (0.91-0.97). Interobserver agreement was good using both the standard and the hybrid protocol, with kappa = 0.62 (0.44-0.67) and kappa = 0.70 (0.59-0.79), respectively. WB-MRA quality scores were significantly higher in the lower leg using the hybrid protocol compared to standard protocol (p = 0.003 and p = 0.03, observers 1 and 2). Distal venous contamination scores were significantly lower with the hybrid protocol (p = 0.02 and p = 0.01, observers 1 and 2). In conclusion, hybrid-protocol WB-MRA shows a better diagnostic performance than standard protocol WB-MRA at 3 T in patients with PAD.
authors.affiliation: Department of Radiology, University Hospital at Herlev, Herlev Ringvej 75, Copenhagen, Denmark. yujwni01@heh.regionh.dk
authors.forename: Yousef W
authors.initials: YW
authors.lastname: Nielsen
authors.forename: Jonas P
authors.initials: JP
authors.lastname: Eiberg
authors.forename: Vibeke B
authors.initials: VB
authors.lastname: Logager
authors.forename: Torben V
authors.initials: TV
authors.lastname: Schroeder
authors.forename: Sven
authors.initials: S
authors.lastname: Just
authors.forename: Henrik S
authors.initials: HS
authors.lastname: Thomsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D003287:Contrast Media; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D016491:Peripheral Vascular Diseases / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D051598:Whole Body Imaging
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine