Nonenhanced ECG-gated quiescent-interval single-shot MRA (QISS-MRA) of the lower extremities: comparison with contrast-enhanced MRA

Clin Radiol. 2012 May;67(5):441-6. doi: 10.1016/j.crad.2011.10.014. Epub 2011 Dec 3.

Abstract

Aim: To evaluate electrocardiogram (ECG)-gated quiescent-interval single-shot magnetic resonance angiography (QISS-MRA) for nonenhanced assessment of peripheral artery occlusive disease (PAOD) using contrast-enhanced MRA (CE-MRA) as the reference standard.

Materials and methods: Twenty-seven patients (mean age 66.6 ± 10.8 years) with PAOD were included in the study. QISS-MRA and CE-MRA of the lower extremity were performed using a 1.5 T MR scanner. In each patient, subjective image quality and the degree of stenosis were evaluated on a four-point scale for 15 predefined arterial segments.

Results: Twenty-five of the 27 patients were considered for analysis. Subjective image quality of QISS-MRA was significantly lower for the distal aorta, pelvic arteries, and femoral arteries as compared to CE-MRA (p < 0.01), while no significant difference was found for other vascular segments. The degree of stenosis was overestimated with QISS-MRA in 23 of 365 (6.3%) segments and underestimated in two of 365 (0.5%) segments. As compared to CE-MRA, QISS-MRA had a high sensitivity (98.6%), specificity (96%) as well as positive and negative predictive value (88.7 and 99.6%, respectively) for the detection of significant stenosis (≥50%).

Conclusion: ECG-gated QISS-MRA is a promising imaging technique for reliable assessment of PAOD without the use of contrast material.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Constriction, Pathologic / diagnosis
  • Contrast Media
  • Electrocardiography
  • Female
  • Humans
  • Lower Extremity / blood supply*
  • Magnetic Resonance Angiography / methods*
  • Male
  • Middle Aged
  • Peripheral Arterial Disease / diagnosis*
  • Reproducibility of Results
  • Sensitivity and Specificity

Substances

  • Contrast Media