Michele Anzidei MD, Presenter: Nothing to Disclose

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

Eugenio Marotta MD, Abstract Co-Author: Nothing to Disclose

Luca Saba MD, Abstract Co-Author: Nothing to Disclose

Luca Bertaccini, Abstract Co-Author: Nothing to Disclose

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

To compare the diagnostic accuracy of two non-enhanced MRA (NE-MRA) sequences (ToF and SSFP) vs. conventional contrast-enhanced MRA (CE-MRA) at 3.0 T in patients with peripheral arterial obstructive disease (PAOD), using CT-angiography (CTA) as reference standard.

30 patients with symptomatic peripheral arterial disease underwent NE-MRA of the femoral and calf regions with 3D ECG-gated ToF sequences and ECG-gated SSFP sequences; thereafter CE-MRA was performed after the administration of Gd-BOPTA. All patients underwent CTA as reference standard. Three blinded observers separately reviewed all MRA datasets in random order while one independent observer evaluated CTA images for the assessment of relevant stenosis (>50%), extent and location. Image quality was evaluated by an independent observer for all MRA datasets. Intraobserver and interobserver agreement for the three MRA techniques were analyzed using Cohen-k statistics. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each technique. The McNemar’s test was used to assess statistically significant differences in the diagnostic accuracy of each MRA technique.

Intraobserver and interobserver agreement were substantial for stenosis assessment. The sensitivity, specificity, accuracy, PPV and NPV values of ToF/SSFP/CE-MRA sequences for stenosis assessment compared to CTA were respectively 90/92/97%, 78/87/94%, 85/86/97%, 94/93/97%, 72/83/94%. The diagnostic performance of CE-MRA was superior to both ToF and SSFP sequences (p<0.001); SSFP sequences were more effective for stenosis assessment compared to ToF sequences (p<0.001).

3T CE-MRA is superior to NE-MRA techniques for both image quality and diagnostic performance. The diagnostic performance of SSFP sequences is significantly higher than that of ToF sequences and may be considered as a potential alternative diagnostic tool in selected patients.

Contrast-enhanced sequences remain the optimal choice for MRA of the peripheral arteries in patients with obstructive disease; ECG-gated SSFP sequences may represent a further diagnostic option in pat

Anzidei, M, Napoli, A, Marotta, E, Saba, L, Bertaccini, L, Catalano, C, Peripheral MRA at 3 T: Intraindividual Comparison between Nonenhanced ToF and SSFP Sequences vs Contrast-enhanced MRA for the Detection of Clinically-relevant Stenosis.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11008820.html