Comparison of contrast‐enhanced MR angiography to intraarterial digital subtraction angiography for evaluation of peripheral arterial occlusive disease: Results of a phase III multicenter trial

Abstract

MPH 5 for the Omniscan MRA Investigator Panel Purpose: To evaluate the efficacy and safety of 0.1 mmol/ kg gadodiamide administration for contrast-enhanced magnetic resonance angiography (CE-MRA) in detecting hemodynamically relevant main stenosis (ie, !50% or occlusion) of aortoiliac arteries. Materials and Methods:In a multicenter, phase 3, controlled study, patients with suspected or proven peripheral arterial occlusive disease (PAOD) underwent CE-MRA with administration of gadodiamide. Intraarterial digital subtraction angiography (IA-DSA) was used as the reference. The study was approved by all Institutional Review Boards or Institutional Ethic Committees prior to commencement of patient recruitment and written informed consent was obtained from all patients.Results: Independent readers rated 25%-45% of CE-MRA images as excellent compared with 0.3%-6% of noncontrast MRA images. Mean imaging acquisition time for CE-MRA was <1 minute (0.7 6 1.9 minutes) versus 10 minutes (10.8 6 3.0) for noncontrast MRA. Sensitivity, specificity, and accuracy of CE-MRA were superior compared with those of noncontrast MRA in detecting significant arterial stenoses. Compared with IA-DSA, the sensitivity of CE-MRA ranged from 80%-88% and the specificity from 73% to 92% for the three blinded readers, at the patient level. Conclusion:Diagnostic results with CE-MRA were superior and more consistent compared with noncontrast MRA for detecting hemodynamically relevant main stenoses in patients with suspected or proven PAOD and compared favorably with IA-DSA as a reference standard.

Plasma–Parathyroid Hormone Is Associated With Subclinical and Clinical Atherosclerotic Disease in 2 Community-Based Cohorts

“…However, the relation between atherosclerosis detected on WBMRA and vascular outcomes has been described previously, 16 and results from WBMRA investigations are in agreement with digital subtraction angiography, the gold standard method for assessing degree of atherosclerotic burden. [37][38][39] Also, the manual assessment was blinded to measures of PTH. Increased support for the validity of our findings are previous studies strongly relating imaging evidence of burden of atherosclerosis to increased risk of disease and death from atherosclerotic diseases.…”

Gadolinium Enhanced MR-angiography Results in Patients with Peripheral Arterial Disease: Positive Predictive Value Compared to Surgery

“…Advanced technological improvements are introduced in field of imaging modalities which changed the old methods of diagnosis ( 24 - 26 ). On the other hand the main question here would be that if these new modalities exactly reflect what happens in the body and how much we can trust on the results provided by these modalities.…”

Hybrid Interventions in Limb Salvage

“…Computed tomography (CT) or magnetic resonance (MR) angiography is increasingly being used to help plan for an intervention. 6,7 In patients with critical ischemia and multilevel arterial occlusive disease, the decision to reconstruct one or more segments is based on clinical judgment. It is estimated that approximately 25% of patients with multilevel arterial occlusive disease need both aortoiliac and infrainguinal revascularization.…”