Nonenhanced ECG-gated quiescent-interval single shot MRA: image quality and stenosis assessment at 3 tesla compared with contrast-enhanced MRA and digital subtraction angiography

J Magn Reson Imaging. 2014 Jun;39(6):1486-93. doi: 10.1002/jmri.24324. Epub 2013 Oct 10.

Abstract

Purpose: To evaluate the diagnostic accuracy of a nonenhanced electrocardiograph-gated quiescent-interval single shot MR-angiography (QISS-MRA) at 3 Tesla with contrast-enhanced MRA (CE-MRA) and digital subtraction angiography (DSA) serving as reference standard.

Materials and methods: Following institutional review board approval, 16 consecutive patients with peripheral arterial disease underwent a combined peripheral MRA protocol consisting of a large field-of-view QISS-MRA, continuous table movement MRA, and an additional time-resolved MRA of the calves. DSA correlation was available in eight patients. Image quality and degree of stenosis was assessed. Sensitivity and specificity of QISS-MRA was evaluated with CE-MRA and DSA serving as the standards of reference and compared using the Fisher exact test.

Results: With the exception of the calf station, image quality with QISS-MRA was rated statistically significantly less than that of CE-MRA (P < 0.05, P = 0.17, and P = 0.6, respectively). A greater percentage of segments were not accessible with QISS-MRA (19.5-20.1%) in comparison to CE-MRA (10.9%). Relative to DSA, sensitivity for QISS-MRA was high (100% versus 91.2% for CE-MRA, P = 0.24) in the evaluated segments; however, specificity (76.5%) was substantially less than that of CE-MRA (94.6%, P = 0.003).

Conclusion: Overall image quality and specificity of QISS-MRA at 3T are diminished relative to CE-MRA. However, when image quality is adequate, QISS-MRA has high sensitivity and, thus, has potential use in patients with contraindications to gadolinium.

Keywords: 3 Tesla; MR-Angiography; QISS; nonenhanced MR-angiography.

MeSH terms

  • Aged
  • Angiography, Digital Subtraction / methods*
  • Constriction, Pathologic
  • Contrast Media*
  • Electrocardiography / methods*
  • Female
  • Humans
  • Image Enhancement / methods*
  • Image Processing, Computer-Assisted / methods
  • Leg / blood supply
  • Leg / pathology
  • Magnetic Resonance Angiography / methods*
  • Magnetics
  • Male
  • Meglumine
  • Observer Variation
  • Organometallic Compounds
  • Peripheral Vascular Diseases / diagnosis*
  • Prospective Studies
  • Reproducibility of Results
  • Sensitivity and Specificity

Substances

  • Contrast Media
  • Organometallic Compounds
  • gadobutrol
  • Meglumine
  • gadoterate meglumine