Ralph Caris MD, Presenter: Nothing to Disclose

Harrie Cornelis M. Van Den Bosch MD, Abstract Co-Author: Nothing to Disclose

Lucien Duijm MD, PhD, Abstract Co-Author: Nothing to Disclose

Jos Westenberg PhD, Abstract Co-Author: Nothing to Disclose

Alexander Victor Tielbeek MD, Abstract Co-Author: Nothing to Disclose

Albert De Roos MD, Abstract Co-Author: Nothing to Disclose

To prospectively evaluate diagnostic performance of 3 Tesla (T) Contrast-Enhanced MR angiography (CE-MRA) in patients with peripheral arterial disease compared to 1.5T CE-MRA using digital subtraction angiography (DSA) as reference standard.

Eighteen consecutive patients (12 men, 6 women; mean age, 67 years; age range, 53-83 years) were included. All patients were referred for suspected peripheral arterial disease. Institutional Review Board approval and written informed consent was obtained from all patients. Within a few days interval patients underwent CE-MRA of the aorto-iliac tract and lower limb arteries both at 3T and 1.5T (Achieva, Philips Medical Systems). DSA was performed 10-25 days after the first MRA. A 3-station single-injection protocol was employed, injection volume 0,2 mmol / kg BW Gadoterate meglumine (Gd-DOTA, Guerbet). DSA was performed with a dedicated angiography system (Multistar, Siemens). MRAs and DSAs were independently assessed by respectively two MR radiologists and two interventional radiologists, who were blinded to the reading results of one another. The arterial tree was divided into 27 segments. The most severe stenosis in each segment was chosen for classification and stenoses showing >50% luminal diameter reduction were considered significant.

In all patients both MRA and DSA examinations were completed successfully. In all, 486 segments were evaluated; 29 segments could not be evaluated due to patient movement or venous enhancement. For stenosis detection, both 3T CE-MRA (kappa=0.96) and 1.5T CE-MRA (kappa=0.93) showed excellent concordance with DSA. For discriminating significant stenosis (>50%) from non-significant stenosis, 3.0T MRA had a sensitivity and specificity of 97% and 95%, respectively, against 92% and 95% for 1.5T. The contrast-to-noise ratio (CNR) of the 3T MRA was significantly higher as compared to1.5T (98 ± 29 vs 30 ± 10, p<0.001).

3T CE-MRA was characterized by a better image quality than 1.5T CE-MRA, but 3T CE-MRA was comparable to 1.5T CE-MRA for the detection of significant stenoses.

Using DSA as standard of reference, this validation study shows that the diagnostic performance of 3T CE-MRA for stenosis detection in lower limb arteries is comparable to that of 1.5T CE-MRA.

Caris, R, Van Den Bosch, H, Duijm, L, Westenberg, J, Tielbeek, A, De Roos, A, 3.0T versus 1.5T MR Angiography in Peripheral Arterial Disease: Comparison to DSA.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8006649.html