Magnetic resonance angiography (MRA) of the calf station at 3.0 T: intraindividual comparison of non-enhanced ECG-gated flow-dependent MRA, continuous table movement MRA and time-resolved MRA.

To compare 3D non-enhanced ECG-gated inflow-dependent MRA (NE-MRA) vs. continuous table movement (CTM) MR-angiography and time-resolved TWIST-MRA in the calf station at 3.0 T in a clinical patient collective.
36 patients (27 male/9 female, 66.1 ± 14.4 years) with PAOD (stage II-IV) underwent during a single MRI: NE-MRA, contrast-enhanced CTM-MRA and TWIST-MRA with a single dose of a gadolinium-based contrast agent. The image quality (IQ) and the degree of stenoses were rated on a four-point scale. Positive (PPV) and negative predictive values (NPV), sensitivity (SS) and specificity (SP) for stenoses detection were calculated for NE-MRA vs. CTM-MRA and vs. TWIST-MRA. Values were obtained for overall graduation of wall changes and for severe stenoses (>70%).
With NE-MRA 122/288 segments were not assessable. Compared with CTM-MRA and TWIST-MRA the IQ was significantly inferior (p < 0.0001 to p = 0.0426). CTM-MRA/TWIST-MRA detected stenoses in 44.9%/46.1% of the segments, NE-MRA in 53.5%. SS/NPV of the NE-MRA ranged from 97.8 to 100%. The SP and PPV ranged from 72.7 to 85.5% and 66.7 to 78.2%.
Contrast-enhanced MRA techniques are superior to NE-MRA regarding IQ and correct identification of stenoses. If technically successful, NE-MRA is characterised by high NPV and overestimation of the degree of stenoses.