Gadofosveset-enhanced MR angiography of the pedal arteries in patients with diabetes mellitus and comparison with selective intraarterial DSA.
To compare gadofosveset-enhanced magnetic resonance angiography (MRA) of the pedal vasculature with selective intraarterial DSA. Eighteen patients with PAOD and type II diabetes were prospectively examined at 1.5 T. For contrast enhancement, 0.03 mmol/kg body weight gadofosveset was used. MR imaging consisted of dynamic and of high-resolution steady-state imaging. Selective digital subtraction angiography (DSA) was performed within 5 days and served as standard of reference. Image analysis was done by two observers. There were no differences between MRA and DSA regarding overall image quality. First-pass MRA detected significantly more patent vessel segments than did DSA (P<0.001, kappa=0.46). Interobserver agreement of MRA was very good with respect to the detection of patent vessel segments and the assessment of hemodynamically relevant stenoses (kappa=0.97 and 0.89, respectively). Steady-state imaging depicted significantly more patent metatarsal arteries than did dynamic imaging, and delineated inflammatory complications including osteomyelitis, soft-tissue abscesses, and fistulas related to the diabetic foot. Gadofosveset-enhanced MRA of the pedal vasculature proved to be superior to DSA. It offered a long imaging time window, and allowed for better depiction of the pedal outflow. Steady-state imaging delineated inflammatory complications associated with the diabetic foot.
Röhrl
Boris
B
Department of Diagnostic and Interventional Radiology, Johannes Gutenberg University Mainz, Germany.
Kunz
Rainer Peter
RP
Oberholzer
Katja
K
Pitton
Michael Bernhard
MB
Neufang
Achim
A
Dueber
Christoph
C
Kreitner
Karl-Friedrich
KF
D015901:Angiography, Digital Subtraction; D003287:Contrast Media; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology*; D017719:Diabetic Foot / Q000473:pathology*; D005260:Female; D005528:Foot / Q000098:blood supply* / Q000473:pathology*; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D018810:Magnetic Resonance Angiography; D008297:Male; D009942:Organometallic Compounds; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media; D009942:Organometallic Compounds; D005682:Gadolinium; C109932:gadofosveset trisodium