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[Contrast media-enhanced 3D MR angiography of peripheral arteries using an automatic tracking technique at 1.0 Tesla]
P Kalden1, K F Kreitner, K Oberholzer
1Klinik und Poliklinik für Radiologie, Johannes Gutenberg Universität, Mainz. kalden@radiologie.klinik.uni-mainz.de
Insights
Contrast-enhanced MR angiography (ceMRA) reliably evaluates pelvic and upper limb arteries in peripheral arterial occlusive disease. However, lower limb artery evaluation with this technique requires further development.
Area of Science:
- Radiology
- Medical Imaging
- Vascular Imaging
Background:
- Peripheral arterial occlusive disease (PAOD) necessitates accurate imaging for diagnosis and management.
- Digital subtraction angiography (DSA) is a conventional reference standard for evaluating arterial disease.
Purpose of the Study:
- To assess the diagnostic value of 1.0 Tesla contrast-enhanced MR angiography (ceMRA) with automatic tracking.
- To compare ceMRA findings against DSA for pelvic and lower limb arteries in PAOD patients.
Main Methods:
- 15 PAOD patients underwent 3D FLASH ceMRA with automatic tracking at 1.0T.
- DSA served as the reference standard for comparison.
- 21 arterial segments per patient were independently assessed by two radiologists for stenosis or occlusion.
Main Results:
- Interobserver agreement for ceMRA was poor in 38% of segments.
- Good concordance between ceMRA and DSA was observed in 62% of segments.
- Moderate to poor concordance was noted in 38% of segments when comparing ceMRA to DSA.
Conclusions:
- ceMRA with automatic tracking at 1.0T provides reliable evaluation of pelvic and upper limb arteries in PAOD.
- Current ceMRA techniques are not yet sufficiently reliable for lower limb artery assessment in PAOD.
Purpose:
Assessment of the value of contrast-enhanced MR angiography (ceMRA) using an automatic tracking technique at 1.0 Tesla in comparison with digital subtraction angiography (DSA) of the pelvic and lower limb arteries.
Materials And Methods:
In 15 patients with peripheral arterial occlusive disease a ceMRA (3D FLASH, TR/TE = 6.2/2.3 ms, Flip angle alpha = 30 degrees, Matrix 170 x 256) using a new automatic tracking technique was accomplished. The reference method was DSA. Twenty-one vessel segments of each patient were graded as normal, stenosed (> 50%) or occluded. Image material was evaluated independently by two radiologists.
Results:
In comparison, the interobserver agreement showed a good (Cohen's kappa > 71%) concordance for 38% of the 21 vessel segments, a moderate (Cohen's kappa between 31%-70%) for 21% and a poor (Cohen's kappa < 30%) concordance for 38% of the 21 vessel segments. Regarding the MRA and DSA results, a good concordance was achieved for 62% of the 21 vessel segments, 14% showed a moderate concordance and 24% only a poor concordance.
Conclusion:
In patients with peripheral arterial occlusive disease ceMRA using an automatic tracking technique enables a reliable evaluation of pelvis and upper limb arteries at 1.0 Tesla. However, a reliable evaluation of lower limb arteries is not yet possible.