High-resolution 3D non-contrast-enhanced, ECG-gated, multi-step MR angiography of the lower extremities: comparison with contrast-enhanced MR angiography.
OBJECTIVE
To determine the diagnostic value of non-contrast-enhanced, 3D-high-resolution, ECG-gated, multi-step MR angiography (non-ceMRA) of the lower extremities using a modified turbo-spin-echo technique in comparison to 1.0-molar contrast-enhanced MR angiography (ceMRA) in patients with suspected peripheral vascular disease (PVD).


METHODS
Fifty consecutive patients underwent non-ceMRA before ceMRA within the same session. We assessed examination time, image quality, localisation and severity of stenosis.


RESULTS
Examination time was shorter for ceMRA (12 ± 4 min) compared with non-ceMRA (28 ± 6 min, p < 0.001). The image quality of the aorta-iliac, femoral and combined popliteal and lower leg arteries was inferior for non-ceMRA (2.8 ± 0.8/3.3 ± 0.8/3.3 ± 0.9) versus ceMRA (4.7 ± 0.8/4.8 ± 0.6/4.8 ± 0.7) on a 5-point scale with 5 for maximum quality (p < 0.01). CeMRA offered more assessable data sets than non-ceMRA (98% vs. 90%). For detecting stenosis >50% or occlusions of pelvic and femoral arteries using non-ceMRA the sensitivity, specificity, positive and negative predictive values were 94%, 86%, 67% and 98% and for popliteal and lower leg arteries 93%, 87%, 69% and 98%, respectively.


CONCLUSIONS
We demonstrated that 3D non-ceMRA represents a very promising technique in patients with lower extremities PVD and could be used as an alternative if gadolinium-based contrast agents cannot be administered.
Mohrs
Oliver K
OK
Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany. mohrs@radiologie-darmstadt.de
Petersen
Steffen E
SE
Heidt
Martin C
MC
Schulze
Thomas
T
Schmitt
Peter
P
Bergemann
Sabine
S
Kauczor
Hans-Ulrich
HU
D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000473:pathology*; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D003287:Contrast Media; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D035002:Lower Extremity / Q000098:blood supply* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009942:Organometallic Compounds; D058729:Peripheral Arterial Disease / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol