title: Improved detection of in-stent restenosis by blood pool agent-enhanced, high-resolution, steady-state magnetic resonance angiography.
abstract: OBJECTIVE
  The aim of this study was to assess whether visualisation of in-stent changes can be improved with high-resolution, steady-state, blood pool contrast-enhanced MR angiography compared with first-pass MR angiography. Intra-arterial digital subtraction angiography (DSA) served as the reference standard.
  
  
  METHODS
  Twenty patients after stent placement in the superficial femoral artery (SFA) underwent MRA prior to reintervention. MRA of the SFA includes first-pass MRA as well as 3D high-resolution MRA in the steady state (SS-MRA) after injection of Gadofosveset trisodium. Sensitivity and specificity values for the detection of significant in-stent lesions by means of SS-MRA were calculated at the proximal, middle and distal stent segments in comparison to DSA. Kappa statistics were used to determine agreement between the two techniques.
  
  
  RESULTS
  Sensitivity and specificity values for the detection of significant stenosis with SS-MRA reached 95% in the proximal, 100% in the middle and 100% in the distal stent segment. Kappa coefficients between SS-MRA and DSA were 0.789, 0.797 and 0.859 for the proximal, middle and distal segments, whereas the Kappa coefficients for FP-MRA were 0,211, 0,200 and 0,594 in these segments, respectively.
  
  
  CONCLUSIONS
  Detection of in stent stenosis is significantly improved using SS MRA, in comparison to state-of-the-art FP-MRA.
authors.affiliation: Department of Radiology, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Vienna, Austria.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Plank
authors.forename: Florian
authors.initials: F
authors.lastname: Wolf
authors.forename: Herbert
authors.initials: H
authors.lastname: Langenberger
authors.forename: Michael
authors.initials: M
authors.lastname: Weber
authors.forename: Dietrich
authors.initials: D
authors.lastname: Beitzke
authors.forename: Alfred
authors.initials: A
authors.lastname: Stadler
authors.forename: Martin
authors.initials: M
authors.lastname: Schillinger
authors.forename: Johannes
authors.initials: J
authors.lastname: Lammer
authors.forename: Christian
authors.initials: C
authors.lastname: Loewe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003251:Constriction, Pathologic; D003287:Contrast Media / Q000494:pharmacology; D005260:Female; D005682:Gadolinium / Q000494:pharmacology; D015637:Gated Blood-Pool Imaging / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000494:pharmacology; D058729:Peripheral Arterial Disease / Q000473:pathology*; D012680:Sensitivity and Specificity; D015607:Stents
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D005682:Gadolinium; C109932:gadofosveset trisodium