title: Detection of infragenual arterial disease using non-contrast-enhanced MR angiography in patients with diabetes.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of a newly developed non-contrast-enhanced MR angiography (NCE-MRA) technique using flow-sensitive dephasing (FSD) prepared steady-state free precession (SSFP) for detecting calf arterial disease in patients with diabetes.
  
  
  METHODS
  Forty-five patients with diabetes who underwent routine contrast-enhanced MR angiography (CE-MRA) of lower extremities were recruited for NCE-MRA at the calf on a 1.5 Tesla MR system. Image quality evaluated on a 4-point scale and diagnostic performance for detecting more than 50% arterial stenosis were statistically analyzed, using CE-MRA as the standard of reference.
  
  
  RESULTS
  A total of 264 calf arterial segments were obtained in the 45 patients with 88 legs. The percentage of diagnostic arterial segments was all 98% for NCE- and CE-MRA. The image quality, SNR, CNR was 3.3, 177, 138, and 3.5, 103, 99, for NCE-MRA and CE-MRA, respectively. The average sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of NCE-MRA were 97%, 96%, 90%, 99%, and 96%, respectively on a per-segment basis and 90%, 84%, 82%, 91%, and 87%, respectively, on a per-patients basis.
  
  
  CONCLUSIONS
  The NCE-MRA technique demonstrates adequate image quality in the delineation of calf arteries and consistent diagnostic performance for detecting significant stenosis with CE-MRA in patients with diabetes.
authors.affiliation: Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology of Chinese Academy of Sciences, Shenzhen Key Laboratory for MRI, Shenzhen, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Liu
authors.forename: Na
authors.initials: N
authors.lastname: Zhang
authors.forename: Zhaoyang
authors.initials: Z
authors.lastname: Fan
authors.forename: Fei
authors.initials: F
authors.lastname: Feng
authors.forename: Qi
authors.initials: Q
authors.lastname: Yang
authors.forename: Hairong
authors.initials: H
authors.lastname: Zheng
authors.forename: Pengcheng
authors.initials: P
authors.lastname: Liu
authors.forename: Debiao
authors.initials: D
authors.lastname: Li
mesh_terms: D001157:Arterial Occlusive Diseases / Q000473:pathology*; D003287:Contrast Media; D003925:Diabetic Angiopathies / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007866:Leg / Q000098:blood supply / Q000473:pathology; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D058729:Peripheral Arterial Disease / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
keywords: diabetes; flow-sensitive dephasing; non-contrast-enhanced MR angiography; peripheral vascular disease; steady-state free precession