Rapid magnetic resonance angiography for detection of atherosclerosis

Abstract

Background: Choice of treatment for atherosclerosis depends on various clinical factors and radiological techniques. We aimed to assess the diagnostic accuracy of a new three-dimensional magnetic resonance angiography (3D MRA) strategy for the display of arterial vasculature from supra-aortic arteries to distal runoff vessels in 72 s.

Methods: We examined five healthy volunteers and six patients over 6 weeks. Conventional digital subtraction angiography (DSA) was available as reference standard in all six patients. Magnetic resonance imaging was done on a commercially available 1.5 Tesla scanner. The imaging technique was based on the acquisition of five 3D data sets in rapid succession with an optimum single injection protocol.

Findings: Compared with conventional catheter angiography, according to the findings of two independent and masked readers, whole-body MRA had overall sensitivities of 91% (95% CI 0.76-0.98) and 94% (0.8-0.99), and specificities of 93% (0.85-0.97) and 90% (0.82-0.96) for the detection of substantial vascular disease (luminal narrowing >50%), interobserver agreement for assessment of whole-body magnetic angiograms was very good (kappa=0.94; 95% CI 0.9-0.98).

Interpretation: The technique provides a comprehensive non-invasive approach for morphological screening assessment of the arterial vasculature from supra-aortic arteries to the distal runoff arteries.