Louis Job MD, Presenter: Nothing to Disclose

Christine Hoeffel, Abstract Co-Author: Nothing to Disclose

Loic Dejugnat, Abstract Co-Author: Nothing to Disclose

Sandra Cardini, Abstract Co-Author: Nothing to Disclose

Anne Long MD, Abstract Co-Author: Nothing to Disclose

Claude Dominique Marcus MD, Abstract Co-Author: Nothing to Disclose

To prospectively compare a 4D Time-Resolved Angiography sequence using Keyhole (TRAK) and a 3D- Fast Field Echo (FFE) MR sequence in the assessment of lower extremity arterial occlusive disease at 3T.

34 patients, 22 men et 12 females (mean age, 69 years; range, 45- 89 years) with peripheral arterial occlusive disease were included in the study. MRA was performed on a 3T system (Achieva, Philips). In all patients, both dynamic 4D-TRAK sequence combining SENSE and CENTRA keyhole methods and a 3D-FFE MRA sequence were performed and compared, with digital substraction angiography (DSA) as reference. This study was approved by the local institutional review board; informed consent was obtained. Two readers independently reviewed the three modalities in a random order; differences were resolved by consensus. Tibioperoneal, anterior tibial, peroneal and posterior tibial arteries were analyzed and stenoses were scored as follows:1, less than 50 %; 2, 50–69%; 3, greater than 70 % and 4, occlusion.

A total of 272 arterial segments were available for analysis. 119/272 were found to have a grade 2 to 4 lesion on DSA. For the diagnosis of significant stenosis (> 50%) and occlusion, the diagnostic accuracy, sensitivity and specificity of the 4D-TRAK sequence was 87.4%, 92.6 % and 92.9%, respectively, with an excellent inter-observer agreement (Cohen Kappa=0.89). The diagnostic accuracy, sensitivity and specificity of the 3D-FFE sequence was 85.4%, 92.2% and 90.2%, respectively with a good interobserver agreement (Cohen Kappa =0.76). When reviewing 4D and 3D sequences together, diagnostic accuracy, sensitivity and specificity improved up to 90%, 94.6% and 94.6% with a k value of 0.83.

Both dynamic 4D-TRAK and 3D-FFE 3 T MR Angiography sequences are statistically indistinguishable in the evaluation of lower extremity vasculature. When associated with the 3D sequence, 4D-TRAK compares favourably with DSA for lower leg arterial occlusive disease assessment.

Dynamic 4D-TRAK associated with 3D-FFE MRA is equal to DSA in assessing lower leg arterial occlusive disease.

Job, L, Hoeffel, C, Dejugnat, L, Cardini, S, Long, A, Marcus, C, Comparison of Dynamic 4D-TRAK and 3D-FFE MR Angiography in the Evaluation of Lower Leg Arteries at 3 T.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6010750.html