title: Nonenhanced ECG-gated quiescent-interval single-shot MRA (QISS-MRA) of the lower extremities: comparison with contrast-enhanced MRA.
abstract: OBJECTIVE
  To evaluate electrocardiogram (ECG)-gated quiescent-interval single-shot magnetic resonance angiography (QISS-MRA) for nonenhanced assessment of peripheral artery occlusive disease (PAOD) using contrast-enhanced MRA (CE-MRA) as the reference standard.
  
  
  METHODS
  Twenty-seven patients (mean age 66.6 ± 10.8 years) with PAOD were included in the study. QISS-MRA and CE-MRA of the lower extremity were performed using a 1.5 T MR scanner. In each patient, subjective image quality and the degree of stenosis were evaluated on a four-point scale for 15 predefined arterial segments.
  
  
  RESULTS
  Twenty-five of the 27 patients were considered for analysis. Subjective image quality of QISS-MRA was significantly lower for the distal aorta, pelvic arteries, and femoral arteries as compared to CE-MRA (p < 0.01), while no significant difference was found for other vascular segments. The degree of stenosis was overestimated with QISS-MRA in 23 of 365 (6.3%) segments and underestimated in two of 365 (0.5%) segments. As compared to CE-MRA, QISS-MRA had a high sensitivity (98.6%), specificity (96%) as well as positive and negative predictive value (88.7 and 99.6%, respectively) for the detection of significant stenosis (≥50%).
  
  
  CONCLUSIONS
  ECG-gated QISS-MRA is a promising imaging technique for reliable assessment of PAOD without the use of contrast material.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Düsseldorf, Medical Faculty, Düsseldorf, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Klasen
authors.forename: D
authors.initials: D
authors.lastname: Blondin
authors.forename: P
authors.initials: P
authors.lastname: Schmitt
authors.forename: X
authors.initials: X
authors.lastname: Bi
authors.forename: R
authors.initials: R
authors.lastname: Sansone
authors.forename: H-J
authors.initials: HJ
authors.lastname: Wittsack
authors.forename: P
authors.initials: P
authors.lastname: Kröpil
authors.forename: M
authors.initials: M
authors.lastname: Quentin
authors.forename: J
authors.initials: J
authors.lastname: Kuhlemann
authors.forename: F
authors.initials: F
authors.lastname: Miese
authors.forename: C
authors.initials: C
authors.lastname: Heiss
authors.forename: M
authors.initials: M
authors.lastname: Kelm
authors.forename: G
authors.initials: G
authors.lastname: Antoch
authors.forename: R S
authors.initials: RS
authors.lastname: Lanzman
mesh_terms: D000368:Aged; D003251:Constriction, Pathologic / Q000175:diagnosis; D003287:Contrast Media; D004562:Electrocardiography; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media