title: Nonenhanced MR angiography of the hand with flow-sensitive dephasing-prepared balanced SSFP sequence: initial experience with systemic sclerosis.
abstract: OBJECTIVE
  To compare the image quality and degree of vessel narrowing at flow-sensitive dephasing (FSD) magnetic resonance (MR) angiography of the hands with those at contrast material-enhanced MR angiography of the hands in patients with systemic sclerosis.
  
  
  METHODS
  In a single-center study with institutional review board approval and HIPAA compliance, six healthy volunteers and six patients with systemic sclerosis were imaged at 1.5-T nonenhanced FSD MR angiography followed by contrast-enhanced MR angiography. Sixteen vascular segments in four vessel groups were evaluated for image quality and assessed semiquantitatively for stenosis degree by using Likert scales. The nonparametric Wilcoxon signed rank test was used to perform pairwise comparisons of the MR angiographic techniques. P < .05 indicated statistical significance.
  
  
  RESULTS
  Performing FSD MR angiography, as compared with time-resolved MR angiography and high-spatial-resolution MR angiography, improved the image quality for all arterial segments combined in the control (mean score, 2.9 [FSD] vs 3.7 [time-resolved technique] and 3.1 [high-spatial-resolution technique]) and patient (mean score, 4.0 [FSD] vs 4.2 [time-resolved technique] and 4.3 [high-spatial-resolution technique]) groups. In the control subjects, FSD angiography depicted proper digital artery stenosis that was less severe (mean grade, 0.7) than that seen with the time-resolved (mean grade, 1.6) and high-spatial-resolution (mean grade, 1.0) techniques. In the patient group, FSD angiography depicted lower degrees of stenosis, with a lower mean grade for all segments combined (1.3) compared with the corresponding mean grades for time-resolved (1.5) and high-spatial-resolution (1.8) MR angiography.
  
  
  CONCLUSIONS
  Preliminary data indicate that the proposed nonenhanced FSD MR angiographic technique is an improvement over existing contrast-enhanced techniques for evaluation of the hand vasculature in vasospastic disorders of the hand. Further technical improvements and a systematic clinical study are warranted.
authors.affiliation: Division of Cardiovascular Imaging, Northwestern Memorial Hospital, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611, USA. jsheehan@hermitageclinic.ie
authors.forename: John J
authors.initials: JJ
authors.lastname: Sheehan
authors.forename: Zhaoyang
authors.initials: Z
authors.lastname: Fan
authors.forename: Amir H
authors.initials: AH
authors.lastname: Davarpanah
authors.forename: Philip A
authors.initials: PA
authors.lastname: Hodnett
authors.forename: John
authors.initials: J
authors.lastname: Varga
authors.forename: James C
authors.initials: JC
authors.lastname: Carr
authors.forename: Debiao
authors.initials: D
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006225:Hand / Q000098:blood supply* / Q000473:pathology; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000209:etiology; D015203:Reproducibility of Results; D012595:Scleroderma, Systemic / Q000150:complications / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media