title: Noncontrast MR angiography (MRA) of infragenual arteries using flow-sensitive dephasing (FSD)-prepared steady-state free precession (SSFP) at 3.0 Tesla: Comparison with contrast-enhanced MRA.
abstract: BACKGROUND
  To evaluate the feasibility and diagnostic performance of flow-sensitive dephasing (FSD)-prepared steady-state free precession (SSFP) MR angiography (MRA) for imaging infragenual arteries at 3.0T, with contrast enhanced MR angiography (CE MRA) as reference.
  
  
  METHODS
  Twenty consecutive patients with suspicion of lower extremity arterial disease undergoing routine CE MRA were recruited. FSD MRA was performed at calf before CE MRA. Image quality and stenosis degree of infragenual arteries from both techniques were independently evaluated and compared. Six patients in this study underwent DSA examination.
  
  
  RESULTS
  Three undiagnostic segments were excluded with severe venous contamination in CE MRA. A total of 197 calf arterial segments images were analyzed. No significant difference existed in the relative signal intensity (rSI) of arterial segments between FSD MRA and CE MRA techniques (0.92 ± 0.09 versus 0.93 ± 0.05; P = 0.207). However, the subjective image quality score was slightly higher in FSD MRA (3.66 ± 0.81 versus 3.49 ± 0.87; P = 0.050). With CE MRA images as reference standard, slight overestimation existed in FSD MRA (2.19 ± 1.24 versus 2.09 ± 1.18; P = 0.019), with total agreement of 84.3% on the basis of all arterial segments. The sensitivity, specificity, negative predictive value, and positive predictive value of FSD MRA was 96.4%, 93.0%, 98.5%, and 84.1%. No significant difference in the stenosis degree score was detected between MRA (FSD MRA and CE MRA) and DSA (P > 0.05).
  
  
  CONCLUSIONS
  FSD MRA performed on at 3.0T without the use of contrast medium provides diagnostic images allowing for arterial stenosis assessment of calf arteries that was highly comparable with CE MRA. Moreover, venous contamination was less problematic with FSD MRA.
authors.affiliation: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Zhaoyang
authors.initials: Z
authors.lastname: Fan
authors.affiliation: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Luo
authors.affiliation: Siemens Medical Solutions USA, Inc., Chicago, Illinois, USA.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Bi
authors.affiliation: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Yike
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Siemens Healthcare, China, MR Collaborations NE Asia, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: An
authors.affiliation: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Jiayi
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhanming
authors.initials: Z
authors.lastname: Fan
authors.affiliation: Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Debiao
authors.initials: D
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D035002:Lower Extremity / Q000098:blood supply* / Q000473:pathology; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000473:pathology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: flow-sensitive dephasing; noncontrast MR angiography; peripheral vascular disease; steady-state free precession