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Vascular and Interventional Radiology |
1 From the Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 10945 Le Conte Ave, Suite 3371, Los Angeles, CA 90095-7206 (K.N., J.P.V., W.B.P., T.O.M., J.P.F.); and Siemens Medical Solutions, Malvern, Pa (G.L.). Received November 2, 2005; revision requested December 21; revision received February 3, 2006; accepted March 7; final version accepted May 5. Address correspondence to K.N. (e-mail: nkambiz{at}mednet.ucla.edu).
Purpose: To prospectively use 3.0-T breath-hold high-spatial-resolution contrast materialenhanced magnetic resonance (MR) angiography with highly accelerated parallel acquisition to image the supraaortic arteries of patients suspected of having arterial occlusive disease.
Materials and Methods: Institutional review board approval and written informed consent were obtained for this HIPAA-compliant study. Eighty patients (44 men, 36 women; age range, 4490 years) underwent contrast-enhanced MR angiography of the head and neck at 3.0 T with an eight-channel neurovascular array coil. By applying a generalized autocalibrating partially parallel acquisition algorithm with an acceleration factor of four, high-spatial-resolution (0.7 x 0.7 x 0.9 mm = 0.44-mm3 voxels) three-dimensional contrast-enhanced MR angiography was performed during a 20-second breath hold. Two neuroradiologists evaluated vascular image quality and arterial stenoses. Interobserver variability was tested with the
coefficient. Quantitation of stenosis at MR angiography was compared with that at digital subtraction angiography (DSA) (n = 13) and computed tomographic (CT) angiography (n = 12) with Spearman rank correlation coefficient (Rs).
Results: Arterial stenoses were detected with contrast-enhanced MR angiography in 208 (reader 1) and 218 (reader 2) segments, with excellent interobserver agreement (
= 0.80). There was a significant correlation between contrast-enhanced MR angiography and CT angiography (Rs = 0.95, reader 1; Rs = 0.87, reader 2) and between contrast-enhanced MR angiography and DSA (Rs = 0.94, reader 1; Rs = 0.92, reader 2) for the degree of stenosis. Sensitivity and specificity of contrast-enhanced MR angiography for detection of arterial stenoses greater than 50% were 94% and 98% for reader 1 and 100% and 98% for reader 2, with DSA as the standard of reference. Vascular image quality was sufficient for diagnosis or excellent for 97% of arterial segments evaluated.
Conclusion: By using highly accelerated parallel acquisition, the described 3.0-T contrast-enhanced MR angiographic protocol enabled visualization and characterization of the majority of supraaortic arteries, with diagnostic or excellent image quality (97% of arterial segments) and diagnostic values comparable with those obtained by using CT angiography and DSA for detection of arterial stenoses.
© RSNA, 2007
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