title: Quadruple inversion-recovery b-SSFP MRA of the abdomen: initial clinical validation.
abstract: The purpose of this study is to assess the image quality and diagnostic accuracy of non-contrast quadruple inversion-recovery balanced-SSFP MRA (QIR MRA) for detection of aortoiliac disease in a clinical population. QIR MRA was performed in 26 patients referred for routine clinical gadolinium-enhanced MRA (Gd-MRA) for known or suspected aortoiliac disease. Non-contrast images were independently evaluated for image quality and degree of stenosis by two radiologists, using consensus Gd-MRA as the reference standard. Hemodynamically significant stenosis (≥50%) was found in 10% (22/226) of all evaluable segments on Gd-MRA. The sensitivity and specificity for stenosis evaluation by QIR MRA for the two readers were 86%/86% and 95%/93% respectively. Negative predictive value and positive predictive value were 98%/98% and 63%/53% respectively. For stenosis evaluation of the aortoiliac region QIR MRA showed good agreement with the reference standard with high negative predictive value and a tendency to overestimate mild disease presumably due to the flow-dependence of the technique. QIR MRA could be a reasonable alternative to Gd-MRA for ruling out stenosis when contrast is contraindicated due to impaired kidney function or in patients who undergo abdominal MRA for screening purposes. Further work is necessary to improve performance and justify routine clinical use.
authors.affiliation: Department of Radiology, New York University School of Medicine and Department of Biomedical Engineering, Columbia University, United States. Electronic address: iatanaso@gmail.com.
authors.forename: Iliyana P
authors.initials: IP
authors.lastname: Atanasova
authors.affiliation: Department of Radiology, Austin Health, Heidelberg, Victoria 3084, Australia; University of Melbourne, Melbourne, Victoria, Australia. Electronic address: Ruthplim74@gmail.com.
authors.forename: Ruth P
authors.initials: RP
authors.lastname: Lim
authors.affiliation: Department of Radiology, New York University School of Medicine, 660 First Avenue, New York, NY 10016, United States. Electronic address: Hersh.Chandarana@nyumc.org.
authors.forename: Hersh
authors.initials: H
authors.lastname: Chandarana
authors.affiliation: Department of Radiology, New York University School of Medicine, 660 First Avenue, New York, NY 10016, United States. Electronic address: Pippa.Storey@nyumc.org.
authors.forename: Pippa
authors.initials: P
authors.lastname: Storey
authors.affiliation: Department of Radiology, New York University School of Medicine, 660 First Avenue, New York, NY 10016, United States. Electronic address: Mary.Bruno@nyumc.org.
authors.forename: Mary T
authors.initials: MT
authors.lastname: Bruno
authors.affiliation: Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, United States. Electronic address: Daniel.Kim@hsc.utah.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kim
authors.affiliation: Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, United States. Electronic address: Vivian.Lee@hsc.utah.edu.
authors.forename: Vivian S
authors.initials: VS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000473:pathology; D001018:Aortic Diseases / Q000175:diagnosis*; D003251:Constriction, Pathologic / Q000175:diagnosis; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D007083:Iliac Artery / Q000473:pathology; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media; D005682:Gadolinium