Purpose: To assess the feasibility of combined first-pass (FP) and steady-state (SS) contrast-enhanced magnetic resonance angiography (MRA) of the peripheral arteries with gadobenate dimeglumine (MultiHance) and to evaluate diagnostic performance relative to digital subtraction angiography (DSA). Materials and methods: A total of 35 patients with symptomatic peripheral arterial occlusive disease (PAOD) underwent FP MRA (repetition time [TR]/echo time [TE]/flip angle [FA]/acquisition time [TA] = 3.5/1.2/30°/14s) at 1.5T after intravenous injection of 10 mL of gadobenate dimeglumine. Thereafter, SS imaging of the calf (TR/TE/FA/TA = 7.5/2.3/20°/40-130s) and femoropopliteal (TR/TE/FA/TA = 7.5/2.3/18°/130-240s) regions was performed after a second injection of 5 mL of gadobenate dimeglumine. All patients underwent conventional DSA. Three readers reviewed separate FP and FP+SS MRA datasets for image quality and presence/absence of clinically relevant PAOD. A fourth independent observer evaluated DSA images. The diagnostic performance (sensitivity, specificity, positive and negative predictive values) achieved with each dataset was determined and compared. Inter-reader agreement was assessed using kappa statistics. Results: The image quality of 134 of 140 vascular regions was optimal or adequate on SS MRA. Inter-reader agreement was good to very good for assessments of FP (κ = 0.725) and combined FP+SS images (κ = 0.866). SS images improved diagnostic confidence in 34 (48.6%) femoropoliteal and 46 (65.7%) crural regions and altered final diagnosis in 8 (11.4%) and 10 (14.3%) regions, respectively. Global diagnostic accuracy increased from 92.9% on FP images to 95.9% on FP+SS images, with significant (P = 0.0384) improvement in the crural region. Conclusion: SS MRA of the peripheral arteries is feasible with gadobenate dimeglumine and potentially improves diagnostic performance in patients with symptomatic PAOD. © 2011 by Lippincott Williams & Wilkins.
First-pass and high-resolution steady-state magnetic resonance angiography of the peripheral arteries with Gadobenate Dimeglumine: An assessment of feasibility and diagnostic performance / Anzidei M.; Napoli A.; Zaccagna F.; Cavallo Marincola B.; Zini C.; Kirchin M.A.; Catalano C.; Passariello R.. - In: INVESTIGATIVE RADIOLOGY. - ISSN 0020-9996. - STAMPA. - 46:5(2011), pp. 307-316. [10.1097/RLI.0b013e3182021879]
First-pass and high-resolution steady-state magnetic resonance angiography of the peripheral arteries with Gadobenate Dimeglumine: An assessment of feasibility and diagnostic performance
Zaccagna F.;
2011
Abstract
Purpose: To assess the feasibility of combined first-pass (FP) and steady-state (SS) contrast-enhanced magnetic resonance angiography (MRA) of the peripheral arteries with gadobenate dimeglumine (MultiHance) and to evaluate diagnostic performance relative to digital subtraction angiography (DSA). Materials and methods: A total of 35 patients with symptomatic peripheral arterial occlusive disease (PAOD) underwent FP MRA (repetition time [TR]/echo time [TE]/flip angle [FA]/acquisition time [TA] = 3.5/1.2/30°/14s) at 1.5T after intravenous injection of 10 mL of gadobenate dimeglumine. Thereafter, SS imaging of the calf (TR/TE/FA/TA = 7.5/2.3/20°/40-130s) and femoropopliteal (TR/TE/FA/TA = 7.5/2.3/18°/130-240s) regions was performed after a second injection of 5 mL of gadobenate dimeglumine. All patients underwent conventional DSA. Three readers reviewed separate FP and FP+SS MRA datasets for image quality and presence/absence of clinically relevant PAOD. A fourth independent observer evaluated DSA images. The diagnostic performance (sensitivity, specificity, positive and negative predictive values) achieved with each dataset was determined and compared. Inter-reader agreement was assessed using kappa statistics. Results: The image quality of 134 of 140 vascular regions was optimal or adequate on SS MRA. Inter-reader agreement was good to very good for assessments of FP (κ = 0.725) and combined FP+SS images (κ = 0.866). SS images improved diagnostic confidence in 34 (48.6%) femoropoliteal and 46 (65.7%) crural regions and altered final diagnosis in 8 (11.4%) and 10 (14.3%) regions, respectively. Global diagnostic accuracy increased from 92.9% on FP images to 95.9% on FP+SS images, with significant (P = 0.0384) improvement in the crural region. Conclusion: SS MRA of the peripheral arteries is feasible with gadobenate dimeglumine and potentially improves diagnostic performance in patients with symptomatic PAOD. © 2011 by Lippincott Williams & Wilkins.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
