title: Comparison of contrast-enhanced multi-station MR angiography and digital subtraction angiography of the lower extremity arterial disease.
abstract: OBJECTIVE
  To compare diagnostic accuracy of multi-station, high-spatial resolution contrast-enhanced MR angiography (CE-MRA) of the lower extremities with digital subtraction angiography (DSA) as the reference standard in patients with symptomatic peripheral arterial occlusive disease.
  
  
  METHODS
  Of 485 consecutive patients undergoing a run-off CE-MRA, 152 patients (86 male, 66 female; mean age, 71.6 years) with suspected peripheral arterial occlusive disease were included into our Institutional Review Board approved study. All patients underwent MRA and DSA of the lower extremities within 30 days. MRA was performed at 1.5 Tesla with a single bolus of 0.1 mmol/kg body weight of gadobutrol administered at a rate of 2.0 mL/s at three stations. Two readers evaluated the MRA images independently for stenosis grade and image quality. Sensitivity and specificity were derived.
  
  
  RESULTS
  Sensitivity and specificity ranged from 73% to 93% and 64% to 89% and were highest in the thigh area. Both readers showed comparable results. Evaluation of good and better quality MRAs resulted in a considerable improvement in diagnostic accuracy.
  
  
  CONCLUSIONS
  Contrast-enhanced MRA demonstrates good sensitivity and specificity in the investigation of the vasculature of the lower extremities. While a minor investigator experience dependence remains, it is standardizable and shows good inter-observer agreement. Our results confirm that the administration of Gadobutrol at a standard dose of 0.1 mmol/kg for contrast-enhanced runoff MRA is able to detect hemodynamically relevant stenoses. Use of contrast-enhanced MRA as an alternative to intra-arterial DSA in the evaluation and therapeutic planning of patients with suspected peripheral arterial occlusive disease is well justified.
authors.affiliation: Department of Diagnostic Radiology, Philipps University, Marburg, Germany.
authors.forename: Mykhaylo
authors.initials: M
authors.lastname: Burbelko
authors.forename: Michael
authors.initials: M
authors.lastname: Augsten
authors.forename: Marc O
authors.initials: MO
authors.lastname: Kalinowski
authors.forename: Johannes T
authors.initials: JT
authors.lastname: Heverhagen
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction / Q000706:statistics & numerical data*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D018810:Magnetic Resonance Angiography / Q000706:statistics & numerical data*; D008297:Male; D009942:Organometallic Compounds; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013557:Switzerland / Q000453:epidemiology
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol