Diagnostic performance of gadobenate dimeglumine-enhanced MR angiography of the iliofemoral and calf arteries: A large-scale multicenter trial

Siegfried Thurnher, Stephan Miller, Günther Schneider, Claudio Ballarati, Georg Bongartz, Christoph U. Herborn, Stefan Schoenberg, Maria Assunta Cova, Giovanni Morana, Khusrow Niazi, Roberto Iezzi, Matthias Taupitz, David A. Bluemke, Karl Friedrich Kreitner, Miles A. Kirchin, Gianpaolo Pirovano

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. The purpose of this study was to compare gadobenate dimeglumine-enhanced MR angiography and unenhanced time-of-flight MR angiography for the detection of significant peripheral arterial occlusive disease using digital subtraction angiography as our reference standard. SUBJECTS AND METHODS. Two hundred seventy-two patients underwent MR angiography and digital subtraction angiography of the iliofemoral arteries. MR angiography was performed before (2D time-of-flight acquisitions) and after (spoiled gradient-echo acquisitions) the administration of 0.1 mmol/kg of gadobenate dimeglumine at 1-2 mL/s. Contrast-enhanced MR angiography and digital subtraction angiography of the calf arteries were performed in 241 of 272 participants. Images were evaluated on-site and by four blinded reviewers (three for MR angiography, one for digital subtraction angiography). Comparative diagnostic performance for the detection of significant (≥ 51% vessel lumen narrowing) disease was evaluated using the McNemar test and generalized estimating equations. Interobserver agreement was assessed with generalized kappa statistics. The chi-square test was used to compare technical failure rates. RESULTS. Digital subtraction angiography confirmed significant disease (597 stenoses, 386 occlusions) in 983 iliofemoral segments. The sensitivity (54-80.9%), specificity (89.7-95.3%), and accuracy (85-87.5%) of contrast-enhanced MR angiography for the detection of significant iliofemoral disease were significantly (p < 0.001, all reviewers) better than those of time-of-flight MR angiography (33.2-62.8%, 74.3-88.9%, and 68-77.3%, respectively). Similar diagnostic performance was obtained for the calf arteries. The technical failure rate with contrast-enhanced MR angiography (2.5-3.4%) was similar to that of digital subtraction angiography (1.4%) and significantly (p < 0.001) lower than that of time-of-flight MR angiography (6.2-18.0%). Significantly better reproducibility (p < 0.001) was obtained with contrast-enhanced MR angiography (82% vs 65.2% agreement; κ = 0.66 vs 0.45). CONCLUSION. Improved diagnostic performance and reproducibility ate achievable with gadobenate dimeglumine-enhanced MR angiography in patients with peripheral arterial occlusive disease.

Original languageEnglish (US)
Pages (from-to)1223-1237
Number of pages15
JournalAmerican Journal of Roentgenology
Volume189
Issue number5
DOIs
StatePublished - Nov 1 2007

Keywords

  • Contrast agents
  • Diagnostic performance
  • Gadobenate dimeglumine
  • MR angiography
  • Peripheral arterial occlusive disease

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Thurnher, S., Miller, S., Schneider, G., Ballarati, C., Bongartz, G., Herborn, C. U., Schoenberg, S., Cova, M. A., Morana, G., Niazi, K., Iezzi, R., Taupitz, M., Bluemke, D. A., Kreitner, K. F., Kirchin, M. A., & Pirovano, G. (2007). Diagnostic performance of gadobenate dimeglumine-enhanced MR angiography of the iliofemoral and calf arteries: A large-scale multicenter trial. American Journal of Roentgenology, 189(5), 1223-1237. https://doi.org/10.2214/AJR.07.2218