title: Unenhanced 3D turbo spin-echo MR angiography of lower limbs in peripheral arterial disease: a comparative study with gadolinium-enhanced MR angiography.
abstract: OBJECTIVE
  The purpose of this study was to assess the feasibility and diagnostic performance of an unenhanced MR angiography sequence (Syngo Native Space, Siemens Healthcare) to detect and quantify lower-limb peripheral arterial disease (PAD), with gadolinium-enhanced MR angiography (CE-MRA) as the reference standard.
  
  
  METHODS
  Fifty-one patients known to have lower-limb arteriopathy were included in this prospective study. For every patient, we performed Native sequence and CE-MRA on a 1.5-T system. We evaluated examination duration, image quality, and location, number, and severity of lesions.
  
  
  RESULTS
  Examination duration was longer for Native sequence (mean, 39.6 min, vs 10 min for CE-MRA). Image quality was significantly better for CE-MRA, with 92% of images listed as good to excellent for CE-MRA, compared to 53% for Native. Sensitivity, specificity, negative predictive value (NPV), and accuracy of Native were respectively 75%, 95%, 89%, and 88% for all mixed levels; 52%, 97%, 88%, and 87% for aortoiliac level; 87%, 99%, 95%, and 92% for femoropopliteal level; and 82%, 87%, 87%, and 85% for subpopliteal level. If we considered only patients with Leriche and Fontaine stage II arteriopathy, Native results were slightly better, with respective specificities and NPVs of 96% and 91% for all mixed levels; 98% and 90% for aortoiliac level; 98% and 93% for femoropopliteal level; and 91% and 90% for subpopliteal level.
  
  
  CONCLUSIONS
  Unenhanced MR angiography, cheaper than CE-MRA, showed in our study a good NPV, which suggests its utility as first-line test to screen for PAD, especially in patients at risk of nephrogenic systemic fibrosis.
authors.affiliation: Department of Radiology B, CHU Gabriel Montpied, Clermont-Ferrand, France.
authors.forename: Abdoulay Dione
authors.initials: AD
authors.lastname: Diop
authors.forename: Chadi
authors.initials: C
authors.lastname: Braidy
authors.forename: Amine
authors.initials: A
authors.lastname: Habouchi
authors.forename: Khadim
authors.initials: K
authors.lastname: Niang
authors.forename: Cristian
authors.initials: C
authors.lastname: Gageanu
authors.forename: Louis
authors.initials: L
authors.lastname: Boyer
authors.forename: Pascal
authors.initials: P
authors.lastname: Chabrot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D035002:Lower Extremity / Q000098:blood supply* / Q000473:pathology*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D058729:Peripheral Arterial Disease / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013113:Spin Labels
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D013113:Spin Labels; D008536:Meglumine; C072417:gadoterate meglumine