Document Detail


Comparison of gadofosveset-enhanced three-dimensional magnetic resonance angiography with digital subtraction angiography for lower-extremity peripheral arterial occlusive disease.
MedLine Citation:
PMID:  20105092     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Minimally invasive imaging techniques are increasingly used for clinical decision making in patients with peripheral arterial occlusive disease (PAOD). PURPOSE: To assess whether gadofosveset-enhanced three-dimensional (3D) magnetic resonance (MR) angiography could replace digital subtraction angiography (DSA) for the evaluation of lower-extremity PAOD. MATERIAL AND METHODS: Thirty patients with symptomatic PAOD underwent prospectively both MR angiography and DSA. Gadofosveset-enhanced 3D MR angiography was performed on a 1.5T system equipped with a peripheral angio matrix coil. Four blinded observers independently analyzed MR angiograms and DSA images. The lower arterial vascular system was divided into three anatomic segments (aortoiliac, femoropopliteal, infrapopliteal) for review. The status of each segment was graded as normal, stenosis less than 50%, stenosis greater than 50%, or occluded and/or aneurismatic. Principal and secondary lesions were reported. RESULTS: Although interobserver agreement for both was excellent, it was higher for DSA (kappa=0.92) than for MR angiography (kappa=0.86) for reporting the principal and secondary lesions in all segments. For different anatomic locations, the interobserver agreement of MR angiography and DSA was as follows: aortoiliac (kappa=0.93, k=0.95), femoropopliteal (kappa=0.86, k=0.90), and infrapopliteal (kappa=0.78, k=0.85). The lowest agreement was found for MR angiography on infrapopliteal segments (kappa=0.78). In four (13.3%) cases, MR angiography showed lesions that were not found by DSA. Five (16.6%) aneurysm cases, not observed by DSA, were shown by MR angiography. CONCLUSION: Gadofosveset-enhanced 3D MR angiography can be proposed for first-line imaging in the management of lower-limb PAOD patients and permits the selective use of DSA as a second-line examination when MR angiography fails or in an endovascular approach.
Authors:
Ferm?n Urtasun Grijalba; Mercedes Ciriza Esandi
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta radiologica (Stockholm, Sweden : 1987)     Volume:  51     ISSN:  1600-0455     ISO Abbreviation:  Acta Radiol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-05     Completed Date:  2010-04-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706123     Medline TA:  Acta Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  284-9     Citation Subset:  IM    
Affiliation:
Vascular Radiology Unit, Department of Radiology, Navarra Hospital, Pamplona, Spain. furtasun@telefonica.net
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angiography, Digital Subtraction / methods*
Arterial Occlusive Diseases / diagnosis*
Contrast Media / diagnostic use
Female
Gadolinium / diagnostic use*
Humans
Imaging, Three-Dimensional / methods*
Lower Extremity / blood supply,  pathology,  radiography
Magnetic Resonance Angiography / methods*
Male
Middle Aged
Observer Variation
Organometallic Compounds / diagnostic use*
Peripheral Vascular Diseases / diagnosis*
Prospective Studies
Radiographic Image Enhancement / methods
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Organometallic Compounds; 0/gadofosveset trisodium; 7440-54-2/Gadolinium

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