Document Detail

Time-of-flight MR arteriography of below-knee arteries with maximum-intensity-projection reconstruction: is interpretation of the axial source images helpful?
MedLine Citation:
PMID:  9308479     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We evaluated the extent to which detailed review of axial source images enhances the interpretation of projectional reconstructions of two-dimensional time-of-flight MR arteriograms of the tibial vessels. SUBJECTS AND METHODS: Thirty-one patients (34 limbs) with limb-threatening ischemia underwent two-dimensional time-of-flight imaging and contrast-enhanced angiography of the below-knee arteries. Maximum-intensity-projection (MIP) reconstructions of the MR arteriograms were independently interpreted by three observers. The studies were then reinterpreted after detailed review of the axial source images. A consensus reading of each study was performed as well. The observers commented on the patency of 816 vascular segments and graded the extent of disease for 272 vessels. Interobserver agreement and correlation with contrast-enhanced angiography were determined. RESULTS: On average, the addition of axial images altered the observers' interpretation of MR arteriograms in 13% of segments for patency and in 18% of vessels for grading of disease severity. For determining the patency of vascular segments, mean interobserver agreement was 0.79 without and 0.80 with axial image interpretation, and mean agreement with contrast-enhanced angiography improved from 0.69 to 0.72 with the addition of axial images. When evaluating the extent of disease, correlation between observers improved for all combinations of observers with the addition of axial images, and correlation with contrast-enhanced angiography improved for two of three observers. Based on the consensus interpretation of the MR arteriograms, review of axial images was found to improve agreement with contrast-enhanced angiography in 34 vascular segments. In addition, axial image review correctly altered the number of stenoses identified in 12 vessels. When consensus interpretation identified a vessel as patent without significant stenosis on the MIP images, the MIP-based interpretation was found to be correct in all cases. CONCLUSION: Review of axial source images provides limited benefit to interpretation of MR arteriograms of the distal lower extremity in patients with peripheral vascular disease. Although selective review of axial source images may be appropriate, axial images can improve interpretation when MIP images are complicated by the presence of patient motion, difficult anatomy, or artifacts. Axial image review may also be appropriate when a significant stenosis is identified on the MIP images.
J R Leyendecker; S P Johnson; D C Diffin; K Elsass; S L Bifano
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  169     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1997-10-16     Completed Date:  1997-10-16     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1145-9     Citation Subset:  AIM; IM    
Department of Radiology/PSRD, Wilford Hall Medical Center, Lackland Air Force Base, TX 78236, USA.
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MeSH Terms
Aged, 80 and over
Contrast Media
Image Processing, Computer-Assisted*
Ischemia / diagnosis,  radiography
Leg / blood supply*
Magnetic Resonance Angiography*
Middle Aged
Observer Variation
Vascular Patency
Reg. No./Substance:
0/Contrast Media

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

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