Peripheral Vascular Disease: Comparison of Continuous MR Angiography and Conventional MR Angiography—Pilot Study 1
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany.Radiology (Impact Factor: 6.87). 04/2007; 243(1):229-38. DOI: 10.1148/radiol.2431052098
The aim of this study was to prospectively assess the accuracy of three-dimensional magnetic resonance (MR) angiography for evaluation of stenosis in the peripheral arterial system with a continuous moving table technique, with conventional MR angiography as reference. This study was approved by the local institutional review board; informed consent was obtained. Five healthy male volunteers (mean age, 27 years; range, 24-35 years) and four men and one woman (mean age, 63 years; range, 46-78 years) with peripheral arterial occlusive disease were examined. Images obtained with both techniques showed excellent concordance (Cohen kappa = 0.75). Images obtained with a conventional protocol had higher quality compared with those obtained with the continuous technique (mean, 1.07 +/- 0.25 [standard deviation] vs 1.58 +/- 0.6; P < .05); small vessels appeared sharper on them. For detection of significant stenosis and occlusion, accuracy, sensitivity, and specificity of the continuous technique were 92.8%, 100%, and 89.2%, respectively.
Article: Peripheral MR angiography[Show abstract] [Hide abstract]
ABSTRACT: Atherosclerotic disease of the lower extremities is a common disorder in western society. Its debilitating nature calls for accurate diagnosis and treatment. The gold standard for diagnosing this disease by depiction of vessel morphology is X-ray angiography (either conventional or digital subtraction angiography). However, the invasive nature of this technique and the possible harmful effects of iodinated contrast agents have led to the idea that non-invasive MR angiography might be a good alternative for acquiring information about vessel morphology. Most extensively studied was time-of-flight MR angiography. Although first results with this technique were encouraging, it is now apparent that time-of-flight MR angiography is hampered by the virtue of which it exists, since blood flow not only generates vessel-to-background contrast, but is also the cause of disturbing artifacts. However, with the introduction of minimally invasive contrast-enhanced MR angiography, using gadolinium chelates to reduce the T1 of blood, image quality has improved dramatically. Moreover, using contrast-enhanced MR angiography, high-resolution three-dimensional data about the entire peripheral vascular tree can be obtained within several minutes, which might make MR angiography a true competitor of X-ray angiography as a diagnostic tool in the clinical work-up of a patient with complaints of peripheral atherosclerosis. The purpose of this article is to explain working mechanisms and usefulness of both time-of-flight and contrast-enhanced MR angiography.European Radiology 02/1999; 9(9):1765-74. DOI:10.1007/s003300050920 · 4.01 Impact Factor
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ABSTRACT: Total-body contrast-enhanced MRA (CE-MRA) provides information of the entire vascular system according to a one-stop-shop approach. Short, wide-bore scanners have not yet been used for total-body CE-MRA, probably due to their restricted field of view in the z-direction. The purpose of this feasibility study is to introduce an image protocol for total-body MRA on a short, wide-bore system. The protocol includes five to six table-moving steps and two injection runs. Two pharmacologically different contrast materials (CM) were applied in ten healthy volunteers in view of possible CM-dependent influences on the protocol outcome (Gd-Bopta, Gd-Dota). Differences consisted of significantly higher CNR with Gd-Bopta with a mean of 73.8+/-38.7 versus 69.1+/-34.3 (p=0.008), significantly better arterial visualization values with Gd-Dota with a mean of 1.26+/-0.44 versus 1.53+/-0.73 (p=0.003) and a tendency to less venous overlay with Gd-Dota, mean 1.19+/-0.44 and 1.34+/-0.72, respectively (p=0.065) (two-tailed Wilcoxon matched-pairs test). Overall 94% of the steps were valued as qualitatively excellent or good. The good results with both CM suggest a transfer to further patient evaluation.European Radiology 05/2008; 18(10):2265-73. DOI:10.1007/s00330-008-0976-z · 4.01 Impact Factor
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ABSTRACT: To perform a quantitative and qualitative comparison of gadobutrol and gadoterate in three-station contrast enhanced magnetic resonance angiography (CE-MRA) of the lower limbs. In this prospective randomized controlled trial, 52 patients with leg ischemia were randomly assigned to one of two groups receiving either gadobutrol (1.0 mmol Gd/mL, 15 mL) or gadoterate (0.5 mmol Gd/mL, 30 mL). Three-station 3D CE-MRAs from the pelvis to the ankles were performed with moving-table technique on a 1.5T MR scanner. Injection time was identical in both groups. Signal-to-noise (SNR) and contrast-to-noise ratios (CNR) were calculated for 816 arteries. Contrast quality in 1196 vessel segments was evaluated separately by two blinded readers on a three-point scale. Mean SNR (61.8 +/- 7.8 for gadobutrol vs. 61.9 +/- 9.1 for gadoterate, P = 0.257), CNR (52.8 +/- 9.1 vs. 52.8 +/- 10.7, P = 0.154), and qualitative ranking (1.41 vs. 1.44, P = 0.21) for all vessels did not differ significantly between the two patient groups. The overall quality was good in 90.4% with gadoterate and 94.2% with gadobutrol (P = 0.462). High-concentration gadobutrol allows neither a higher CNR nor any qualitative advantage over the ordinary unspecific Gd agent gadoterate when the same Gd load and injection times are used in multistation CE-MRA of the peripheral arteries.Journal of Magnetic Resonance Imaging 06/2008; 27(6):1399-405. DOI:10.1002/jmri.21351 · 3.21 Impact Factor
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