Diagnostik der Becken-Bein-Gefässe mittels kontrastmittelangehobener 3D-MR-Angiographie
OBJECTIVE: To evaluate contrast-enhanced 3D-MR-Angiography for the assessment of peripheral arteries from the abdominal aorta to the lower leg arteries. METHODS: 3D-MRA was performed in 62 patients, using a Gd-DTPA enhanced T1 weighted 3D gradient-echo sequence (FFE). Results for 23 vascular segments from the abdominal aorta to the calves were compared with the gold standard DSA. All examinations were reviewed by four experienced radiologists and one cardiovascular surgeon. Degree of stenosis, image quality and correlation of both methods were evaluated. Therapeutical decisions by the cardiovascular surgeon based on 3D-MRA and DSA were compared. RESULTS: Contrast-enhanced 3D-MRA was able to detect all types of pathology in the examined vascular segments and showed moderate to good correlation with DSA. Sensitivity/ speficity of 3D-MRA for the assessment of peripheral arteries was 0.94/0.95 for the aorta, 0.92/0.87 for pelvic arteries, 0.84/0.94 for upper leg arteries and 0.84/0.96 for lower leg arteries. Imaging quality of 3D-MRA was rated good for evaluation of the aorta, moderate for pelvic arteries, good for upper leg arteries and good for lower leg arteries and was equal to the imaging quality of DSA in all areas. The correlation of 3D-MRA and DSA as calculated by kappa- and p-values ranged from fair to good. Decisions of the vascular surgeon based on 3D-MRA for further treatment of the patient showed 100% correlation with DSA-based decisions. CONCLUSION: Contrast-enhanced 3D-MRA of peripheral arteries is a fast, reliable technique with multiple advantages over DSA and detects all relevant vascular pathology.
info:eu-repo/classification/ddc/610, Medizin, MR-Angiographie, MRA, Becken-Bein-Gefässe, Kontrastmittel
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