Noncontrast MR angiography (MRA) of infragenual arteries using flow-sensitive dephasing (FSD)-prepared steady-state free precession (SSFP) at 3.0 Tesla: Comparison with contrast-enhanced MRA - PubMed (original) (raw)

Comparative Study

Noncontrast MR angiography (MRA) of infragenual arteries using flow-sensitive dephasing (FSD)-prepared steady-state free precession (SSFP) at 3.0 Tesla: Comparison with contrast-enhanced MRA

Nan Zhang et al. J Magn Reson Imaging. 2016 Feb.

Abstract

Background: To evaluate the feasibility and diagnostic performance of flow-sensitive dephasing (FSD)-prepared steady-state free precession (SSFP) MR angiography (MRA) for imaging infragenual arteries at 3.0T, with contrast enhanced MR angiography (CE MRA) as reference.

Methods: Twenty consecutive patients with suspicion of lower extremity arterial disease undergoing routine CE MRA were recruited. FSD MRA was performed at calf before CE MRA. Image quality and stenosis degree of infragenual arteries from both techniques were independently evaluated and compared. Six patients in this study underwent DSA examination.

Results: Three undiagnostic segments were excluded with severe venous contamination in CE MRA. A total of 197 calf arterial segments images were analyzed. No significant difference existed in the relative signal intensity (rSI) of arterial segments between FSD MRA and CE MRA techniques (0.92 ± 0.09 versus 0.93 ± 0.05; P = 0.207). However, the subjective image quality score was slightly higher in FSD MRA (3.66 ± 0.81 versus 3.49 ± 0.87; P = 0.050). With CE MRA images as reference standard, slight overestimation existed in FSD MRA (2.19 ± 1.24 versus 2.09 ± 1.18; P = 0.019), with total agreement of 84.3% on the basis of all arterial segments. The sensitivity, specificity, negative predictive value, and positive predictive value of FSD MRA was 96.4%, 93.0%, 98.5%, and 84.1%. No significant difference in the stenosis degree score was detected between MRA (FSD MRA and CE MRA) and DSA (P > 0.05).

Conclusion: FSD MRA performed on at 3.0T without the use of contrast medium provides diagnostic images allowing for arterial stenosis assessment of calf arteries that was highly comparable with CE MRA. Moreover, venous contamination was less problematic with FSD MRA.

Keywords: flow-sensitive dephasing; noncontrast MR angiography; peripheral vascular disease; steady-state free precession.

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Figures

Figure 1

Detection of the systolic and diastolic phase for ECG trigger with PC sequence. a. cine image of bilateral popliteal arteries (arrow); b. phase image of bilateral popliteal arteries (arrowhead); c. blood flow velocity curve through R-R interval of bilateral popliteal arteries. (Red, right popliteal artery; Green, left popliteal artery)

Figure 2

First-order gradient moment (m1) scouts for bilateral popliteal arteries. a. m1=10 mT·ms2/m, bright blood in bilateral popliteal arteries lumen; b. m1=20 mT·ms2/m, bright blood in right popliteal artery lumen (arrow), and dark blood in left one (arrowhead); c. m1=30 mT·ms2/m, dark blood in bilateral popliteal arteries lumen. In this case, the optimal M1 was 30 mT·ms2/m.

Figure 3

A 83-years-old male patient with a 2 years history of intermittent claudication, and left little toe gangrene for 1 month. Left perennial artery occluded in FSD MRA (a) with confirmation of CE MRA and DSA (b & c). And multiple arterial stenosis lesions in left anterior tibial artery with different degree were shown in three techniques (arrowhead). Venous contamination overlapped left anterior tibial artery and posterior tibial artery (arrow). Useful FOV on frequency direction was 325.2 mm.

Figure 4

A 61-years-old male patient with diffused arthrosclerosis. Compared with CE MRA (b), overestimated stenosis lesions (arrow) at bilateral anterior tibial artery were shown on FSD MRA (a). From CTA images (c), multiple calcified plaques can be noticed there. Useful FOV on frequency direction was 266.2 mm.

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Noncontrast MR angiography (MRA) of infragenual arteries using flow-sensitive dephasing (FSD)-prepared steady-state free precession (SSFP) at 3.0 Tesla: Comparison with contrast-enhanced MRA - PubMed (original) (raw)