Non-contrast MR angiography using three-dimensional balanced steady-state free-precession imaging for evaluation of stenosis in the celiac trunk and superior mesenteric artery: a preliminary comparative study with computed tomography angiography

Cardia, Patrícia Prando; Penachim, Thiago José; Prando, Adilson; Torres, Ulysses S.; D'Ippólito, Giuseppe

doi:10.1259/bjr.20170011

Cited by 13 publications

(10 citation statements)

References 40 publications

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“…28 In the evaluation of abdominal vessels using bSSFP, the specificity and negative predictive value of our study was similar to a study by Cardia et al, who evaluated the stenosis of the celiac trunk and the superior mesenteric artery using bSSFP. 24 Studies by Maki et al and Wyttenbach et al also showed similar specificity of SSFP in the evaluation of renal artery stenosis. 29,30 Lanzman et al found similar results in the evaluation of transplant renal artery.…”

Section: Degree Of Stenosismentioning

confidence: 69%

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Balanced Steady-State Free Precision and Time of Flight Noncontrast Magnetic Resonance Angiography in Peripheral Arterial Disease

Regi

Irodi

Keshava

et al. 2021

Journal of Clinical Interventional Radiology ISVIR

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Purpose To determine the diagnostic efficacy of balanced steady-state free precession (bSSFP) and time-of-flight (TOF)-based noncontrast magnetic resonance angiography (NC-MRA) in lower limb peripheral arterial disease (PAD). Material and Methods 10 patients with suspected PAD underwent both NC-MRA (bSSFP and 2D TOF) and contrast-enhanced MR angiography (CE-MRA)/CT angiography (CTA). A total of 170 arterial segments (17 segments in each patient) were analyzed on NC-MRA and compared with CE-MRA/CTA for quality of images and for estimating the degree of stenoses. Image quality was graded as 1—poor, 2—fair, 3—good, and 4—excellent. The degree of stenoses was graded as 0—normal, 1— ≤ 50% narrowing, 2— > 50% narrowing, 3—near complete/100% occlusion. Sensitivity, specificity, positive predictive value, and negative predictive value of NC-MRA in identifying significant stenosis, as compared with CE-MRA/CTA, were estimated. Results a) Mean grade of the image quality of NC-MRA was 3.10 and the CE-MRA/CTA was 3.64. b) The agreement in the estimation of the degree of stenosis on NC-MRA as compared with CE-MRA/CTA was substantial in aortoiliac segments (weighted kappa 0.646 [95% CI] [0.361–0.931] [p < 0.001]), almost perfect in femoropopliteal segments (weighted kappa 0.911 [95% CI] [0.79–1.032] [p < 0.001]), and poor in infrapopliteal segments (weighted kappa 0.052 [95% CI] [0.189–0.293] [p < 0.33587]). Conclusion TOF and bSSFP-based NC-MRA was found to be comparable to the CE-MRA/CTA in the evaluation of PAD in lower limbs in the aortoiliac and femoropopliteal regions. NC-MRA was especially helpful in assessing the aortoiliac vessels and femoropopliteal vessels, with the imaging of infrapopliteal arteries being suboptimal.

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Section: Degree Of Stenosismentioning

confidence: 69%

“…31 As seen in our study, Caria et al also found NC-MRA to overestimate the stenosis in arterial sgements. 24 Lanzman et al also demonstrated that SSFP using 3T significantly improved the visualization of renal arteries as compared with a 1.5T MRI. 32…”

Section: Discussionmentioning

confidence: 97%

Balanced Steady-State Free Precision and Time of Flight Noncontrast Magnetic Resonance Angiography in Peripheral Arterial Disease

Regi

Irodi

Keshava

et al. 2021

Journal of Clinical Interventional Radiology ISVIR

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“…The quality evaluation was done subjectively and was based on parameters established previously ( 23 - 25 ) , including the use of a 4-point scale to classify the degree of vessel wall definition, luminal contrast, and diagnostic confidence: class A, excellent quality (high signal intensity in the arterial lumen-high degree of diagnostic confidence); class B, good quality (moderate signal intensity in the arterial lumen-suitable for diagnosis); class C, moderate quality (minimal signal intensity in the arterial lumen-less suitable for diagnosis); and class D, nondiagnostic quality (no signal in the arterial lumen-insufficient for diagnosis). For statistical analysis purposes, the results were divided into two groups ( 26 ) : diagnostic (classes A and B) and nondiagnostic (classes C and D).…”

Section: Methodsmentioning

confidence: 99%

Unenhanced magnetic resonance angiography as an accurate alternative in the preoperative assessment of potential living kidney donors with contraindications to computed tomography angiography and to contrast-enhanced magnetic resonance angiography

et al. 2020

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Objective: To evaluate the accuracy of steady-state free precession (SSFP) unenhanced magnetic resonance angiography (MRA) at 1.5 T for the identification of multiple renal arteries, using computed tomography angiography (CTA) as the reference standard. Materials and Methods: This was a prospective study involving 39 patients (26 males; mean age, 62.6 years) who underwent CTA and unenhanced MRA to evaluate the proximal and middle segments of the renal arteries. The analysis was performed in two phases: the quality of unenhanced MRA images was classified as diagnostic or nondiagnostic for the presence of multiple renal arteries by two independent readers; two other independent readers then evaluated the images previously classified as being of diagnostic quality. The sensitivity, specificity, and overall accuracy of unenhanced MRA were calculated, CTA being used as the reference standard. The kappa statistic was used in order to calculate interobserver agreement. Results: The image quality of unenhanced MRA was considered diagnostic in 70-90% of the extrarenal arterial segments. The CTA examination revealed 19 multiple renal arteries (8 on the right and 11 on the left). The accuracy of unenhanced MRA for the identification of multiple renal arteries was greater than 90%, with a sensitivity of 72.7-100% and a specificity of 96.3-100%. Conclusion: Unenhanced MRA provides high quality imaging of the extrarenal segments of renal arteries. This method may be used as an alternative for the evaluation of the renal arteries, given that it has an accuracy comparable to that of CTA.

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“…Other applications of IFDIR include the evaluation of celiac trunk stenosis, for which Braidy et al found a sensitivity of 100% and specificity of 97% (evidence level 1b) with respect to CEMRA. Using CTA as the reference standard, Cardia et al reported that IFDIR provides accuracies of 89% and 95% for the diagnosis of celiac trunk stenosis and superior mesenteric artery stenosis, respectively (evidence level 1b). IFDIR has also been applied for portraying the portal veins and hepatic arteries .…”

Section: Level Of Evidence For Noncontrast Mramentioning

confidence: 99%

Noncontrast MR angiography: An update

Edelman

Koktzoglou

2018

Magnetic Resonance Imaging

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Both computed tomography (CT) angiography (CTA) and contrast-enhanced MR angiography (CEMRA) have proven to be useful and accurate cross-sectional imaging modalities over a wide range of vascular territories and vascular disorders. A key advantage of MRA is that, unlike CTA, it can be performed without the administration of a contrast agent. In this review article we consider the motivations for using noncontrast MRA, potential contrast mechanisms, imaging techniques, advantages, and drawbacks with respect to CTA and CEMRA, and the level of evidence for using the various MRA techniques. In addition, we explore new developments that promise to expand the reliability and range of clinical applications for noncontrast MRA, along with functional MRA capabilities not available with CTA or CEMRA.

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Non-contrast MR angiography using three-dimensional balanced steady-state free-precession imaging for evaluation of stenosis in the celiac trunk and superior mesenteric artery: a preliminary comparative study with computed tomography angiography

Cited by 13 publications

References 40 publications

Balanced Steady-State Free Precision and Time of Flight Noncontrast Magnetic Resonance Angiography in Peripheral Arterial Disease

Balanced Steady-State Free Precision and Time of Flight Noncontrast Magnetic Resonance Angiography in Peripheral Arterial Disease

Unenhanced magnetic resonance angiography as an accurate alternative in the preoperative assessment of potential living kidney donors with contraindications to computed tomography angiography and to contrast-enhanced magnetic resonance angiography

Noncontrast MR angiography: An update

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