Document Detail


3D nongadolinium-enhanced ECG-gated MRA of the distal lower extremities: preliminary clinical experience.
MedLine Citation:
PMID:  18581339     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report our initial experience implementing a noncontrast-enhanced electrocardiograph (ECG) gated fast spin echo magnetic resonance angiography (MRA) technique for assessment of the calf arteries. MATERIALS AND METHODS: Noncontrast MRA images of 36 clinical patients examined over a 6-month period were evaluated by two radiologists for length and degree of stenosis of arterial segments. Diagnostic confidence in the technique was also recorded. The reference standard was a consensus reading by both radiologists using the noncontrast technique combined with two gadolinium-enhanced techniques: bolus-chase and time-resolved imaging. RESULTS: For stenosis evaluation the noncontrast technique demonstrated accuracy 79.4% (1083/1364), sensitivity 85.4% (437/512), and specificity 75.8% (646/852). The sequence demonstrated high negative predictive value (92.3%, 646/700). The technique had serious artifacts leading to poor diagnostic confidence in 17 patients (47.2%). These included motion (n = 7) and artifacts specific to the sequence, including inaccurate trigger delays (n = 5), linear artifact (n = 7), and vessel blurring (n = 5). When only patients in whom there was satisfactory diagnostic confidence were considered, accuracy, sensitivity, and negative predictive value were 92.2% (661/717), 92.4% (158/171), and 97.5% (503/516), respectively. CONCLUSION: Our results indicate that when technically successful, noncontrast-enhanced MRA using ECG-gated fast spin echo can provide accurate imaging of the calf and pedal arteries. However, further development and optimization are needed to improve the robustness of the technique.
Authors:
Ruth P Lim; Elizabeth M Hecht; Jian Xu; James S Babb; Niels Oesingmann; Samson Wong; Bart E Muhs; Paul Gagne; Vivian S Lee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of magnetic resonance imaging : JMRI     Volume:  28     ISSN:  1053-1807     ISO Abbreviation:  J Magn Reson Imaging     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-10     Completed Date:  2008-11-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9105850     Medline TA:  J Magn Reson Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  181-9     Citation Subset:  IM    
Copyright Information:
(c) 2008 Wiley-Liss, Inc.
Affiliation:
Department of Radiology (MRI), New York University Medical Center, 560 First Avenue, New York, NY 10016, USA. limr02@med.nyu.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Artifacts
Constriction, Pathologic / diagnosis
Electrocardiography*
Female
Humans
Imaging, Three-Dimensional
Leg / blood supply*
Magnetic Resonance Angiography / methods*
Male
Middle Aged
Motion
Peripheral Vascular Diseases / diagnosis
Predictive Value of Tests
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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