title: Nonenhanced ECG-gated quiescent-interval single shot MRA: image quality and stenosis assessment at 3 tesla compared with contrast-enhanced MRA and digital subtraction angiography.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of a nonenhanced electrocardiograph-gated quiescent-interval single shot MR-angiography (QISS-MRA) at 3 Tesla with contrast-enhanced MRA (CE-MRA) and digital subtraction angiography (DSA) serving as reference standard.
  
  
  METHODS
  Following institutional review board approval, 16 consecutive patients with peripheral arterial disease underwent a combined peripheral MRA protocol consisting of a large field-of-view QISS-MRA, continuous table movement MRA, and an additional time-resolved MRA of the calves. DSA correlation was available in eight patients. Image quality and degree of stenosis was assessed. Sensitivity and specificity of QISS-MRA was evaluated with CE-MRA and DSA serving as the standards of reference and compared using the Fisher exact test.
  
  
  RESULTS
  With the exception of the calf station, image quality with QISS-MRA was rated statistically significantly less than that of CE-MRA (P < 0.05, P = 0.17, and P = 0.6, respectively). A greater percentage of segments were not accessible with QISS-MRA (19.5-20.1%) in comparison to CE-MRA (10.9%). Relative to DSA, sensitivity for QISS-MRA was high (100% versus 91.2% for CE-MRA, P = 0.24) in the evaluated segments; however, specificity (76.5%) was substantially less than that of CE-MRA (94.6%, P = 0.003).
  
  
  CONCLUSIONS
  Overall image quality and specificity of QISS-MRA at 3T are diminished relative to CE-MRA. However, when image quality is adequate, QISS-MRA has high sensitivity and, thus, has potential use in patients with contraindications to gadolinium.
authors: Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Mannheim, Germany.
authors: Jan
authors: J
authors: Hansmann
authors: John N
authors: JN
authors: Morelli
authors: Henrik J
authors: HJ
authors: Michaely
authors: Thomas
authors: T
authors: Riester
authors: Johannes
authors: J
authors: Budjan
authors: Stefan O
authors: SO
authors: Schoenberg
authors: Ulrike I
authors: UI
authors: Attenberger
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D003251:Constriction, Pathologic; D003287:Contrast Media; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007866:Leg / Q000098:blood supply / Q000473:pathology; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008280:Magnetics; D008297:Male; D008536:Meglumine; D015588:Observer Variation; D009942:Organometallic Compounds; D016491:Peripheral Vascular Diseases / Q000175:diagnosis*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol; D008536:Meglumine; C072417:gadoterate meglumine
keywords: 3 Tesla; MR-Angiography; QISS; nonenhanced MR-angiography