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Non-enhanced, ECG-gated MR angiography of the pedal vasculature: comparison with contrast-enhanced MR angiography and digital subtraction angiography in peripheral arterial occlusive disease

  • Magnetic Resonance
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Abstract

Objectives

This study was conducted in order to compare a high resolution, non-contrast-enhanced MRA (NATIVE SPACE, NE-MRA) of the pedal vasculature with contrast-enhanced MRA (CE-MRA) and digital subtraction angiography (DSA) in patients with peripheral arterial occlusive disease (PAOD).

Methods

The prospective study consists of 20 PAOD patients. All patients underwent percutaneous transluminal angioplasty or stenting and received MR angiographies the following day.

Results

With CE-MRA, 75.7 % of vessel segments showed good, 16.4 % suboptimal and 7.9 % not usable image quality. With NE-MRA, 64.6 % showed good, 18.6 % suboptimal and 16.8 % not usable image quality. CE-MRA showed a sensitivity and negative predictive value of 90 %/95 % regarding significant stenosis (greater than 50 %), and specificity and positive predictive value were 88 %/77 %. Accordingly, sensitivity and negative predictive value for the NE-MRA were 96 %/97 % and specificity and positive predictive value were 80 %/69 % for stenoses greater than 50 %.

Conclusions

The applied NE-MRA technique achieves high diagnostic accuracy even in very small distal arteries of the foot. However, the rate of non-diagnostic vessel segments is considerably higher for NE-MRA than for CE-MRA. NE-MRA is a valuable alternative to CE-MRA in selected patients.

Key points

• Comparison of non-enhanced MRA with contrast-enhanced MRA and DSA as gold standard.

• High resolution MRA at 3 T for the depiction of small pedal vessels.

• Evaluation of high resolution non-enhanced MRA in PAOD patients.

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Acknowledgments

The scientific guarantor of this publication is Sebastian Kos, M.D. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors would like to thank Denise Schubert for help with image layout. This study has received funding by Bayer Healthcare Switzerland (Unrestricted Research Fund). One of the authors has significant statistical expertise. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Some study subjects or cohorts have been previously reported at the Swiss Congress of Radiology 2013. Methodology: prospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Clinic of Radiology and Nuclear Medicine, Basel University Hospital, Basel, Switzerland

    Tilman Schubert, Martin Takes & Tanja Haas

  2. Department of Angiology, Basel University Hospital, Basel, Switzerland

    Markus Aschwanden

  3. Division of Radiological Physics, Clinic of Radiology and Nuclear Medicine, Basel University Hospital, Basel, Switzerland

    Markus Klarhoefer

  4. Radiology Clinic Hirslanden, Zurich, Switzerland

    Augustinus L. Jacob

  5. Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, Canada

    David Liu

  6. Department of Radiology and Nuclear Medicine, Hirslanden Clinic St. Anna, Lucerne, Switzerland

    Andreas Gutzeit & Sebastian Kos

  7. Department of Radiology, University of Wisconsin, 600 Highland Ave, E1/374, Madison, WI, 53792, USA

    Tilman Schubert

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  1. Tilman Schubert
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  2. Martin Takes
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  4. Markus Klarhoefer
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  6. Augustinus L. Jacob
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  7. David Liu
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  8. Andreas Gutzeit
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  9. Sebastian Kos
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Correspondence to Tilman Schubert.

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Schubert, T., Takes, M., Aschwanden, M. et al. Non-enhanced, ECG-gated MR angiography of the pedal vasculature: comparison with contrast-enhanced MR angiography and digital subtraction angiography in peripheral arterial occlusive disease. Eur Radiol 26, 2705–2713 (2016). https://doi.org/10.1007/s00330-015-4068-6

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  • DOI: https://doi.org/10.1007/s00330-015-4068-6

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