Cardiovascular magnetic resonance imaging of aorto-iliac and ilio-femoral vascular calcifications using proton density-weighted in-phase stack of stars

• Published in: Journal of cardiovascular magnetic resonance 2018-08, Vol.20 (1), p.51-51, Article 51
• Main Authors: Serhal, Ali, Koktzoglou, Ioannis, Aouad, Pascale, Carr, James C, Giri, Shivraman, Morcos, Omar, Edelman, Robert R
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aneurysms; Angiography; Aorta - diagnostic imaging; Aortic Diseases - diagnostic imaging; Aortography - methods; Calcification; Calcium; Computed tomography; Computed Tomography Angiography; Confidence; Conspicuity; Correlation coefficient; Correlation coefficients; CT angiography; CT imaging; Diagnosis; Female; Femoral Artery - diagnostic imaging; Femur; Field strength; Humans; Iliac Artery - diagnostic imaging; Illinois; Image analysis; Image detection; Image Interpretation, Computer-Assisted - methods; Image processing; Magnetic Fields; Magnetic Resonance Angiography - methods; Magnetic resonance imaging; Male; Medical imaging; Middle Aged; NMR; Nuclear magnetic resonance; Patients; Peripheral arterial disease; Peripheral Arterial Disease - diagnostic imaging; Peripheral vascular diseases; Predictive Value of Tests; Prospective Studies; Proton density (concentration); Qualitative analysis; Quantitative analysis; Quiescent-interval slice-selective; Reproducibility of Results; Resonance; Stack of stars; Technical Notes; Vascular calcification; Vascular Calcification - diagnostic imaging; Veins & arteries
• ISSN: 1097-6647; 1532-429X
• DOI: 10.1186/s12968-018-0479-2

Comparing cardiovascular magnetic resonance (CMR) angiography with computed tomography angiography (CTA), a major deficiency has been its inability to reliably image peripheral vascular calcifications that may impact the choice of interventional strategy and influence patient prognosis. Recently, MRI using a proton density-weighted, in-phase stack of stars (PDIP-SOS) technique has proved capable of detecting these calcifications. The goal of the present study was two-fold: (1) to determine whether magnetic field strength impacts the apparent size and conspicuity of ilio-femoral arterial calcifications; and (2) to determine whether the technique can be accurately applied to image aorto-iliac arterial calcifications. Two patient cohorts were studied. For the first cohort, ilio-femoral arterial calcifications were imaged at 1.5 Tesla in 20 patients and at 3 Tesla in 12 patients. For the second cohort, aorto-iliac arterial calcifications were imaged in 10 patients at 3 Tesla and one patient at 1.5 Tesla. Qualitative image analysis as well as quantitative analysis using a semi-automated technique were performed using CTA as the reference standard. Qualitatively, most PDIP-SOS CMR images showed good-to-excellent confidence to detect vascular calcifications, with good-to-excellent inter-reader agreement (κ = 0.67 for ilio-femoral region, P