Frank Berg MD, Presenter: Nothing to Disclose

Christopher Bangard MD, Abstract Co-Author: Nothing to Disclose

Henning Bovenschulte MD, Abstract Co-Author: Nothing to Disclose

Martin Hellmich MD, PhD, Abstract Co-Author: Nothing to Disclose

Klaus Lackner MD, Abstract Co-Author: Nothing to Disclose

Axel Gossmann MD, Abstract Co-Author: Nothing to Disclose

The aim of this study was to prospectively determine the diagnostic accuracy of 3D contrast-enhanced MR-Angiography (CE-MRA) at 3.0 Tesla in patients with peripheral atherosclerotic occlusive disease (PAOD). Digital subtraction angiography (DSA) was used as reference standard.

Thirty consecutive patients with suspected PAOD were examined on a 3.0 Tesla MR system by using the integrated whole body coil. A four station examination protocol in hybrid technique was chosen, containing two gadodiamide injections, the first one for imaging the calf and foot arteries (single-step technique), and the second injection for the visualization of the aortoiliacal and femoral arteries (bolus chase MRA). For the femoropopliteal and calf station a randomly segmented central k-space ordering (contrast-enhanced timing-robust angiography [CENTRA]) was used. All patients underwent DSA within the following 48 hours. The arterial tree of each leg was divided in 15 segments and four anatomical regions (iliacal, femoral, popliteal/proximal calf, distal calf/foot). MR-images were analyzed independently by two radiologists with regard to image quality, grade of stenosis and venous overlap. In consensus, two radiologists analyzed DSA images with regard to the stenosis grade.

885 and 884 of 889 arterial segments at MRA were rated with excellent or good diagnostic image quality by observer 1 and observer 2, respectively (agreement 96.3%, kappa 0.65). In only 3 segments image quality was affected by venous contamination (agreement 99.6%, kappa 0.94). Sensitivity of MRA for determination of relevant arterial stenoses (50-99%) and occlusions - as compared to DSA - was 95.3% (observer 1 and 2) and specificity was 98.5% and 97.8% for observer 1 and observer 2, respectively.

Hybrid CE-MR-Angiography at 3.0 Tesla offers high diagnostic accuracy of the whole pelvic and lower leg arterial system by assessment of high spatial resolution images.

For the evaluation of peripheral atherosclerotic occlusive disease CE-MR-Andiography at 3.0 Tesla represents an alternative, noninvasive imaging method to conventional angiography.

Berg, F, Bangard, C, Bovenschulte, H, Hellmich, M, Lackner, K, Gossmann, A, Accuracy of Peripheral Contrast-enhanced MR Angiography at 3.0 Tesla in Hybrid Technique.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5011499.html