title: ECG-triggered non-contrast-enhanced MR angiography (TRANCE) versus digital subtraction angiography (DSA) in patients with peripheral arterial occlusive disease of the lower extremities.
abstract: OBJECTIVE
  To prospectively determine the diagnostic value of electrocardiography-triggered non-contrast-enhanced magnetic resonance angiography (TRANCE) of the lower extremities including the feet versus DSA.
  
  
  METHODS
  All 43 patients with symptomatic peripheral arterial occlusive disease (PAOD) underwent TRANCE before DSA. Quality of MRA vessel depiction was rated by two independent radiologists on a 3-point scale. Arterial segments were graded for stenoses using a 4-point scale (grade 1: no stenosis; grade 2: moderate stenosis; grade 3: severe stenosis; grade 4: occlusion). Findings were compared with those of DSA.
  
  
  RESULTS
  In the 731 vessel segments analysed, intra-arterial DSA revealed 283 stenoses: 33.6% moderate, 16.6% severe and 49.8% occlusions. TRANCE yielded a mean sensitivity, specificity, positive and negative predictive value and diagnostic accuracy to detect severe stenoses or occlusions of 95.6%, 97.4%, 87.2%, 99.2%, 97.1% for the thigh segments and 95.2%, 87.5%, 83.2%, 96.6%, 90.5% for the calf segments. Excellent overall image quality was observed for TRANCE in 91.4% versus 95.7% (DSA) for the thigh and in 60.7% versus 91.0% for the calves, while diagnostic quality of the pedal arteries was rated as insufficient.
  
  
  CONCLUSIONS
  TRANCE achieves high diagnostic accuracy in the thigh and calf regions, whereas the pedal arteries showed limited quality.
authors.affiliation: Department of Radiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland. Andreas.Gutzeit@ksw.ch
authors.forename: Andreas
authors.initials: A
authors.lastname: Gutzeit
authors.forename: Reto
authors.initials: R
authors.lastname: Sutter
authors.forename: Johannes M
authors.initials: JM
authors.lastname: Froehlich
authors.forename: Justus E
authors.initials: JE
authors.lastname: Roos
authors.forename: Thomas
authors.initials: T
authors.lastname: Sautter
authors.forename: Erik
authors.initials: E
authors.lastname: Schoch
authors.forename: Barbara
authors.initials: B
authors.lastname: Giger
authors.forename: Michael
authors.initials: M
authors.lastname: Wyss
authors.forename: Nicole
authors.initials: N
authors.lastname: Graf
authors.forename: Constantin
authors.initials: C
authors.lastname: von Weymarn
authors.forename: Regula
authors.initials: R
authors.lastname: Jenelten
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Binkert
authors.forename: Klaus
authors.initials: K
authors.lastname: Hergan
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015331:Cohort Studies; D016001:Confidence Intervals; D003287:Contrast Media; D004562:Electrocardiography; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply / Q000000981:diagnostic imaging; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D003287:Contrast Media