Evaluation of contrast-enhanced magnetic resonance angiography (MRA) using Gd-DOTA compared with time-of-flight MRA in the diagnosis of clinically significant non-coronary arterial disease.
OBJECTIVE
This trial assessed diagnostic accuracy of contrast-enhanced magnetic resonance angiography (MRA) with meglumine gadoterate (Gd-DOTA) at 3 Tesla (T) over unenhanced MRA at 3 T in non-coronary arterial diseases by comparing their accuracy with that of the gold standard, x-ray angiography.


METHODS
Ninety-two patients with suspected non-coronary arterial disease underwent in fixed sequence unenhanced time-of flight (TOF) MRA, contrast-enhanced MRA using a Gd-DOTA bolus (intravenous bolus 0.1 mmol/kg) and x-ray angiography.


RESULTS
Eighty-four patients (71 male, 13 female; median age 64.5 years) were included in an intent-to-treat efficacy analysis. Targeted vascular areas were aorto-iliac, calf, carotid, femoral, popliteal and renal. Within-patient accuracy was significantly higher with contrast-enhanced MRA using Gd-DOTA than with unenhanced MRA (p = 0.0003). There was 84.4 +/- 17.5% agreement between contrast-enhanced MRA (Gd-DOTA) and x-ray angiography, compared with 76.8 +/- 20.4% between non-enhanced MRA and x-ray angiography. Sensitivity and specificity were also better with Gd-DOTA compared with non-enhanced MRA at the segment level. Duration of the MRA procedure was 3.5 times shorter with Gd-DOTA compared with non-enhanced MRA. Six patients reported six mild or moderate adverse events. No serious adverse events occurred.


CONCLUSIONS
Contrast-enhanced MRA using Gd-DOTA at 3 T was superior to unenhanced TOF MRA in the vascular territories investigated.
Kang
Joon-Won
JW
Department of Radiology, Asan Medical Centre, Songpa-gu, Seoul, South Korea.
Lim
Tae-Hwan
TH
Choi
Choong-Gon
CG
Ko
Gi-Young
GY
Kim
Jeong-Kon
JK
Kwon
Tae-Won
TW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003324:Coronary Artery Disease; D005260:Female; D006571:Heterocyclic Compounds; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D058729:Peripheral Arterial Disease / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C050823:gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate
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