First-pass and high-resolution steady-state magnetic resonance angiography of the peripheral arteries with gadobenate dimeglumine: an assessment of feasibility and diagnostic performance.

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.

• Authors: Michele Anzidei, Alessandro Napoli, Fulvio Zaccagna, Beatrice Cavallo Marincola, Chiara Zini, Miles A Kirchin, Carlo Catalano, Roberto Passariello
• Journal: Investigative radiology (Invest Radiol) Vol. 46 Issue 5 Pg. 307-16 (May 2011) ISSN: 1536-0210 [Electronic] United States
• PMID: 21317793 (Publication Type: Journal Article)

Chemical References

• Contrast Media
• Organometallic Compounds
• gadobenic acid
• Meglumine

Topics

• Adult
• Aged
• Aged, 80 and over
• Angiography, Digital Subtraction
• Arteries
• Contrast Media
• Feasibility Studies
• Female
• Humans
• Leg (blood supply)
• Magnetic Resonance Angiography (instrumentation, methods)
• Male
• Meglumine (analogs & derivatives)
• Middle Aged
• Organometallic Compounds
• Peripheral Arterial Disease (diagnosis, pathology)
• Predictive Value of Tests
• ROC Curve
• Reproducibility of Results
• Statistics as Topic