Michele Anzidei MD, Presenter: Nothing to Disclose

Alessandro Napoli MD, Abstract Co-Author: Nothing to Disclose

Fulvio Zaccagna MD, Abstract Co-Author: Nothing to Disclose

Gaia Cartocci, Abstract Co-Author: Nothing to Disclose

Beatrice Cavallo Marincola MD, Abstract Co-Author: Nothing to Disclose

Carlo Catalano MD, Abstract Co-Author: Nothing to Disclose

To assess the feasibility of steady-state (SS) contrast-enhanced MR angiography (CE-MRA) of the peripheral arteries with gadobenate dimeglumine (MultiHance, Gd-BOPTA) and to compare the diagnostic accuracy of first-pass (FP) and SS imaging using digital subtraction angiography (DSA) as reference standard.  

35 patients with symptomatic peripheral arterial disease (PAD) underwent CE-MRA of the peripheral arteries at 1.5T using a standard 3D spoiled GRE sequence and 0.1 mmol/kg of gadobenate dimeglumine. High resolution SS acquisitions (voxel 0.7 mm3) were obtained immediately after the routine acquisition of FP images. All patients subsequently underwent conventional DSA. Three readers in consensus reviewed separate FP and SS CE-MRA datasets for quality of vessel visualization and then for the presence/absence of significant (>50% vessel lumen narrowing) steno-occlusive disease. A fourth independent observer evaluated DSA images using similar assessment criteria. The diagnostic performance (sensitivity, specificity, positive and negative predictive values [PPV and NPV]) achieved with each dataset was determined and compared using McNemar’s test. Agreement between FP and SS images was assessed using kappa statistics.  

All datasets were considered to be of sufficient quality for subsequent elaboration. The sensitivity, specificity, PPV and NPV for the grading of stenosis was 90%, 92%, 91.1% and 91%, respectively, for the FP dataset, and 95%, 95.4%, 95% and 95.4%, respectively, for the SS dataset. Differences in the performance of FP and SS were statistically significant (p<0.001). The agreement between DSA and SS images was substantial (к=0.93).  

Our preliminary results suggest that SS CE-MRA of the peripheral vessels is feasible with gadobenate dimeglumine and that acquisition of SS images may improve overall diagnostic performance in patients with symptomatic PAD.  

SS MRA imaging of the peripheral arteries with gadobenate Dimeglumine is superior to conventional FP imaging for the evaluation of stenosis as compared to DSA and may change patients management.

Anzidei, M, Napoli, A, Zaccagna, F, Cartocci, G, Cavallo Marincola, B, Catalano, C, Steady State MR Angiography of the Peripheral Arteries Using Gadobenate Dimeglumine: A Comparison with Conventional Angiography.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9009072.html