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Published in: European Radiology 6/2011

01-06-2011 | Vascular-Interventional

Unenhanced calf MR angiography at 3.0 T using electrocardiography-gated partial-fourier fast spin echo imaging with variable flip angle

Authors: Dan Li, Jiang Lin, Fuhua Yan, Qingyuan Wu, Weiwei Lv, Yan San, Hong Yun

Published in: European Radiology | Issue 6/2011

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Abstract

Objective

This study was to evaluate diagnostic performance of unenhanced electrocardiography-gated fast spin echo based MRA with variable flip angle on 3.0 T for assessment of calf arteries in patients with peripheral arterial occlusive disease (PAOD).

Methods

64 patients underwent unenhanced MRA (UE), time-resolved contrast-enhanced MRA of the calf and bolus-chase contrast-enhanced lower peripheral MRA (BCE). Diagnostic performance of UE was evaluated and compared with contrast-enhanced MRA in 61 patients and x-ray angiography in 10 patients.

Results

With UE, 852 of 960 segments (88.75%) were diagnostic even in patients with arrhythmia, demonstrating similar image quality with those on BCE (P > 0.05). For those diagnostic segments, statistics revealed good agreement between unenhanced and contrast-enhanced techniques with a Kappa value of 0.77 and 0.75 for stenosis detection and visualized vessel length, respectively. When using X-ray angiography as reference standard, no significant difference was found between UE and contrast-enhanced MRA concerning sensitivity and specificity in depiction of severe stenosis and occlusion (P > 0.05).

Conclusions

Although further technical refinements are required, this optimized UE technique may be used as a supplement to contrast-enhanced MRA particularly in patients with PAOD in whom venous contamination occurs frequently.
Literature
1.
go back to reference Vogt MT, Wolfson SK, Kuller LH (1992) Lower extremity arterial disease and the aging process: a review. J Clin Epidemiol 45:529–542PubMedCrossRef Vogt MT, Wolfson SK, Kuller LH (1992) Lower extremity arterial disease and the aging process: a review. J Clin Epidemiol 45:529–542PubMedCrossRef
2.
go back to reference Balkau B, Vray M, Eschwege E (1994) Epidemiology of peripheral arterial disease. J Cardiovasc Pharmacol 23:S8–S16PubMed Balkau B, Vray M, Eschwege E (1994) Epidemiology of peripheral arterial disease. J Cardiovasc Pharmacol 23:S8–S16PubMed
3.
go back to reference Norgren L, Hiatt WR, Dormandy JA et al (2007) Inter-society consensus for the management of peripheral arterial disease (TASC II). Eur J Vasc Endovasc Surg 33:S1–S75PubMedCrossRef Norgren L, Hiatt WR, Dormandy JA et al (2007) Inter-society consensus for the management of peripheral arterial disease (TASC II). Eur J Vasc Endovasc Surg 33:S1–S75PubMedCrossRef
4.
go back to reference Berg F, Bangard C, Bovenschulte H et al (2008) Feasibility of peripheral contrast-enhanced magnetic resonance angiography at 3.0 Tesla with a hybrid technique: comparison with digital subtraction angiography. Invest Radiol 43:642–649PubMedCrossRef Berg F, Bangard C, Bovenschulte H et al (2008) Feasibility of peripheral contrast-enhanced magnetic resonance angiography at 3.0 Tesla with a hybrid technique: comparison with digital subtraction angiography. Invest Radiol 43:642–649PubMedCrossRef
5.
go back to reference Ho VB, Corse WR (2003) MR angiography of the abdominal aorta and peripheral vessels. Radiol Clin N Am 41:115–144PubMedCrossRef Ho VB, Corse WR (2003) MR angiography of the abdominal aorta and peripheral vessels. Radiol Clin N Am 41:115–144PubMedCrossRef
6.
go back to reference Ersoy H, Rybicki FJ (2003) MR angiography of the lower extremities. Am J Roentgenol 190:1675–1684CrossRef Ersoy H, Rybicki FJ (2003) MR angiography of the lower extremities. Am J Roentgenol 190:1675–1684CrossRef
7.
go back to reference Dinter DJ, Neff KW, Visciani G et al (2009) Peripheral bolus-chase MR angiography: analysis of risk factors for nondiagnostic image quality of the calf vessels-a combined retrospective and prospective study. Am J Roentgenol 193:234–240CrossRef Dinter DJ, Neff KW, Visciani G et al (2009) Peripheral bolus-chase MR angiography: analysis of risk factors for nondiagnostic image quality of the calf vessels-a combined retrospective and prospective study. Am J Roentgenol 193:234–240CrossRef
8.
go back to reference Zhang HL, Ho BY, Chao M et al (2004) Decreased venous contamination on 3D gadolinium-enhanced bolus chase peripheral MR angiography using thigh compression. Am J Roentgenol 183(1041–10):47 Zhang HL, Ho BY, Chao M et al (2004) Decreased venous contamination on 3D gadolinium-enhanced bolus chase peripheral MR angiography using thigh compression. Am J Roentgenol 183(1041–10):47
9.
go back to reference Andreisek G, Pfammatter T, Goepfert K et al (2007) Peripheral arteries in diabetic patients: standard bolus-chase and time-resolved MR angiography. Radiology 242:610–620PubMedCrossRef Andreisek G, Pfammatter T, Goepfert K et al (2007) Peripheral arteries in diabetic patients: standard bolus-chase and time-resolved MR angiography. Radiology 242:610–620PubMedCrossRef
10.
go back to reference Zhang HL, Khilnani NM, Prince MR et al (2005) Diagnostic accuracy of time-resolved 2D projection MR angiography for symptomatic infrapopliteal arterial occlusive disease. Am J Roentgenol 184:938–947 Zhang HL, Khilnani NM, Prince MR et al (2005) Diagnostic accuracy of time-resolved 2D projection MR angiography for symptomatic infrapopliteal arterial occlusive disease. Am J Roentgenol 184:938–947
11.
go back to reference Pereles FS, Collins JD, Carr JC et al (2006) Accuracy of stepping-table lower extremity MR angiography with dual-level bolus timing and separate calf acquisition: hybrid peripheral MR angiography. Radiology 240:283–290PubMedCrossRef Pereles FS, Collins JD, Carr JC et al (2006) Accuracy of stepping-table lower extremity MR angiography with dual-level bolus timing and separate calf acquisition: hybrid peripheral MR angiography. Radiology 240:283–290PubMedCrossRef
12.
go back to reference Sadowski EA, Bennett LK, Chan MR et al (2007) Nephrogenic systemic fibrosis: risk factors and incidence estimation. Radiology 243:148–157PubMedCrossRef Sadowski EA, Bennett LK, Chan MR et al (2007) Nephrogenic systemic fibrosis: risk factors and incidence estimation. Radiology 243:148–157PubMedCrossRef
13.
go back to reference Hoppe H, Spagnuolo S, Froehlich JM et al (2010) Retrospective analysis of patients for development of nephrogenic systemic fibrosis following conventional angiography using gadolinium-based contrast agents. Eur Radiol 20:595–603PubMedCrossRef Hoppe H, Spagnuolo S, Froehlich JM et al (2010) Retrospective analysis of patients for development of nephrogenic systemic fibrosis following conventional angiography using gadolinium-based contrast agents. Eur Radiol 20:595–603PubMedCrossRef
14.
go back to reference O’Hare AM, Bertenthal D, Shlipak MG et al (2005) Impact of renal insufficiency on mortality in advanced lower extremity peripheral arterial disease. J Am Soc Nephrol 16:514–519PubMedCrossRef O’Hare AM, Bertenthal D, Shlipak MG et al (2005) Impact of renal insufficiency on mortality in advanced lower extremity peripheral arterial disease. J Am Soc Nephrol 16:514–519PubMedCrossRef
15.
go back to reference Miyazaki M, Takai H, Sugiura S et al (2003) Peripheral MR angiography: separation of arteries from veins with flow-spoiled gradient pulses in electrocardiography-triggered three-dimensional half-fourier fast spin-echo imaging. Radiology 227:890–896PubMedCrossRef Miyazaki M, Takai H, Sugiura S et al (2003) Peripheral MR angiography: separation of arteries from veins with flow-spoiled gradient pulses in electrocardiography-triggered three-dimensional half-fourier fast spin-echo imaging. Radiology 227:890–896PubMedCrossRef
16.
go back to reference Lim RP, Hecht EM, Xu J et al (2008) 3D nongadolinium-enhanced ECG-gated MRA of the distal lower extremities: preliminary clinical experience. J Magn Reson Imaging 28:181–189PubMedCrossRef Lim RP, Hecht EM, Xu J et al (2008) 3D nongadolinium-enhanced ECG-gated MRA of the distal lower extremities: preliminary clinical experience. J Magn Reson Imaging 28:181–189PubMedCrossRef
17.
go back to reference Xu J, Weale P, Laub G et al (2008) A novel noncontrast MR angiography technique using triggered non-selective refocused SPACE for improved spatial resolution and speed. Proc Intl Soc Mag Reson Med 16:730 Xu J, Weale P, Laub G et al (2008) A novel noncontrast MR angiography technique using triggered non-selective refocused SPACE for improved spatial resolution and speed. Proc Intl Soc Mag Reson Med 16:730
18.
go back to reference Lim RP, Storey P, Atanasova IP et al (2009) Three-dimensional electrocardiographically gated variable flip angle FSE imaging for MR angiography of the hands at 3.0 T: initial experience. Radiology 252:874–881PubMedCrossRef Lim RP, Storey P, Atanasova IP et al (2009) Three-dimensional electrocardiographically gated variable flip angle FSE imaging for MR angiography of the hands at 3.0 T: initial experience. Radiology 252:874–881PubMedCrossRef
19.
go back to reference Kramer H, Michaely HJ, Matschl V et al (2007) High-resolution magnetic resonance angiography of the lower extremities with a dedicated 36-element matrix coil at 3 Tesla. Invest Radiol 42:477–483PubMedCrossRef Kramer H, Michaely HJ, Matschl V et al (2007) High-resolution magnetic resonance angiography of the lower extremities with a dedicated 36-element matrix coil at 3 Tesla. Invest Radiol 42:477–483PubMedCrossRef
20.
go back to reference Likert R (1932) A technique for the measurement of attitudes. Arch Psychol 140:1–55 Likert R (1932) A technique for the measurement of attitudes. Arch Psychol 140:1–55
21.
go back to reference Herborn CU, Watkins DM, Runge VM et al (2006) Renal arteries: comparison of steady-state free precession MR angiography and contrast-enhanced MR angiography. Radiology 239:263–268PubMedCrossRef Herborn CU, Watkins DM, Runge VM et al (2006) Renal arteries: comparison of steady-state free precession MR angiography and contrast-enhanced MR angiography. Radiology 239:263–268PubMedCrossRef
22.
go back to reference McCauley TR, Monib A, Dickey KW et al (1994) Peripheral vascular occlusive disease: accuracy and reliability of time-of-flight MR angiography. Radiology 192:351–357PubMed McCauley TR, Monib A, Dickey KW et al (1994) Peripheral vascular occlusive disease: accuracy and reliability of time-of-flight MR angiography. Radiology 192:351–357PubMed
23.
go back to reference Hahn WY, Hecht EM, Friedman B et al (2007) Distal lower extremity imaging: prospective comparison of 2-dimensional time of flight, 3-dimensional time-resolved contrast-enhanced magnetic resonance angiography, and 3-dimensional bolus chase contrast-enhanced magnetic resonance angiography. J Comput Assist Tomogr 31:29–36PubMedCrossRef Hahn WY, Hecht EM, Friedman B et al (2007) Distal lower extremity imaging: prospective comparison of 2-dimensional time of flight, 3-dimensional time-resolved contrast-enhanced magnetic resonance angiography, and 3-dimensional bolus chase contrast-enhanced magnetic resonance angiography. J Comput Assist Tomogr 31:29–36PubMedCrossRef
24.
go back to reference Chang KJ, Kamel IR, Macura KJ et al (2008) 3.0-T MR imaging of the abdomen: comparison with 1.5 T. Radiographics 28:1983–1998PubMedCrossRef Chang KJ, Kamel IR, Macura KJ et al (2008) 3.0-T MR imaging of the abdomen: comparison with 1.5 T. Radiographics 28:1983–1998PubMedCrossRef
25.
go back to reference Xu J, Oesingmann N, Stemmer A et al (2006) Reduced acquisition window with parallel technique improves non contrast 3D HASTE MRA imaging. Proc Intl Soc Mag Reson Med 14:1931 Xu J, Oesingmann N, Stemmer A et al (2006) Reduced acquisition window with parallel technique improves non contrast 3D HASTE MRA imaging. Proc Intl Soc Mag Reson Med 14:1931
26.
go back to reference Chen Q, Quijano CV, Mai VM et al (2004) On improving temporal and spatial resolution of 3D contrast-enhanced body MR angiography with parallel imaging. Radiology 231:893–899PubMedCrossRef Chen Q, Quijano CV, Mai VM et al (2004) On improving temporal and spatial resolution of 3D contrast-enhanced body MR angiography with parallel imaging. Radiology 231:893–899PubMedCrossRef
27.
go back to reference Griswold MA, Jakob PM, Heidemann RM et al (2002) Generalized autocalibrating partially parallel acqusitions (GRAPPA). Magn Reson Med 47:1202–1210PubMedCrossRef Griswold MA, Jakob PM, Heidemann RM et al (2002) Generalized autocalibrating partially parallel acqusitions (GRAPPA). Magn Reson Med 47:1202–1210PubMedCrossRef
28.
go back to reference Priatna A, Foster G, Xu J et al (2009) NATIVE SPACE angiography with MTC and fat saturation pulses. Proc Intl Soc Mag Reson Med 17:593 Priatna A, Foster G, Xu J et al (2009) NATIVE SPACE angiography with MTC and fat saturation pulses. Proc Intl Soc Mag Reson Med 17:593
29.
go back to reference Arizono S, Isoda H, Maetani YS et al (2008) High-spatial-resolution three-dimensional MR cholangiography using a high-sampling-efficiency technique (SPACE) at 3 T: comparison with the conventional constant flip angle sequence in healthy volunteers. J Magn Reson Imaging 28:685–690PubMedCrossRef Arizono S, Isoda H, Maetani YS et al (2008) High-spatial-resolution three-dimensional MR cholangiography using a high-sampling-efficiency technique (SPACE) at 3 T: comparison with the conventional constant flip angle sequence in healthy volunteers. J Magn Reson Imaging 28:685–690PubMedCrossRef
Metadata
Title
Unenhanced calf MR angiography at 3.0 T using electrocardiography-gated partial-fourier fast spin echo imaging with variable flip angle
Authors
Dan Li
Jiang Lin
Fuhua Yan
Qingyuan Wu
Weiwei Lv
Yan San
Hong Yun
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
European Radiology / Issue 6/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-2028-8

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