Comparison of Nonenhanced MR Angiographic Subtraction Techniques for Infragenual Arteries at 1.5 T: A Preliminary Study

Lim, Ruth; Fan, Zhaoyang; Chatterji, Manjil; Baadh, Amanjit S.; Atanasova, Iliyana P.; Storey, Pippa; Kim, Danny; Kim, Sooah; Hodnett, Philip A.; Ahmad, Afhsan; Stoffel, David R.; Babb, James S.; Adelman, Mark A.; Xu, Jian; Li, Debiao; Lee, Vivian S.

doi:10.1148/radiol.12120859

Cited by 27 publications

(27 citation statements)

References 36 publications

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“…Image quality of QISS-MRA was non-diagnostic in 2-3 % of the vessel segments. Non-diagnostic Vessel segments: Aorta (1), AIC right and left common iliac artery (2, 3), AIE right and left external iliac artery (4,5), AFC right and left common femoral artery (6, 7), AFP right and left deep femoral artery (8,9), AFS right and left proximal and distal superficial femoral artery (10)(11)(12)(13), AP right and left proximal, middle, and distal popliteal artery (14)(15)(16)(17)(18)(19), ATA right and left proximal and distal anterior tibial artery (20)(21)(22)(23), TFT right and left tibiofibular trunk (24,25), PTA right and left proximal and distal posterior tibial artery (26)(27)(28)(29), and AF right and left proximal and distal fibular artery (30)(31)(32)(33) image quality was attributed to off-resonance artifacts. Off-resonance refers to a deviation of the local spins' resonant frequency in relation to the nominated scanner center frequency and is caused by main field inhomogeneities or magnetic susceptibilities [21].…”

Section: Discussionmentioning

confidence: 99%

“…Another promising nonenhanced MRA technique for assessment of PAD is subtraction MRA. Recent studies demonstrated that nonenhanced subtraction MRA allows assessment of PAD with high image quality [23,24]. However, several studies also revealed the drawbacks of nonenhanced subtraction MRA.…”

Section: Discussionmentioning

confidence: 99%

“…The arterial vascular tree was divided into 32 segments for analysis of image quality and diagnostic performance: abdominal aorta (1), pelvic vessel segments including right and left common iliac artery (2, 3), right and left external iliac artery (4,5), and right and left common femoral artery (6,7), thigh vessel segments including right and left deep femoral artery (8,9), right and left proximal and distal superficial femoral artery (10-13), right and left proximal, middle, and distal popliteal artery (14)(15)(16)(17)(18)(19), and calf vessel segments including right and left proximal and distal anterior tibial artery (20)(21)(22)(23), right and left tibiofibular trunk (24,25), right and left proximal and distal posterior tibial artery (26)(27)(28)(29), and right and left proximal and distal fibular artery (30-33). Two blinded readers (M.W.…”

Section: Methodsmentioning

confidence: 99%

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Nonenhanced peripheral MR-angiography (MRA) at 3 Tesla: evaluation of quiescent-interval single-shot MRA in patients undergoing digital subtraction angiography

Wagner¹,

Knobloch²,

Gielen³

et al. 2015

Int J Cardiovasc Imaging

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Quiescent-interval single-shot MRA (QISS-MRA) is a promising nonenhanced imaging technique for assessment of peripheral arterial disease (PAD). Previous studies at 3 Tesla included only very limited numbers of patients for correlation of QISS-MRA with digital subtraction angiography (DSA) as standard of reference (SOR). The aim of this prospective institutional review board-approved study was to compare QISS-MRA at 3 Tesla with DSA in a larger patient group. Our study included 32 consecutive patients who underwent QISS-MRA, contrast-enhanced MRA (CE-MRA), and DSA. Two readers independently performed a per-segment evaluation of QISS-MRA and CE-MRA for image quality and identification of non-significant stenosis (<50%) versus significant stenosis (50-100%). The final dataset included 1,027 vessel segments. Reader 1 and 2 rated image quality as diagnostic in 96.8 and 98.0% of the vessel segments on QISS-MRA and in 99.3 and 98.4% of the vessel segments on CE-MRA, respectively. DSA was available for 922 segments and detected significant stenosis in 133 segments (14.4%). Consensus reading yielded the following diagnostic parameters for QISS-MRA versus CE-MRA: sensitivity: 83.5% (111/133) versus 82.7% (110/133), p = 0.80; specificity: 93.9% (741/789) versus 95.7% (755/789), p = 0.25; and diagnostic accuracy: 92.4% (852/922) versus 93.8% (865/922), p = 0.35. In conclusion, using DSA as SOR, QISS-MRA and CE-MRA at 3 Tesla showed similar diagnostic accuracy in the assessment of PAD. A limitation of QISS-MRA was the lower rate of assessable vessel segments compared to CE-MRA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Nonenhanced peripheral MR-angiography (MRA) at 3 Tesla: evaluation of quiescent-interval single-shot MRA in patients undergoing digital subtraction angiography

Wagner¹,

Knobloch²,

Gielen³

et al. 2015

Int J Cardiovasc Imaging

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“…This approach was established recently with superior sensitivity and specificity. 21 The MRI perfusion and oxygenation measurements were subsequently performed at rest and during a sustained isometric contraction of the plantar flexor muscles, which included the gastrocnemius and soleus muscles. Specifically, each measurement started at 2 minutes after the start of contraction, resulting in a total contraction time of approximately 3 minutes for a perfusion measurement and 6 minutes for an oxygenation measurement (see Imaging Methods section).…”

Section: Methodsmentioning

confidence: 99%

A pilot study of regional perfusion and oxygenation in calf muscles of individuals with diabetes with a noninvasive measure

Zheng

Hasting

Zhang

et al. 2014

Journal of Vascular Surgery

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Objective To assess alterations in the regional perfusion and oxygenation of the calf muscles in individuals with diabetes. Methods Age-matched individuals with (n = 5) and without diabetes (n = 6) were investigated. Skeletal muscle perfusion, oxygen extraction fraction, and oxygen consumption rate were measured by newly developed noncontrast magnetic resonance imaging (MRI) techniques. The subjects lay supine on the MRI table with their foot firmly strapped to a custom-built isometric exercise device. The measurements were performed at rest and during an isometric plantar flexion muscle contraction. Results Individuals without diabetes had up to a 10-fold increase in muscle perfusion, 25% elevation in muscle oxygen extraction fraction, and a 12-fold increase in oxygen consumption rate in the calf during the plantar flexion isometric contraction. In patients with diabetes, the increases in these parameters were only up to sixfold, 2%, and sixfold, respectively. Exercise oxygen consumption rate was inversely associated with blood HbA1c levels (r2 = .91). Conclusions This is the first study to quantify regional skeletal muscle oxygenation in patients with diabetes using noncontrast MRI and warrants additional study. Attenuation of perfusion and oxygenation during exercise may have implications for understanding diabetic complications in the lower extremities.

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“…These include fresh-blood imaging, quiescent-interval single-shot (QISS) imaging, and flow-sensitizing dephasing gradient-prepared steady-state free precession imaging [20,25,[27][28][29][30]. QISS MRA has good accuracy and robustness for PAD assessment, specifically in diabetic patients, with an estimated sensitivity of 87.0-89.7% and specificity of 94.6-96.5% using gadolinium-enhanced MRA for comparison [23,26].…”

Section: Introductionmentioning

confidence: 99%

Patient Perception of Lower Limb Non-Contrast Magnetic Resonance Angiography and Digital Subtraction Angiography in Diabetic Patients with Peripheral Arterial Disease

Lukies

Richmond

Hornsey

et al. 2017

Cardiovasc Imaging Asia

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Peripheral arterial disease (PAD) is common in diabetic patients, with an estimated prevalence of 20-29% in those over 50 years of age, and causes significant morbidity, with amputation or limb loss occurring in around 4% of patients [1]. The imaging diagnosis of PAD in diabetic patients is challenging because renal impairment is common and vessels tend to be cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective: Non-contrast magnetic resonance angiography (NC-MRA) is an attractive technique for imaging peripheral arterial disease (PAD) in diabetic patients where arterial calcification and renal impairment are common. Our purpose was to evaluate patient perception of lower limb NC-MRA and compare this perception to that of digital subtraction angiography (DSA). Materials and Methods:Thirty-one diabetic patients (18 male, 13 female, mean age=69 years) with symptomatic PAD (critical ischemia, n=10) referred for DSA were prospectively recruited, and 1.5T quiescent-interval single-shot NC-MRA was performed before DSA (intervention performed during DSA, n=23). Patients rated anxiety, pain, discomfort, willingness to repeat (Likert scale: 1 most favorable to 7 least favorable), and difficulty compared to expectations (-3 better to +3 worse).Results: Twenty-nine patients' results were analyzed (DSA under general anesthesia, n=1; incomplete NC-MRA due to morbid obesity, n=1). NC-MRA and DSA median scores were 1 vs. 3, 1 vs. 2, 2 vs. 2, and 1 vs. 1 for anxiety, pain, discomfort, and willingness to repeat, respectively. The median score for difficulty compared to expectations was 0 (as expected) for both examinations. The anxiety and pain scores for NC-MRA were significantly lower than those for DSA (p=0.006 and p=0.001, respectively). Reasons for the less favorable NC-MRA experience included machine noise (n=3), pain from coil pressure (n=3), and claustrophobia (n=1).Conclusion: NC-MRA was well tolerated overall, and better than DSA for anxiety and pain. Although DSA is commonly required for intervention in PAD, NC-MRA may inform disease management and potentially obviate DSA where conservative management, or open surgery, are indicated. Reduced acoustic noise, lighter receiver coils, and wider scan bores may improve procedural tolerance.

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Comparison of Nonenhanced MR Angiographic Subtraction Techniques for Infragenual Arteries at 1.5 T: A Preliminary Study

Abstract: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120859/-/DC1.

Cited by 27 publications

References 36 publications

Nonenhanced peripheral MR-angiography (MRA) at 3 Tesla: evaluation of quiescent-interval single-shot MRA in patients undergoing digital subtraction angiography

Nonenhanced peripheral MR-angiography (MRA) at 3 Tesla: evaluation of quiescent-interval single-shot MRA in patients undergoing digital subtraction angiography

A pilot study of regional perfusion and oxygenation in calf muscles of individuals with diabetes with a noninvasive measure

Patient Perception of Lower Limb Non-Contrast Magnetic Resonance Angiography and Digital Subtraction Angiography in Diabetic Patients with Peripheral Arterial Disease

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