title: Non-contrast-enhanced MR angiography at 3 Tesla in patients with advanced peripheral arterial occlusive disease.
abstract: OBJECTIVE
  The aim of this study was to assess the diagnostic performance of ECG-gated non-contrast-enhanced quiescent interval single-shot (QISS) magnetic resonance angiography at a magnetic field strength of 3 Tesla in patients with advanced peripheral arterial occlusive disease (PAOD).
  
  
  METHODS
  A total of 21 consecutive patients with advanced PAOD (Fontaine stage IIb and higher) referred for peripheral magnetic resonance angiography (MRA) were included. Imaging was performed on a 3 T whole body MR. Image quality and stenosis diameter were evaluated in comparison to contrast-enhanced continuous table and TWIST MRA (CE-MRA) as standard of reference. QISS images were acquired with a thickness of 1.5 mm each (high-resolution QISS, HR-QISS). Two blinded readers rated the image quality and the degree of stenosis for both HR-QISS and CE-MRA in 26 predefined arterial vessel segments on 5-point Likert scales.
  
  
  RESULTS
  With CE-MRA as the reference standard, HR-QISS showed high sensitivity (94.1%), specificity (97.8%), positive (95.1%), and negative predictive value (97.2%) for the detection of significant (≥ 50%) stenosis. Interreader agreement for stenosis assessment of both HR-QISS and CE-MRA was excellent (κ-values of 0.951 and 0.962, respectively). As compared to CR-MRA, image quality of HR-QISS was significantly lower for the distal aorta, the femoral and iliac arteries (each with p<0.01), while no significant difference was found in the popliteal (p = 0.09) and lower leg arteries (p = 0.78).
  
  
  CONCLUSIONS
  Non-enhanced ECG-gated HR-QISS performs very well in subjects with severe PAOD and is a good alternative for patients with a high risk of nephrogenic systemic fibrosis.
authors.affiliation: Department of Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors.forename: Kolja M
authors.initials: KM
authors.lastname: Thierfelder
authors.affiliation: Department of Vascular and Endovascular Surgery, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors.forename: Georgios
authors.initials: G
authors.lastname: Meimarakis
authors.affiliation: Department of Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Nikolaou
authors.affiliation: Department of Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors.forename: Wieland H
authors.initials: WH
authors.lastname: Sommer
authors.affiliation: Siemens AG, Healthcare Sector, Erlangen, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Schmitt
authors.affiliation: Department of Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors.forename: Philipp M
authors.initials: PM
authors.lastname: Kazmierczak
authors.affiliation: Department of Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
authors.affiliation: Department of Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Theisen
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography; D008297:Male; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000473:pathology*
chemical_list: D003287:Contrast Media