title: Non-enhanced, ECG-gated MR angiography of the pedal vasculature: comparison with contrast-enhanced MR angiography and digital subtraction angiography in peripheral arterial occlusive disease.
abstract: OBJECTIVE
  This study was conducted in order to compare a high resolution, non-contrast-enhanced MRA (NATIVE SPACE, NE-MRA) of the pedal vasculature with contrast-enhanced MRA (CE-MRA) and digital subtraction angiography (DSA) in patients with peripheral arterial occlusive disease (PAOD).
  
  
  METHODS
  The prospective study consists of 20 PAOD patients. All patients underwent percutaneous transluminal angioplasty or stenting and received MR angiographies the following day.
  
  
  RESULTS
  With CE-MRA, 75.7 % of vessel segments showed good, 16.4 % suboptimal and 7.9 % not usable image quality. With NE-MRA, 64.6 % showed good, 18.6 % suboptimal and 16.8 % not usable image quality. CE-MRA showed a sensitivity and negative predictive value of 90 %/95 % regarding significant stenosis (greater than 50 %), and specificity and positive predictive value were 88 %/77 %. Accordingly, sensitivity and negative predictive value for the NE-MRA were 96 %/97 % and specificity and positive predictive value were 80 %/69 % for stenoses greater than 50 %.
  
  
  CONCLUSIONS
  The applied NE-MRA technique achieves high diagnostic accuracy even in very small distal arteries of the foot. However, the rate of non-diagnostic vessel segments is considerably higher for NE-MRA than for CE-MRA. NE-MRA is a valuable alternative to CE-MRA in selected patients.
  
  
  CONCLUSIONS
  • Comparison of non-enhanced MRA with contrast-enhanced MRA and DSA as gold standard. • High resolution MRA at 3 T for the depiction of small pedal vessels. • Evaluation of high resolution non-enhanced MRA in PAOD patients.
authors.affiliation: Clinic of Radiology and Nuclear Medicine, Basel University Hospital, Basel, Switzerland. tschubert2@wisc.edu.|Department of Radiology, University of Wisconsin, 600 Highland Ave, E1/374, Madison, WI, 53792, USA. tschubert2@wisc.edu.
authors.forename: Tilman
authors.identifier: http://orcid.org/0000-0003-2373-5870
authors.initials: T
authors.lastname: Schubert
authors.affiliation: Clinic of Radiology and Nuclear Medicine, Basel University Hospital, Basel, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Takes
authors.affiliation: Department of Angiology, Basel University Hospital, Basel, Switzerland.
authors.forename: Markus
authors.initials: M
authors.lastname: Aschwanden
authors.affiliation: Division of Radiological Physics, Clinic of Radiology and Nuclear Medicine, Basel University Hospital, Basel, Switzerland.
authors.forename: Markus
authors.initials: M
authors.lastname: Klarhoefer
authors.affiliation: Clinic of Radiology and Nuclear Medicine, Basel University Hospital, Basel, Switzerland.
authors.forename: Tanja
authors.initials: T
authors.lastname: Haas
authors.affiliation: Radiology Clinic Hirslanden, Zurich, Switzerland.
authors.forename: Augustinus L
authors.initials: AL
authors.lastname: Jacob
authors.affiliation: Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Radiology and Nuclear Medicine, Hirslanden Clinic St. Anna, Lucerne, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Gutzeit
authors.affiliation: Department of Radiology and Nuclear Medicine, Hirslanden Clinic St. Anna, Lucerne, Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kos
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000503:physiopathology; D001158:Arteries / Q000000981:diagnostic imaging*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005528:Foot / Q000098:blood supply*; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014680:Veins / Q000000981:diagnostic imaging
keywords: High resolution; Magnetic resonance angiography; Non-contrast; Peripheral arterial occlusive disease; Small vessel