title: Evaluation of velocity-sensitized and acceleration-sensitized NCE-MRA for below-knee peripheral arterial disease.
abstract: To evaluate the diagnostic performance of velocity- and acceleration-sensitized noncontrast-enhanced magnetic resonance angiography (NCE-MRA) of the infrageniculate arteries using contrast-enhanced MRA (CE-MRA) as a reference standard.
  
  
  
  Twenty-four patients with symptoms of peripheral arterial disease were recruited. Each patient's infrageniculate arterial tree was examined using a velocity-dependent flow-sensitized dephasing (VEL-FSD) technique, an acceleration-dependent (ACC-FSD) technique, and our conventional CE-MRA technique performed at 1.5T. The images were independently reviewed by two experienced vascular radiologists, who evaluated each vessel segment to assess visibility, diagnostic confidence, venous contamination, and detection of pathology.
  
  
  
  In all, 432 segments were evaluated by each of the three techniques by each reader in total. Overall diagnostic confidence was rated as moderate or high in 98.5% of segments with CE-MRA, 92.1% with VEL-FSD, and 79.9% with ACC-FSD. No venous contamination was seen in 96% of segments with CE-MRA, 72.2% with VEL-FSD, and 85.8% with ACC-FSD. Per-segment, per-limb, and per-patient sensitivities for detecting significant stenotic disease were 63.4%, 73%, and 92%, respectively, for ACC-FSD, and 65.3%, 87.2%, and 96% for VEL-FSD, and as such no significant statistical change was detected using McNemar's chi-squared test with P-values of 1.00, 0.13, and 0.77 obtained, respectively.
  
  
  
  Flow-dependent NCE-MRA techniques may have a role to play in evaluation of patients with peripheral vascular disease. Increased sensitivity of a velocity-based technique compared to an acceleration-based technique comes at the expense of greater venous contamination.
  
  
  
  2J. Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1846-1853.
authors.affiliation: Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Nadeem
authors.initials: N
authors.lastname: Shaida
authors.affiliation: Department of Medical Physics, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Priest
authors.affiliation: Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: T C
authors.initials: TC
authors.lastname: See
authors.affiliation: Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Winterbottom
authors.affiliation: Department of Medical Physics, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Graves
authors.affiliation: Academic Department of Radiology, University of Cambridge, Cambridge, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Lomas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007866:Leg / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000473:pathology; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted
keywords: acceleration; blood flow velocity; magnetic resonance angiography; peripheral arterial disease; peripheral vascular diseases