Comparison of quiescent inflow single-shot and native space for nonenhanced peripheral MR angiography

• Published in: Journal of magnetic resonance imaging 2013-12, Vol.38 (6), p.1531-1538
• Main Authors: Ward, Emily V., Galizia, Mauricio S., Usman, Asad, Popescu, Andrada R., Dunkle, Eugene, Edelman, Robert R.
• Format: Article
• Language: English
• Subjects: Aged; angiography; Arterial Occlusive Diseases - pathology; Contrast Media; Contrast-enhanced MR angiography; Female; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; imaging; Ischemia - pathology; Leg - blood supply; Leg - pathology; Magnetic Resonance Angiography - methods; Magnetic resonance imaging; Male; NATIVE SPACE MR; nonenhanced MR angiography; Peripheral Arterial Disease - pathology; peripheral artery disease; Pilot Projects; quiescent-Interval single-shot (QISS) MR angiography; Reproducibility of Results; Sensitivity and Specificity
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.24124

Purpose To evaluate two nonenhanced MRA methods: quiescent‐interval single‐shot (QISS) and Native SPACE (NATIVE = Non‐contrast Angiography of the Arteries and Veins; SPACE = Sampling Perfection with Application Optimized Contrast by using different flip angle Evolution), using contrast‐enhanced MR angiography (CEMRA) as a reference standard. Materials and Methods Twenty patients (14 male; mean, 69.3 years old) referred for lower extremity MRA were recruited in a HIPAA‐compliant prospective study. QISS and Native SPACE of the lower extremities were performed at 1.5 Tesla with a hybrid dual‐injection contrast‐enhanced MRA as reference. Image quality and stenosis severity were assessed in segments by two blinded radiologists. Methods were compared with logistic regression for correlated data for diagnostic accuracy. Results Of 496 arterial segments, 24 were considered nondiagnostic on the Native SPACE images. There were no QISS or CEMRA imaging segments considered to be nondiagnostic. Image quality was significantly higher for QISS than for Native SPACE. QISS stenosis sensitivity (84.9%) was not significantly different from Native SPACE (87.3%). QISS had better specificity (95.6%) than Native SPACE (87.0%), P = 0.0041. In comparison with QISS, Native SPACE proved less robust for imaging of the abdominal and pelvic segments. Conclusion Native SPACE and QISS were sensitive for hemodynamically significant stenosis in this pilot study. QISS NEMRA demonstrated superior specificity and image quality, and was more robust in the abdominal and pelvic regions. J. Magn. Reson. Imaging 2013;38:1531–1538. © 2013 Wiley Periodicals, Inc.