Nonenhanced peripheral MR-angiography (MRA) at 3 Tesla: evaluation of quiescent-interval single-shot MRA in patients undergoing digital subtraction angiography
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Quiescent-interval single-shot MRA (QISS-MRA) is a promising nonenhanced imaging technique for assessment of peripheral arterial disease (PAD). Previous studies at 3 Tesla included only very limited numbers of patients for correlation of QISS-MRA with digital subtraction angiography (DSA) as standard of reference (SOR). The aim of this prospective institutional review board-approved study was to compare QISS-MRA at 3 Tesla with DSA in a larger patient group. Our study included 32 consecutive patients who underwent QISS-MRA, contrast-enhanced MRA (CE-MRA), and DSA. Two readers independently performed a per-segment evaluation of QISS-MRA and CE-MRA for image quality and identification of non-significant stenosis (<50 %) versus significant stenosis (50–100 %). The final dataset included 1,027 vessel segments. Reader 1 and 2 rated image quality as diagnostic in 96.8 and 98.0 % of the vessel segments on QISS-MRA and in 99.3 and 98.4 % of the vessel segments on CE-MRA, respectively. DSA was available for 922 segments and detected significant stenosis in 133 segments (14.4 %). Consensus reading yielded the following diagnostic parameters for QISS-MRA versus CE-MRA: sensitivity: 83.5 % (111/133) versus 82.7 % (110/133), p = 0.80; specificity: 93.9 % (741/789) versus 95.7 % (755/789), p = 0.25; and diagnostic accuracy: 92.4 % (852/922) versus 93.8 % (865/922), p = 0.35. In conclusion, using DSA as SOR, QISS-MRA and CE-MRA at 3 Tesla showed similar diagnostic accuracy in the assessment of PAD. A limitation of QISS-MRA was the lower rate of assessable vessel segments compared to CE-MRA.
KeywordsQuiescent-interval single-shot (QISS) Angiography MR angiography (MRA) Peripheral arterial disease (PAD) Nonenhanced MR angiography
The authors thank Carsten Schwenke (SCO:SSiS Statistical Consulting, Berlin, Germany) for his contribution to the statistical analysis and Peter Schmitt (Siemens Healthcare, Erlangen Germany) for his technical support. This work is part of the dissertations of Martin Gielen and Marie-Teres Lauff.
Conflict of interest
Bayer Healthcare (Berlin, Germany) provided financial support for conduction of the study. Bayer Healthcare did not have control over the study conduct or data analysis.
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