| Diagnostic performance of gadobenate dimeglumine enhanced MR angiography of the iliofemoral and calf arteries: a large-scale multicenter trial. | |
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MedLine Citation:
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PMID: 17954665 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of this study was to compare gadobenate dimeglumine-enhanced MR angiography and unenhanced time-of-flight MR angiography for the detection of significant peripheral arterial occlusive disease using digital subtraction angiography as our reference standard. SUBJECTS AND METHODS: Two hundred seventy-two patients underwent MR angiography and digital subtraction angiography of the iliofemoral arteries. MR angiography was performed before (2D time-of-flight acquisitions) and after (spoiled gradient-echo acquisitions) the administration of 0.1 mmol/kg of gadobenate dimeglumine at 1-2 mL/s. Contrast-enhanced MR angiography and digital subtraction angiography of the calf arteries were performed in 241 of 272 participants. Images were evaluated on-site and by four blinded reviewers (three for MR angiography, one for digital subtraction angiography). Comparative diagnostic performance for the detection of significant (> or = 51% vessel lumen narrowing) disease was evaluated using the McNemar test and generalized estimating equations. Interobserver agreement was assessed with generalized kappa statistics. The chi-square test was used to compare technical failure rates. RESULTS: Digital subtraction angiography confirmed significant disease (597 stenoses, 386 occlusions) in 983 iliofemoral segments. The sensitivity (54-80.9%), specificity (89.7-95.3%), and accuracy (85-87.5%) of contrast-enhanced MR angiography for the detection of significant iliofemoral disease were significantly (p < 0.001, all reviewers) better than those of time-of-flight MR angiography (33.2-62.8%, 74.3-88.9%, and 68-77.3%, respectively). Similar diagnostic performance was obtained for the calf arteries. The technical failure rate with contrast-enhanced MR angiography (2.5-3.4%) was similar to that of digital subtraction angiography (1.4%) and significantly (p < 0.001) lower than that of time-of-flight MR angiography (6.2-18.0%). Significantly better reproducibility (p < 0.001) was obtained with contrast-enhanced MR angiography (82% vs 65.2% agreement; kappa = 0.66 vs 0.45). CONCLUSION: Improved diagnostic performance and reproducibility are achievable with gadobenate dimeglumine-enhanced MR angiography in patients with peripheral arterial occlusive disease. |
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Authors:
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Siegfried Thurnher; Stephan Miller; Günther Schneider; Claudio Ballarati; Georg Bongartz; Christoph U Herborn; Stefan Schoenberg; Maria Assunta Cova; Giovanni Morana; Khusrow Niazi; Roberto Iezzi; Matthias Taupitz; David A Bluemke; Karl-Friedrich Kreitner; Miles A Kirchin; Gianpaolo Pirovano |
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Publication Detail:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 189 ISSN: 1546-3141 ISO Abbreviation: AJR Am J Roentgenol Publication Date: 2007 Nov |
Date Detail:
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Created Date: 2007-10-23 Completed Date: 2007-11-20 Revised Date: 2008-02-15 |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
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Languages: eng Pagination: 1223-37 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiology and Nuclear Medicine, Hospital Brothers of St. John of God, Grosse Mohrengasse 9, Vienna, Austria A-1020. siegfried.thurnher@bbwien.at |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Arterial Occlusive Diseases / diagnosis* Contrast Media Europe Female Humans Image Enhancement / methods* Magnetic Resonance Angiography / methods* Male Meglumine / analogs & derivatives*, therapeutic use Middle Aged Organometallic Compounds / therapeutic use* Peripheral Vascular Diseases / diagnosis* Reproducibility of Results Sensitivity and Specificity South America Thigh / blood supply*, pathology* |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 0/Organometallic Compounds; 113662-23-0/gadobenic acid; 6284-40-8/Meglumine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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