Gadolinium-enhanced Magnetic Resonance Angiography, Digital Subtraction Angiography and Duplex of the Iliac Arteries Compared with Intra-arterial Pressure Gradient Measurements

Wikström, Johan; Holmberg, Anders; Johansson, Lars; Löfberg, Anne-Marie; Smedby, Örjan; Karacagil, Sadettin; Åhlström, Håkan

doi:10.1053/ejvs.1999.1083

Cited by 32 publications

(34 citation statements)

References 16 publications

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“…For evaluation of each vascular region, we used three-dimensional (3-D) fast spin echo (FSE) T1-weighted sequences with the following parameters: TR= 6 ms, TE 1.5 ms, flip angle 35°, slice thickness 1.5 mm (3 mm with 1.5-mm overlap), field of view 430 mm, matrix 512×512, number of slices 70 and acquisition time 28 s. Overall acquisition time of successive sequences, including the time needed for two table moveIntroduzione L'angiografia mediante risonanza magnetica (Angio-RM) ha trovato negli ultimi anni applicazione sempre più ampia nella valutazione delle arteriopatie degli arti inferiori. I progressi tecnologici hanno fatto sì che tale indagine possa garantire una sensibilità ed una specificità elevate, utilizzando l'angiografia digitale come gold standard, pur se i lavori pubblicati riportano un range di percentuali assai ampio (sensibilità tra il 71% e il 100%, specificità tra il 63% e il 100%) [1][2][3][4][5][6][7][8][9][10][11]. Molti lavori hanno preso quindi in considerazione il suo apporto diagnostico ed hanno sottolineato i suoi benefici, per il trascurabile costo biologico.…”

Section: Examination Techniqueunclassified

“…The high diagnostic accuracy of MRA in the evaluation of lower-limb arteries is an established fact [1][2][3][4][5][6][7][8][9][10][11]. In addition, MRA no doubt offers clear advantages over angiography if biological costs are considered since it is non-invasive, involves no ionising radiation and makes use of a paramagnetic contrast agent, which is safer than organic iodinated products.…”

Section: Full Costmentioning

confidence: 99%

“…È chiaro che un'analisi dei costi rappresenta solo un primo tassello per giungere ad un'analisi costo-efficacia, che consideri quindi da un lato i benefici diagnostici, includendo le ricadute terapeutiche, e dall'altro i costi biologici. L'elevata accuratezza diagnostica dell'Angio-RM nella valutazione delle arterie degli arti inferiori è un dato acquisito [1][2][3][4][5][6][7][8][9][10][11].…”

Section: Full Costunclassified

“…Technological advancements have allowed this technique to provide high levels of sensitivity and specificity as compared with digital subtraction angiography (DSA) as the gold standard even though the reported ranges are extremely wide (sensitivity: 71%-100%, specificity: 63%-100%) [1][2][3][4][5][6][7][8][9][10][11]. Most papers have, therefore, considered its diagnostic contribution and emphasised its advantages of having a negligible biological cost.…”

Section: Introductionmentioning

confidence: 99%

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MR angiography versus intra-arterial digital subtraction angiography of the lower extremities: activity-based cost analysis

Stacul

Mucelli

Lubin³

et al. 2006

Radiol med

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Intra-arterial DSA costs more than MRA, mainly because of the higher costs of supplies used during the procedure and higher personnel costs (as a result of the longer duration of intra-arterial DSA). It should be noted that our evaluation considers costs pertaining to the radiology department only. It is evident that an economic analysis considering hospital costs as well would result in much higher costs for DSA if post-procedure hospitalisation is required. Our results cannot be simply exported to other radiology departments since they refer to the technology and organisation adopted in our department. However, our cost analysis model can be easily applied to other environments. MRA provides good diagnostic accuracy in the evaluation of arteries of the lower extremities, and its biological cost is far lower than that of intra-arterial DSA (MRA is noninvasive, it does not use ionising radiation, and the contrast medium is safe). Its lower cost is another argument in favour of the use of MRA instead of intra-arterial DSA in the evaluation of lower-extremity arterial disease.

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Section: Examination Techniqueunclassified

Section: Full Costmentioning

confidence: 99%

Section: Full Costunclassified

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

MR angiography versus intra-arterial digital subtraction angiography of the lower extremities: activity-based cost analysis

Stacul

Mucelli

Lubin³

et al. 2006

Radiol med

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“…Comparisons with intra-arterial pressure measurements (IAPM) have, however, shown that some hemodynamically significant stenoses will remain undetected if only morphological modalities are used (22,24). For this reason, invasive pressure measurements are still required before decisions on interventional procedures can be made, at least in borderline cases.…”

mentioning

confidence: 99%

Correlation of femoral artery flow velocity waveform with ipsilateral iliac artery stenoses assessed with magnetic resonance imaging

et al. 2007

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Contrast‐enhanced magnetic resonance angiography of the lower extremities: Standard‐dose vs. high‐dose gadodiamide injection

Krause

Kroencke

Spielhaupter³

et al. 2005

Magnetic Resonance Imaging

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Purpose:To compare the efficacy and safety of two different doses (0.1 and 0.3 mmol/kg of body weight [BW]) of gadodiamide for contrast-enhanced magnetic resonance angiography (ce-MRA) of the lower extremities with intraarterial digital subtraction angiography (IA-DSA). Materials and Methods:A total of 30 patients with peripheral arterial occlusive disease underwent IA-DSA and ce-MRA from the aortic bifurcation down to the ankle. Patients were randomized to receive a total dose of 0.1 or 0.3 mmol/kg of BW gadodiamide (Omniscan, Amersham Buchler), administered intravenously as a series of three automatic bolus injections. Ce-MRA was performed with a 1.5-T system using a body phased-array coil, centered stepwise over the calf, thigh, and pelvic region. A fast T1-weighted, three-dimensional gradient-echo sequence was obtained before and after injection of the allocated dose. IA-DSA was performed using the Seldinger technique and a femoral approach. The vessels under investigation were divided into 31 segments, and ce-MRA and IA-DSA image sets were evaluated in a double-blind fashion for the presence of stenosis, presence of collateral vessels, vessel delineation, and overall image quality. Both dose groups were compared with regard to contrast index (CI) and signal-and contrast-to-noise ratios (SNR, CNR). The occurrence of adverse events or side effects was also documented. Sensitivity, specificity, and accuracy were calculated in relation to the results of stenosis grading.Results: A total of 26 patients were entered in the efficacy evaluation, while all 30 patients were included in the safety assessment. The sensitivity, specificity, and accuracy for the 0.1 and 0.3 mmol/kg dose groups were 78.8%/93.0%/ 88.9% vs. 60.2.%/91.5%/83.2%, respectively. The detection of collaterals was similar to IA-DSA for the 0.3 mmol/kg dose group (30.2% vs. 27.4%), but was lower in the 0.1 mmol/kg dose group (27.3% vs. 12.3%). The highdose gadodiamide injection proved to be superior to the 0.1 mmol/kg dose group with regard to vessel delineation and overall image quality (P ϭ 0.007 and P ϭ 0.002, respectively). The difference between the two dose groups regarding CI, SNR, and CNR was significant (P ϭ 0.0001), in favor of the 0.3 mmol/kg dose group. No adverse events were observed in any of the patients. Conclusion:Ce-MRA with gadodiamide is safe and efficacious. Comparison of two different doses with IA-DSA as the standard of reference showed that the 0.3 mmol/kg dose is superior to the standard 0.1 mmol/kg dose with respect to contrast enhancement, vessel delineation, image quality, and detection of collaterals. However, the 0.1 mmol/kg dose was superior to the high dose in the grading of stenosis.

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Gadolinium-enhanced Magnetic Resonance Angiography, Digital Subtraction Angiography and Duplex of the Iliac Arteries Compared with Intra-arterial Pressure Gradient Measurements

Cited by 32 publications

References 16 publications

MR angiography versus intra-arterial digital subtraction angiography of the lower extremities: activity-based cost analysis

MR angiography versus intra-arterial digital subtraction angiography of the lower extremities: activity-based cost analysis

Correlation of femoral artery flow velocity waveform with ipsilateral iliac artery stenoses assessed with magnetic resonance imaging

Contrast‐enhanced magnetic resonance angiography of the lower extremities: Standard‐dose vs. high‐dose gadodiamide injection

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