Peripheral Bolus-Chase MR Angiography: Analysis of Risk Factors for Nondiagnostic Image Quality of the Calf Vessels—A Combined Retrospective and Prospective Study

Dinter, Dietmar; Neff, K. W.; Visciani, Giovanni; Lachmann, Ricarda; Weiss, Christel; Schoenberg, Stefan O.; Michaely, Henrik J.

doi:10.2214/ajr.08.1814

Cited by 16 publications

(8 citation statements)

References 25 publications

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“…In previous studies, investigators have reported that lower limb ulceration and infections, particularly in diabetic patients, may cause increased and early venous return in the affected limb, rendering delineation and visualization of patent vessels suboptimal [29]. Additional studies have shown that the presence of advanced PAD or the additive effect of endogenous risk factors including hypertension may predict the likelihood of a nondiagnostic CEMRA study [30]. …”

Section: Discussionmentioning

confidence: 99%

Peripheral Arterial Disease in a Symptomatic Diabetic Population: Prospective Comparison of Rapid Unenhanced MR Angiography (MRA) With Contrast-Enhanced MRA

Hodnett

Ward

Davarpanah³

et al. 2011

American Journal of Roentgenology

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OBJECTIVE The joint guidelines of the American College of Cardiology and American Heart Association support the use of contrast-enhanced MR angiography (CEMRA) to diagnose the location and degree of stenosis in patients with known or suspected peripheral arterial disease (PAD). The high prevalence of chronic renal impairment in diabetic patients with PAD and the need for high doses of gadolinium-based contrast agents place them at risk for nephrogenic systemic fibrosis. The purpose of our study was to evaluate the accuracy of the rapid technique of quiescent-interval single-shot (QISS) unenhanced MR angiography (MRA) compared with CEMRA for the diagnosis in diabetic patients referred with symptomatic chronic PAD. SUBJECTS AND METHODS This prospective two-center study evaluated 25 consecutive diabetic patients with documented or suspected symptomatic PAD. Both centers used identical imaging protocols. Images were independently analyzed by two radiologists. A subgroup analysis was performed of patients who were also assessed with digital subtraction angiography (DSA) as part of the standard-of-care protocol before revascularization. RESULTS For this study, 775 segments were analyzed. On a per-segment basis, the mean values of the diagnostic accuracy of unenhanced MRA compared with reference CEMRA for two reviewers, reviewers 1 and 2, were as follows: sensitivity, 87.4% and 92.1%; specificity, 96.8% and 96.0%; positive predictive value, 90.8% and 94.0%; and negative predictive value, 95.5% and 94.6%. Substantial agreement was found when overall DSA results were compared with QISS unenhanced MRA (κ = 0.68) and CEMRA (κ = 0.63) in the subgroup of patients who also underwent DSA. There was almost perfect agreement between the two readers for stenosis scores, with Cohen’s kappa values being greater than 0.80 for both MRA techniques. CONCLUSION The results of our study indicate that QISS unenhanced MRA is an accurate noncontrast alternative to CEMRA for showing clinically significant arterial disease in patients with diabetes with symptomatic PAD.

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Section: Discussionmentioning

confidence: 99%

Peripheral Arterial Disease in a Symptomatic Diabetic Population: Prospective Comparison of Rapid Unenhanced MR Angiography (MRA) With Contrast-Enhanced MRA

Hodnett

Ward

Davarpanah³

et al. 2011

American Journal of Roentgenology

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“…64 No published studies have been designed or completed specifically to evaluate gender-based diagnostic accuracy.…”

Section: Pad Diagnostic Methods In Womenmentioning

confidence: 99%

A Call to Action: Women and Peripheral Artery Disease

Hirsch

Allison²,

Gomes³

et al. 2012

Circulation

290

138

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“…7-13 However the data describing impact of gender based on peripheral arterial interventions lacks a strong evidence 14 and is also quite limited. 2,6,15-17 …”

Section: Introductionmentioning

confidence: 99%

The effect of gender on outcomes of aortoiliac artery interventions for claudication

et al. 2016

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Objective To explore the relationship between gender, native artery diameters and outcomes of stent revascularization in the Claudication: Exercise versus Endoluminal Revascularization (CLEVER) trial. Methods A comparative analysis was performed of the impact of gender, age, weight, height, body mass index, and body surface area, on revascularization outcomes at baseline and 6 months in 55 arterial segments of aorta, common iliac and external iliac (EIA) arteries. Results Women demonstrated smaller diameter of the EIA. However, the clinical outcomes of revascularization were not negatively affected by the gender-based differences. Conclusion Gender-based differences are unlikely to significantly impact outcome of stent revascularization.

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Peripheral Bolus-Chase MR Angiography: Analysis of Risk Factors for Nondiagnostic Image Quality of the Calf Vessels—A Combined Retrospective and Prospective Study

Abstract: Based on the retrospective statistical analysis of PAOD stages and risk factors, selected patients can be triaged to undergo a specific hybrid MRA technique and thus circumvent the occurrence of nondiagnostic images and the need for repeated MRA examinations.

Cited by 16 publications

References 25 publications

Peripheral Arterial Disease in a Symptomatic Diabetic Population: Prospective Comparison of Rapid Unenhanced MR Angiography (MRA) With Contrast-Enhanced MRA

Peripheral Arterial Disease in a Symptomatic Diabetic Population: Prospective Comparison of Rapid Unenhanced MR Angiography (MRA) With Contrast-Enhanced MRA

A Call to Action: Women and Peripheral Artery Disease

The effect of gender on outcomes of aortoiliac artery interventions for claudication

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