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Impact of time-resolved MRA on diagnostic accuracy in patients with symptomatic peripheral artery disease of the calf station.

Authors :
Hansmann J
Michaely HJ
Morelli JN
Diehl SJ
Meyer M
Schoenberg SO
Attenberger UI
Source :
AJR. American journal of roentgenology [AJR Am J Roentgenol] 2013 Dec; Vol. 201 (6), pp. 1368-75.
Publication Year :
2013

Abstract

Objective: The purpose of this article is to evaluate the added diagnostic accuracy of time-resolved MR angiography (MRA) of the calves compared with continuous-table-movement MRA in patients with symptomatic lower extremity peripheral artery disease (PAD) using digital subtraction angiography (DSA) correlation.<br />Materials and Methods: Eighty-four consecutive patients with symptomatic PAD underwent a low-dose 3-T MRA protocol, consisting of continuous-table-movement MRA, acquired from the diaphragm to the calves, and an additional time-resolved MRA of the calves; 0.1 mmol/kg body weight (bw) of contrast material was used (0.07 mmol/kg bw for continuous-table-movement MRA and 0.03 mmol/kg bw for time-resolved MRA). Two radiologists rated image quality on a 4-point scale and stenosis degree on a 3-point scale. An additional assessment determined the degree of venous contamination and whether time-resolved MRA improved diagnostic confidence. The accuracy of stenosis gradation with continuous-table-movement and time-resolved MRA was compared with that of DSA as a correlation. Overall diagnostic accuracy was calculated for continuous-table-movement and time-resolved MRA.<br />Results: Median image quality was rated as good for 578 vessel segments with continuous-table-movement MRA and as excellent for 565 vessel segments with time-resolved MRA. Interreader agreement was excellent (κ = 0.80-0.84). Venous contamination interfered with diagnosis in more than 60% of continuous-table-movement MRA examinations. The degree of stenosis was assessed for 340 vessel segments. The diagnostic accuracies (continuous-table-movement MRA/time-resolved MRA) combined for the readers were obtained for the tibioperoneal trunk (84%/93%), anterior tibial (69%/87%), posterior tibial (85%/91%), and peroneal (67%/81%) arteries. The addition of time-resolved MRA improved diagnostic confidence in 69% of examinations.<br />Conclusion: The addition of time-resolved MRA at the calf station improves diagnostic accuracy over continuous-table-movement MRA alone in symptomatic patients with PAD.

Details

Language :
English
ISSN :
1546-3141
Volume :
201
Issue :
6
Database :
MEDLINE
Journal :
AJR. American journal of roentgenology
Publication Type :
Academic Journal
Accession number :
24261379
Full Text :
https://doi.org/10.2214/AJR.13.10584