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Value of single-dose contrast-enhanced magnetic resonance angiography versus intraarterial digital subtraction angiography in therapy indications in abdominal and iliac arteries. | LitMetric

AI Article Synopsis

  • * A total of 37 patients suspected of having arterial stenosis participated, with 34 ultimately included for imaging evaluation; both imaging techniques were used to assess the degree of stenosis in 476 vessel segments.
  • * The results indicated that 3D ceMRA showed lower sensitivity and higher misinterpretation rates, leading to discrepancies in therapy decisions in 13 out of 34 patients, suggesting it is not a reliable alternative to i.a.DSA

Article Abstract

The objective of the study was to prove the value of single-dose contrast-enhanced magnetic resonance angiography [three-dimensional (3D) ceMRA] in abdominal and iliac arteries versus the reference standard intra-arterial digital subtraction angiography (i.a.DSA) when indicating a therapy. Patients suspected of having abdominal or iliac artery stenosis were included in this study. A positive vote of the local Ethics Committe was given. After written informed consent was obtained, 37 patients were enrolled, of which 34 were available for image evaluation. Both 3D ceMRA and i.a. DSA were performed for each patient. The dosage for 3D ceMRA was 0.1 mmol/kg body weight in a 1.5-T scanner with a phased-array coil. The parameters of the 3D-FLASH sequence were as follows: TR/TE 4.6/1.8 ms, effective thickness 3.5 mm, matrix 512 x 200, flip angle 30 degrees , field of view 420 mm, TA 23 s, coronal scan orientation. Totally, 476 vessel segments were evaluated for stenosis degree by two radiologists in a consensus fashion in a blinded read. For each patient, a therapy was proposed, if clinically indicated. Sensitivity, specificity, positive and negative predictive values, and accuracy for stenoses > or = 50% were 68%, 92%, 44%, 97%, and 90%, respectively. In 13/34 patients, a discrepancy was found concerning therapy decisions based on MRA findings versus therapy decisions based on the reference standard DSA. The results showed that the used MRA imaging technique of abdominal and iliac arteries is not competitive to i.a. DSA, with a high rate of misinterpretation of the MRAs resulting in incorrect therapies.

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Source
http://dx.doi.org/10.1007/s00270-006-0132-6DOI Listing

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