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Evaluation of the iliac arteries: Comparison of two‐dimensional time of flight magnetic resonance angiography with cardiac compensated fast gradient recalled echo and contrast‐enhanced three‐dimensional time of flight magnetic resonance angiography

1997; Wiley; Volume: 7; Issue: 1 Linguagem: Inglês

10.1002/jmri.1880070130

1522-2586

Stephen Quinn, Robert C. Sheley, Jerzy Szumowski, Ann Shimakawa,

MRI in cancer diagnosis

Abstract We compared dynamic contrast‐enhanced three‐dimensional time of flight (3DTOF) magnetic resonance angiography (MRA) with two‐dimensional time of flight (2DTOF) MRA with cardiac compensated fast gradient recalled echo (C‐MON) and conventional angiography (CA) when it was available. C‐MON re‐orders the normal data acquisition to minimize ghosting artifacts generated by pulsatile flow. The initial phase of the study involved optimization of parameters and comparison C‐MON with no C=MON in eight patients and volunteers. The final phase of the study involved 53 patients who were imaged with contrast‐enhanced 3DTOF MRA and 2DTOF MRA with C‐MON. Thirty of these patients also had CA. In the initial phase, 2DTOF MRA with C‐MON was found to be equal (n = 3) or superior (n = 5) to 2DTOF without C‐MON. In the final phase, the agreement among all imaging modalities varied from substantial to almost perfect (Cohen's K = .6‐.83). The lowest agreement was using 2DTOF to evaluate the external iliac segments. The among suggested treatments varied from substantial to almost perfect for all imaging modalities (Cohen's K = .73–93). The diagnostic efficacies of 2DTOF with C‐MON and contrast‐enhanced 3DTOF were high overall, with the lowest value being a specificity of 63% for one reader in the evaluation of an external iliac segment using 2DTOF. In summary, 2DTOF with C‐MON helped to eliminate artifacts due to pulsatility in the iliac arterial segments. In our experience, both dynamic constrast‐enhanced 3DTOF MRA and 2DTOF MRA with C‐MON performed well in the evaluation of the iliac arteries. Both studies have high interobserver agreement and high diagnostic efficacy. Contrast‐enhanced 3DTOF MRA should be reserved for situations in which the iliac vessels are extremely tortuous or occluded or the external iliac segments are poorly seen.