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Assessment of Aortoiliac and Renal Arteries: MR Angiography with Parallel Acquisition versus Conventional MR Angiography and Digital Subtraction Angiography¹

¹ From the Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland (R.S., D.N., A.M.L., T.P., A.S., C.H., D.W., B.M., J.K.W.); Molecular Imaging Program at Stanford, Department of Radiology and Bio-X Program, Stanford University School of Medicine, E 150 Clark Center, 318 Campus Dr, Palo Alto, CA, 94305-5427 (A.M.L., J.K.W.); and Department of Biostatistics, University of Zurich, Zurich, Switzerland (B.S.). From the 2006 RSNA Annual Meeting. Received December 7, 2006; revision requested February 16, 2007; revision received March 1; accepted March 20; final version accepted April 16. J.K.W. supported in part by the Swiss Foundation of Medical-Biological Grants, Novartis Research Foundation, and Swiss Society of Radiology. Address correspondence to J.K.W. (e-mail: willmann{at}stanford.edu).

Purpose: To prospectively compare the image quality, sensitivity, and specificity of three-dimensional gadolinium-enhanced magnetic resonance (MR) angiography accelerated by parallel acquisition (ie, fast MR angiography) with MR angiography not accelerated by parallel acquisition (ie, conventional MR angiography) for assessment of aortoiliac and renal arteries, with digital subtraction angiography (DSA) as the reference standard.

Materials and Methods: The study was approved by the institutional review board; informed consent was obtained from all patients. Forty consecutive patients (33 men, seven women; mean age, 63 years) suspected of having aortoiliac and renal arterial stenoses and thus examined with DSA underwent both fast (mean imaging time, 17 seconds) and conventional (mean imaging time, 29 seconds) MR angiography. The arterial tree was divided into segments for image analysis. Two readers independently evaluated all MR angiograms for image quality, presence of arterial stenosis, and renal arterial variants. Image quality, sensitivity, and specificity were analyzed on per-patient and per-segment bases for multiple comparisons (with Bonferroni correction) and for dependencies between segments (with patient as the primary sample unit). Interobserver agreement was evaluated by using statistics.

Results: Overall, the image quality with fast MR angiography was significantly better (P = .001) than that with conventional MR angiography. At per-segment analysis, the image quality of fast MR angiograms of the distal renal artery tended to be better than that of conventional MR angiograms of these vessels. Differences in sensitivity for the detection of arterial stenosis between the two MR angiography techniques were not significant for either reader. Interobserver agreement in the detection of variant renal artery anatomy was excellent with both conventional and fast MR angiography ( = 1.00).

Conclusion: Fast MR angiography and conventional MR angiography do not differ significantly in terms of arterial stenosis grading or renal arterial variant detection.

Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2451062081/DC1

© RSNA, 2007