Dataset Information

Comparison of nonenhanced MR angiographic subtraction techniques for infragenual arteries at 1.5 T: a preliminary study.

ABSTRACT:

Purpose

To evaluate diagnostic performance of three nonenhanced methods: variable-refocusing-flip angle (FA) fast spin-echo (SE)-based magnetic resonance (MR) angiography (variable FA MR) and constant-refocusing-FA fast SE-based MR angiography (constant-FA MR) and flow-sensitive dephasing (FSD)-prepared steady-state free precession MR angiography (FSD MR) for calf arteries, with dual-injection three-station contrast material-enhanced MR angiography (gadolinium-enhanced MR) as reference.

Materials and methods

This prospective study was institutional review board approved and HIPAA compliant, with informed consent. Twenty-one patients (13 men, eight women; mean age, 62.6 years) underwent calf-station variable-FA MR, constant-FA MR, and FSD MR at 1.5 T, with gadolinium-enhanced MR as reference. Image quality and stenosis severity were assessed in 13 segments per leg by two radiologists blinded to clinical data. Combined constant-FA MR and FSD MR reading was also performed. Methods were compared (logistic regression for correlated data) for diagnostic accuracy.

Results

Of 546 arterial segments, 148 (27.1%) had a hemodynamically significant (? 50%) stenosis. Image quality was satisfactory for all nonenhanced MR sequences. FSD MR was significantly superior to both other sequences (P < .0001), with 5-cm smaller field of view; 9.6% variable-FA MR, 9.6% constant-FA MR, and 0% FSD MR segmental evaluations had nondiagnostic image quality scores, mainly from high diastolic flow (variable-FA MR) and motion artifact (constant-FA MR). Stenosis sensitivity and specificity were highest for FSD MR (80.3% and 81.7%, respectively), compared with those for constant-FA MR (72.3%, P = .086; and 81.8%, P = .96) and variable-FA MR (75.9%, P = .54; and 75.6%, P = .22). Combined constant-FA MR and FSD MR had superior sensitivity (81.8%) and specificity (88.3%) compared with constant-FA MR (P = .0076), variable-FA MR (P = .0044), and FSD MR (P = .0013). All sequences had an excellent negative predictive value (NPV): 93.2%, constant-FA MR; 94.7%, variable-FA MR; 91.7%, FSD MR; and 92.9%, combined constant-FA MR and FSD MR.

Conclusion

At 1.5 T, all evaluated nonenhanced MR angiographic methods demonstrated satisfactory image quality and excellent NPV for hemodynamically significant stenosis.

Supplemental material

http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120859/-/DC1.

SUBMITTER: Lim RP

PROVIDER: S-EPMC3606542 | biostudies-literature | 2013 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Comparison of nonenhanced MR angiographic subtraction techniques for infragenual arteries at 1.5 T: a preliminary study.

Lim Ruth P RP Fan Zhaoyang Z Chatterji Manjil M Baadh Amanjit A Atanasova Iliyana P IP Storey Pippa P Kim Danny C DC Kim Sooah S Hodnett Philip A PA Ahmad Afhsan A Stoffel David R DR Babb James S JS Adelman Mark A MA Xu Jian J Li Debiao D Lee Vivian S VS

Radiology 20130107 1

<h4>Purpose</h4>To evaluate diagnostic performance of three nonenhanced methods: variable-refocusing-flip angle (FA) fast spin-echo (SE)-based magnetic resonance (MR) angiography (variable FA MR) and constant-refocusing-FA fast SE-based MR angiography (constant-FA MR) and flow-sensitive dephasing (FSD)-prepared steady-state free precession MR angiography (FSD MR) for calf arteries, with dual-injection three-station contrast material-enhanced MR angiography (gadolinium-enhanced MR) as reference.< ...[more]

PMID: 23297320

Similar Datasets

Project description:PURPOSE:To validate three widely-used acceleration methods in four-dimensional (4D) flow cardiac MR; segmented 4D-spoiled-gradient-echo (4D-SPGR), 4D-echo-planar-imaging (4D-EPI), and 4D-k-t Broad-use Linear Acquisition Speed-up Technique (4D-k-t BLAST). MATERIALS AND METHODS:Acceleration methods were investigated in static/pulsatile phantoms and 25 volunteers on 1.5 Tesla MR systems. In phantoms, flow was quantified by 2D phase-contrast (PC), the three 4D flow methods and the time-beaker flow measurements. The later was used as the reference method. Peak velocity and flow assessment was done by means of all sequences. For peak velocity assessment 2D PC was used as the reference method. For flow assessment, consistency between mitral inflow and aortic outflow was investigated for all pulse-sequences. Visual grading of image quality/artifacts was performed on a four-point-scale (0?=?no artifacts; 3?=?nonevaluable). RESULTS:For the pulsatile phantom experiments, the mean error for 2D PC?=?1.0?±?1.1%, 4D-SPGR?=?4.9?±?1.3%, 4D-EPI?=?7.6?±?1.3% and 4D-k-t BLAST?=?4.4?±?1.9%. In vivo, acquisition time was shortest for 4D-EPI (4D-EPI?=?8?±?2?min versus 4D-SPGR?=?9?±?3?min, P?<?0.05 and 4D-k-t BLAST?=?9?±?3?min, P?=?0.29). 4D-EPI and 4D-k-t BLAST had minimal artifacts, while for 4D-SPGR, 40% of aortic valve/mitral valve (AV/MV) assessments scored 3 (nonevaluable). Peak velocity assessment using 4D-EPI demonstrated best correlation to 2D PC (AV:r?=?0.78, P?<?0.001; MV:r?=?0.71, P?<?0.001). Coefficient of variability (CV) for net forward flow (NFF) volume was least for 4D-EPI (7%) (2D PC:11%, 4D-SPGR: 29%, 4D-k-t BLAST: 30%, respectively). CONCLUSION:In phantom, all 4D flow techniques demonstrated mean error of less than 8%. 4D-EPI demonstrated the least susceptibility to artifacts, good image quality, modest agreement with the current reference standard for peak intra-cardiac velocities and the highest consistency of intra-cardiac flow quantifications. LEVEL OF EVIDENCE:1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:272-281.

Project description:To assess the diagnostic performance of quiescent-interval single-shot (QISS) magnetic resonance (MR) angiography, a nonenhanced two-dimensional electrocardiographically gated single-shot balanced steady-state free precession examination for the evaluation of symptomatic chronic lower limb ischemia.For this prospective institutional review board-approved, HIPAA-compliant study, the institutional review board waived the requirement for informed patient consent. The QISS nonenhanced MR angiography technique was evaluated in a two-center trial involving 53 patients referred for lower extremity MR angiography for suspected or known chronic peripheral arterial disease (PAD), with contrast material-enhanced MR angiography serving as the noninvasive reference standard. The accuracy of stenosis assessments performed with the nonenhanced MR angiography sequence was evaluated relative to the reference standard. Per-segment, per-region, and per-limb sensitivities and specificities were calculated, and assessments were considered correct only if they were in exact agreement with the reference standard-derived assessments. Generalized estimating equation (GEE) modeling with use of an unstructured binomial logit analysis was used to account for clustering of multiple measurements per case. The sensitivity and specificity of QISS MR angiography for the determination of nonsignificant (<50%) versus significant (50%-100%) stenosis were compared with the sensitivity and specificity of the reference standard.The diagnostic performance of nonenhanced MR angiography was found to be nearly equivalent to the diagnostic performances of contrast-enhanced MR angiography and digital subtraction angiography. Non-GEE segment-based analysis revealed that for the two reviewers, nonenhanced MR angiography had sensitivities of 89.7% (436 of 486 segments) and 87.0% (423 of 486 segments) and specificities of 96.5% (994 of 1030 segments) and 94.6% (973 of 1028 segments).QISS nonenhanced MR angiography offers an alternative to currently used imaging tests for symptomatic chronic lower limb ischemia, for which the administration of iodinated or gadolinium-based contrast agents is contraindicated.

Dataset Information

Comparison of nonenhanced MR angiographic subtraction techniques for infragenual arteries at 1.5 T: a preliminary study.

Purpose

Materials and methods

Results

Conclusion

Supplemental material

Publications

Comparison of nonenhanced MR angiographic subtraction techniques for infragenual arteries at 1.5 T: a preliminary study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets