title: Nonenhanced peripheral MR-angiography (MRA) at 3 Tesla: evaluation of quiescent-interval single-shot MRA in patients undergoing digital subtraction angiography.
abstract: Quiescent-interval single-shot MRA (QISS-MRA) is a promising nonenhanced imaging technique for assessment of peripheral arterial disease (PAD). Previous studies at 3 Tesla included only very limited numbers of patients for correlation of QISS-MRA with digital subtraction angiography (DSA) as standard of reference (SOR). The aim of this prospective institutional review board-approved study was to compare QISS-MRA at 3 Tesla with DSA in a larger patient group. Our study included 32 consecutive patients who underwent QISS-MRA, contrast-enhanced MRA (CE-MRA), and DSA. Two readers independently performed a per-segment evaluation of QISS-MRA and CE-MRA for image quality and identification of non-significant stenosis (<50%) versus significant stenosis (50-100%). The final dataset included 1,027 vessel segments. Reader 1 and 2 rated image quality as diagnostic in 96.8 and 98.0% of the vessel segments on QISS-MRA and in 99.3 and 98.4% of the vessel segments on CE-MRA, respectively. DSA was available for 922 segments and detected significant stenosis in 133 segments (14.4%). Consensus reading yielded the following diagnostic parameters for QISS-MRA versus CE-MRA: sensitivity: 83.5% (111/133) versus 82.7% (110/133), p = 0.80; specificity: 93.9% (741/789) versus 95.7% (755/789), p = 0.25; and diagnostic accuracy: 92.4% (852/922) versus 93.8% (865/922), p = 0.35. In conclusion, using DSA as SOR, QISS-MRA and CE-MRA at 3 Tesla showed similar diagnostic accuracy in the assessment of PAD. A limitation of QISS-MRA was the lower rate of assessable vessel segments compared to CE-MRA.
authors.affiliation: Department of Radiology, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany, moritz.wagner@charite.de.
authors.forename: Moritz
authors.initials: M
authors.lastname: Wagner
authors.forename: Gesine
authors.initials: G
authors.lastname: Knobloch
authors.forename: Martin
authors.initials: M
authors.lastname: Gielen
authors.forename: Marie-Teres
authors.initials: MT
authors.lastname: Lauff
authors.forename: Valentina
authors.initials: V
authors.lastname: Romano
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.forename: Thomas
authors.initials: T
authors.lastname: Kröncke
mesh_terms: D015901:Angiography, Digital Subtraction; D005858:Germany; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D015588:Observer Variation; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index