PMID- 24637590
OWN - NLM
STAT- MEDLINE
DCOM- 20141222
LR  - 20191210
IS  - 1536-0210 (Electronic)
IS  - 0020-9996 (Linking)
VI  - 49
IP  - 5
DP  - 2014 May
TI  - Initial evaluation of non-contrast-enhanced magnetic resonance angiography in 
      patients with peripheral arterial occlusive disease at 7 T.
PG  - 331-8
LID - 10.1097/RLI.0000000000000044 [doi]
AB  - OBJECTIVES: The aim of this study was to achieve initial experience with 
      non-contrast-enhanced (ne) magnetic resonance angiography (MRA) of the lower leg 
      arteries in patients with peripheral arterial occlusive disease (PAOD) at 7 T. 
      MATERIALS AND METHODS: Seven patients with PAOD were examined on a 7-T whole-body 
      magnetic resonance system. A custom-built 16-channel transmit/receive coil and a 
      manually positionable AngioSURF table were used for multistation imaging. For 
      ne-MRA, an axial T1-weighted Turbo-fast low angle shot sequence (repetition time, 
      700 milliseconds; echo time, 3.84 milliseconds; bandwidth, 930 Hz/pixel; voxel 
      volume, 1 x 1 x 2 mm; matrix, 384 x 288) with phonocardiogram gating was acquired 
      at 7 T. Acquisition time of an entire angiogram covering the vasculature from 
      pelvis to feet amounted to approximately 30 minutes, depending on the patient's 
      heart frequency. All patients underwent a contrast-enhanced MRA (ce-MRA) at 1.5 T 
      as standard of reference. The presence of stenosis and occlusions was evaluated 
      segment based and compared for both MRA techniques. The degree of stenosis was 
      defined as low grade (<50%), high grade (50%-99%), and occlusion (100%). 
      High-grade stenosis and occlusion were considered to be hemodynamically 
      significant stenosis. RESULTS: The 7-T ne-MRA enabled a homogenous, hyperintense 
      artery signal and nearly total venous suppression with accurate delineation of 
      arterial anatomy both proximal and distal to stenotic disease. A total of 154 
      artery segments were depicted with ce-MRA at 1.5 T. At 7 T, only 124 segments 
      (80.5%) were displayed and involved for analysis, as the iliacal region was 
      displayed incompletely in 4 patients because of the fact that the fixed coil 
      diameter was too small to contain the lower abdomen and pelvis of these patients. 
      In comparison with ce-MRA at 1.5 T as the reference standard, there was total 
      agreement regarding the characterization of an artery segment as being normal or 
      having any kind of stenosis. Of the 124 included segments, 28 segments (23%) had 
      hemodynamically significant stenosis evaluated with 7-T ne-MRA and 26 segments 
      (21%) assessed with 1.5-T ce-MRA. The sensitivity and specificity values of 7-T 
      ne-MRA for detecting segments with hemodynamically significant stenosis were 93% 
      and 98%, respectively. CONCLUSIONS: Non-contrast-enhanced MRA by means of 
      T1-weighted Turbo-fast low angle shot imaging at 7 T in patients with PAOD is 
      feasible and allowed for good visualization of stenosis and occlusions in all 
      analyzed artery segments in this small patient group. However, this study also 
      shows the challenges of ultrahigh-field body imaging, and more experience is 
      required to determine the impact of 7-T ne-MRA in clinical practice.
FAU - Fischer, Anja
AU  - Fischer A
AD  - From the *Department of Diagnostic and Interventional Radiology and 
      Neuroradiology, University Hospital Essen; daggerErwin L. Hahn Institute for Magnetic 
      Resonance Imaging, University Duisburg-Essen, Essen; double daggerMedical Physics in 
      Radiology, German Cancer Research Center, Heidelberg; and  section signClinic for Vascular 
      Surgery, Elisabeth Hospital Essen, Essen, Germany.
FAU - Maderwald, Stefan
AU  - Maderwald S
FAU - Johst, Soren
AU  - Johst S
FAU - Orzada, Stephan
AU  - Orzada S
FAU - Ladd, Mark E
AU  - Ladd ME
FAU - Umutlu, Lale
AU  - Umutlu L
FAU - Lauenstein, Thomas C
AU  - Lauenstein TC
FAU - Kniemeyer, Horst-Wilhelm
AU  - Kniemeyer HW
FAU - Nassenstein, Kai
AU  - Nassenstein K
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - United States
TA  - Invest Radiol
JT  - Investigative radiology
JID - 0045377
RN  - 0 (Contrast Media)
SB  - IM
MH  - Aged
MH  - Contrast Media
MH  - Humans
MH  - Image Enhancement
MH  - Image Processing, Computer-Assisted/methods
MH  - Leg/*blood supply
MH  - Magnetic Resonance Angiography/*methods
MH  - Male
MH  - Middle Aged
MH  - Observer Variation
MH  - Peripheral Arterial Disease/*diagnosis
MH  - Prospective Studies
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Whole Body Imaging/methods
EDAT- 2014/03/19 06:00
MHDA- 2014/12/23 06:00
CRDT- 2014/03/19 06:00
PHST- 2014/03/19 06:00 [entrez]
PHST- 2014/03/19 06:00 [pubmed]
PHST- 2014/12/23 06:00 [medline]
AID - 10.1097/RLI.0000000000000044 [doi]
PST - ppublish
SO  - Invest Radiol. 2014 May;49(5):331-8. doi: 10.1097/RLI.0000000000000044.