title: Image Quality and Stenosis Assessment of Non-Contrast-Enhanced 3-T Magnetic Resonance Angiography in Patients with Peripheral Artery Disease Compared with Contrast-Enhanced Magnetic Resonance Angiography and Digital Subtraction Angiography.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of flow-sensitive dephasing (FSD)-prepared steady-state free precession (SSFP) magnetic resonance angiography (MRA) at 3 T for imaging infragenual arteries relative to contrast-enhanced MRA (CE-MRA) and digital subtraction angiography (DSA).
  
  
  METHODS
  A series of 16 consecutive patients with peripheral arterial disease (PAD) underwent a combined peripheral MRA protocol consisting of FSD-MRA for the calves and large field-of-view CE-MRA. DSA was performed on all patients within 1 week of the MR angiographies. Image quality and degree of stenosis was assessed by two readers with rich experience. Inter-observer agreement was determined using kappa statistics. Receiver operating characteristic (ROC) curve analysis determined the diagnostic value of FSD-MRA, CE-MRA, and CE-MRA combined with FSD-MRA (CE+FSD MRA) in predicting vascular stenosis.
  
  
  RESULTS
  At the calf station, no significantly difference of subjective image quality scores was found between FSD-MRA and CE-MRA. Inter-reader agreement was excellent for both FSD-MRA and CE-MRA. Both of FSD-MRA and CE-MRA carry a stenosis overestimation risk relative to DSA standard. With DSA as the reference standard, ROC curve analysis showed that the area under the curve was largest for CE+FSD MRA. The greatest sensitivity and specificity were obtained when a cut-off stenosis score of 2 was used.
  
  
  CONCLUSIONS
  In patients with severe PAD,3 T FSD-MRA provides good-quality diagnostic images without a contrast agent and is a good supplement for CE-MRA. CE+FSD MRA can improve the accuracy of vascular stenosis diagnosis.
authors.affiliation: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District Anzhen Road 2nd, Beijing, 100029, China.
authors.forename: Jiayi
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District Anzhen Road 2nd, Beijing, 100029, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America.
authors.forename: Zhaoyang
authors.initials: Z
authors.lastname: Fan
authors.affiliation: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District Anzhen Road 2nd, Beijing, 100029, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Luo
authors.affiliation: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District Anzhen Road 2nd, Beijing, 100029, China.
authors.forename: Yike
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Bi
authors.affiliation: Siemens Healthcare, China, MR Collaborations NE Asia, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: An
authors.affiliation: Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District Anzhen Road 2nd, Beijing, 100029, China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District Anzhen Road 2nd, Beijing, 100029, China.
authors.forename: Dongting
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District Anzhen Road 2nd, Beijing, 100029, China.
authors.forename: Zhaoying
authors.initials: Z
authors.lastname: Wen
authors.affiliation: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District Anzhen Road 2nd, Beijing, 100029, China.
authors.forename: Zhanming
authors.initials: Z
authors.lastname: Fan
authors.affiliation: Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America.
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; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D012372:ROC Curve; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media