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(Radiology. 1999;211:59-67.)
© RSNA, 1999

Vascular and Interventional Radiology

Stepping-Table Gadolinium- enhanced Digital Subtraction MR Angiography of the Aorta and Lower Extremity Arteries: Preliminary Experience1

James F. M. Meaney, FRCR, John P. Ridgway, PhD, Sam Chakraverty, FRCR, Iain Robertson, FRCR, David Kessel, FRCR, Aleksandra Radjenovic, MSc, Marc Kouwenhoven, MSc, Andrea Kassner and Michael A. Smith

1 From the Depts of Magnetic Resonance Imaging (J.F.M.M., A.R.) and Medical Physics (J.P.R., A.R., M.A.S.), Leeds General Infirmary, United Kingdom; Dept of Radiology, Bradford Royal Infirmary, Leeds (S.C.); Dept of Radiology, St James University Hospital, Leeds (I.R., D.K.); and Philips Medical Systems, Best, the Netherlands (M.K., A.K.). Received Oct 8, 1997; revision requested Nov 24; final revision received Aug 19, 1998; accepted Nov 5. Supported by Northern and Yorkshire Research and Development Directorate. Address reprint requests to J.F.M.M., CT Department, Jubillee Wing, Leeds General Infirmary, Leeds LS2 1EX, United Kingdom.

PURPOSE: To compare stepping-table digital subtraction gadolinium-enhanced magnetic resonance (MR) angiography of the distal aorta and lower extremity arteries with conventional catheter digital subtraction x-ray angiography in patients with arterio-occlusive disease.

MATERIALS AND METHODS: Twenty patients underwent both conventional catheter angiography and fast three-dimensional gadolinium-enhanced MR angiography of the aorta and outflow vessels at 1.5 T; the images were acquired in three consecutive imaging locations during a single infusion of a gadolinium chelate.

RESULTS: Compared with catheter angiography, according to the findings of two blinded independent reviewers, MR angiography had sensitivities of 81% and 89% and specificities of 91% and 95%, respectively, for demonstration of insignificant (<=50%) stenosis versus significant (51%–100%) stenosis. For demonstration of occlusion, the sensitivity and specificity were 94% and 97%, respectively, by consensus. There was good interobserver correlation between the two readers overall ({kappa} = 0.65 for reporting the degree of narrowing in all lesions; 0.86, for reporting of insignificant versus significant stenoses; and 0.928, for reporting of occluded versus patent segments).

CONCLUSION: Stepping-table digital subtraction contrast material–enhanced MR angiography has high accuracy compared with catheter angiography in patients with arterio-occlusive disease of the aorta and outflow vessels. These preliminary study results suggest that this technique may ultimately provide a safe, noninvasive, and cost-effective alternative to catheter angiography.

Index terms: Angiography, contrast media, 928.1211, 928.122, 988.1211, 988.122 • Angiography, technology, 928.1211, 928.122, 988.1211, 988.122 • Aorta, stenosis or obstruction, 981.721 • Arteries, stenosis or obstruction, 928.721, 988.721 • Magnetic resonance (MR), vascular studies, 928.121412, 928.12942, 988.121412, 988.12942




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R. Watts, Y. Wang, M. R. Prince, P. A. Winchester, N. M. Khilnani, and K. C. Kent
Anatomically Tailored k-Space Sampling for Bolus-Chase Three-dimensional MR Digital Subtraction Angiography
Radiology, March 1, 2001; 218(3): 899 - 904.
[Abstract] [Full Text]

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