Document Detail


Peripheral arterial occlusive disease: evaluation of a high spatial and temporal resolution 3-T MR protocol with a low total dose of gadolinium versus conventional angiography.
MedLine Citation:
PMID:  20959539     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate a peripheral magnetic resonance (MR) angiographic protocol combining continuous table movement (CTM) MR angiography of the entire runoff vasculature with time-resolved (TWIST) 3-T MR angiography of the calves with a total gadolinium dose of 0.1 mmol per kilogram of body weight.
MATERIALS AND METHODS: In this retrospective institutional review board-approved study, 31 consecutive patients (22 men, nine women; mean age, 65 years ± 14 [standard deviation]) with peripheral arterial occlusive disease who had undergone a low-dose MR angiographic protocol that consisted of CTM MR angiography (repetition time msec/echo time msec, 2.4/1.0; 21° flip angle; voxel size, 1.2 mm(3); gadolinium dose, 0.07 mmol per kilogram of body weight) and TWIST MR angiography (2.8/1.1; 20° flip angle; voxel size, 1.1 mm(3); temporal resolution, 4.8-5.5 sec, gadolinium dose, 0.03 mmol/kg), as well as digital subtraction angiography (DSA), were included. Two radiologists rated image quality and stenosis degree on four-point scales. The accuracy of stenosis gradation and, specifically, the detection of high-grade stenoses (stenosis of 70%-99%) with CTM MR angiography alone and with the combined protocol were compared with accuracy of stenosis gradation and detection of high-grade stenoses with DSA. Means and standard deviations were calculated for all data. Interobserver agreement was determined with κ statistics. Positive and negative predictive values, sensitivity, specificity, and overall diagnostic accuracy were calculated for CTM MR angiography alone and for the combined protocol.
RESULTS: For CTM MR angiography, image quality was good or excellent in 95.9% of vessel segments; for TWIST MR angiography, image quality was good or excellent in 94.3% and 97.8% of vessel segments for readers 1 and 2, respectively. The combined protocol resulted in high overall diagnostic accuracy of more than 80% for detection of stenosis and diagnostic accuracy of 93.5% for detection of high-grade vessel stenosis. Inclusion of TWIST MR angiography increased diagnostic value over that achieved with CTM MR angiography alone.
CONCLUSION: A combined MR angiographic approach in which a low total gadolinium dose (0.1 mmol/kg) is used yields excellent image quality and is accurate in the diagnosis of peripheral arterial stenosis.
Authors:
Ulrike I Attenberger; Stefan Haneder; John N Morelli; Steffen J Diehl; Stefan O Schoenberg; Henrik J Michaely
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2010-10-19
Journal Detail:
Title:  Radiology     Volume:  257     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-18     Completed Date:  2011-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  879-87     Citation Subset:  AIM; IM    
Copyright Information:
© RSNA, 2010.
Affiliation:
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. ulrike.attenberger@medma.uni-heidelberg.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angiography, Digital Subtraction
Arterial Occlusive Diseases / diagnosis*
Contrast Media / administration & dosage
Female
Humans
Magnetic Resonance Angiography / methods*
Male
Meglumine / administration & dosage
Middle Aged
Organometallic Compounds / administration & dosage
Peripheral Vascular Diseases / diagnosis*
Retrospective Studies
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Organometallic Compounds; 0/gadoterate meglumine; 138071-82-6/gadobutrol; 6284-40-8/Meglumine

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


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