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[Magnetic resonance angiography of the peripheral vessels with automatic moving bed infusion tracking]
A Carriero1, A Maggialetti, D Pinto
1Dipartimento di Scienze Cliniche e Bioimmagini, Sezione di Scienze Radiologiche, Università degli Studi Gabriele D'Annunzio, Chieti CH.
Purpose:
To investigate the actual diagnostic reliability of the Mobitrack technique with a slow intravenous infusion of paramagnetic contrast agent (CA) in MR Angiography of the peripheral arterial district.
Material And Methods:
Twelve healthy volunteers (mean age: 34) with no personal or family history of peripheral arterial pathologic conditions, underwent MR Angiography of the peripheral vascular district. A 1.5 T superconductive magnet equipped with automatic table feed was used. In the preliminary phase, the circulation time at the abdominal aorta was optimized and customized for each patient. This was done by performing a pre-targeting Fast Field Echo 2D (FFE 2D) sequence with intravenous administration of 1-2 mL CA by an injector, to evaluate the delay time. A 2D Time of Flight (2D TOF) sequence was then performed for topographic purposes. The partially overlapping volumes were acquired using Fast T1-weighted sequences, intravenous CA administration and an automatic table feed of 10 mm/s. A Fast Field Echo 3D (FFE 3D) T1-weighted sequence with TR/TE/FA: of 6.3/1.6/40 degrees and a slice thickness of 1.5 mm were also performed. Thirty to forty mL CA were slowly administered intravenously at a rate of 0.3-0.6 mL/s. Two blinded readers independently evaluated the images giving one of three diagnostic judgements: 1) arteries were well visualized, 2) heterogeneous arteries with(out) the presence of veins, and 3) arteries seen poorly or not at all. The first two judgements were considered diagnostic. The readers considered 19 different anatomical districts for each patient, giving a total of 190 evaluations.
Results:
A blinded evaluation of the readers judgements did not indicate a statistically significant difference (agreement: 100%). Overall, 82% of the images were rated as 1, 8.5% as 2 and 8.4% as 3.
Discussion:
In 174/190 judgements the vessels were rated as 1 or 2, that is of diagnostic value. Judgement 3 was always due to the inability to visualize the medial and/or distal third of the arterial circulation of the leg.
Conclusions:
The results of this technique optimization study confirm the overall validity of the Mobitrack technique. However they also indicate that further technical advances are required to ensure maximum diagnostic accuracy in this vascular district.
Insights
The Mobitrack technique with slow contrast agent infusion in MR angiography demonstrates good diagnostic reliability for peripheral arteries. Further technical improvements are needed for optimal visualization of distal leg vasculature.
Area of Science:
- Radiology and Imaging Science
- Vascular Imaging
- Magnetic Resonance Angiography
Context:
- Peripheral arterial disease diagnosis requires accurate imaging techniques.
- Magnetic Resonance Angiography (MRA) offers non-invasive visualization of the vascular system.
- Optimizing contrast agent delivery is crucial for enhancing MRA image quality.
Purpose:
- To evaluate the diagnostic reliability of the Mobitrack technique for peripheral arterial MR Angiography.
- To assess the effectiveness of a slow intravenous infusion of paramagnetic contrast agent (CA).
- To determine the accuracy of Mobitrack in visualizing the peripheral arterial district.
Summary:
- Twelve healthy volunteers underwent peripheral MR Angiography using the Mobitrack technique with a slow CA infusion (0.3-0.6 mL/s).
- Images were evaluated by two blinded readers, with 82% rated as excellent visualization (grade 1) and 8.5% as heterogeneous (grade 2).
- A total of 174 out of 190 judgments (91.6%) were considered diagnostic (grades 1 or 2).
Impact:
- The study confirms the overall validity and diagnostic value of the Mobitrack technique for peripheral MRA.
- Findings suggest that Mobitrack is a reliable method for assessing arterial circulation in the upper and mid-leg.
- Further technical advancements are recommended to improve visualization of distal arterial segments in the leg.