Evaluation of Quiescent-Interval Single-Shot Magnetic Resonance Angiography in Diabetic Patients With Critical Limb Ischemia Undergoing Digital Subtraction Angiography: Comparison With Contrast-Enhanced Magnetic Resonance Angiography With Calf Compression at 3.0 Tesla

• Published in: Journal of endovascular therapy 2019-02, Vol.26 (1), p.44-53
• Main Authors: Wei, Li-Ming, Zhu, Yue-Qi, Zhang, Pei-Lei, Lu, Hai-Tao, Zhao, Jun-Gong
• Format: Article
• Language: English
• Subjects: Aged; Angiography, Digital Subtraction; Contrast Media - administration & dosage; Critical Illness; Diabetic Angiopathies - diagnostic imaging; Diabetic Angiopathies - physiopathology; Female; Gadolinium DTPA - administration & dosage; Humans; Ischemia - diagnostic imaging; Ischemia - physiopathology; Lower Extremity - blood supply; Magnetic Resonance Angiography; Male; Middle Aged; Observer Variation; Peripheral Arterial Disease - diagnostic imaging; Peripheral Arterial Disease - physiopathology; Predictive Value of Tests; Prospective Studies; Regional Blood Flow; Reproducibility of Results
• ISSN: 1526-6028; 1545-1550
• DOI: 10.1177/1526602818817887

Purpose: To assess the diagnostic performance of quiescent-interval single-shot magnetic resonance angiography (QISS-MRA) at 3 tesla in diabetic patients with critical limb ischemia (CLI) vs contrast-enhanced MR angiography (CE-MRA) using digital subtraction angiography (DSA) as the standard of reference. Method: Thirty-seven consecutive diabetic patients (mean age 71.8±7.2 years; 30 men) with CLI (Fontaine stage III–IV) underwent QISS-MRA and CE-MRA with calf compression; DSA was the standard. Image quality (5-point Likert-type scale) and stenosis severity (5-point grading) for QISS-MRA and CE-MRA were evaluated by 2 blinded readers in 1147 and 654 vessel segments, respectively. Per-segment and per-region (pelvis, thigh, calf) sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Results: Image quality of QISS-MRA was lower compared with CE-MRA in the pelvic region (p0.999)]. In region-based analyses, QISS-MRA and CE-MRA yielded similar sensitivity and specificity in all areas but the pelvic region for reader 2 (specificity 95.5% vs 84.8%, p=0.041). Conclusion: QISS-MRA performed very well in diabetic patients with CLI and was a good alternative for patients with contraindications to CE-MRA.