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  • Title: ECG-triggered non-contrast-enhanced MR angiography (TRANCE) versus digital subtraction angiography (DSA) in patients with peripheral arterial occlusive disease of the lower extremities.
    Author: Gutzeit A, Sutter R, Froehlich JM, Roos JE, Sautter T, Schoch E, Giger B, Wyss M, Graf N, von Weymarn C, Jenelten R, Binkert CA, Hergan K.
    Journal: Eur Radiol; 2011 Sep; 21(9):1979-87. PubMed ID: 21533632.
    Abstract:
    OBJECTIVE: To prospectively determine the diagnostic value of electrocardiography-triggered non-contrast-enhanced magnetic resonance angiography (TRANCE) of the lower extremities including the feet versus DSA. METHODS: All 43 patients with symptomatic peripheral arterial occlusive disease (PAOD) underwent TRANCE before DSA. Quality of MRA vessel depiction was rated by two independent radiologists on a 3-point scale. Arterial segments were graded for stenoses using a 4-point scale (grade 1: no stenosis; grade 2: moderate stenosis; grade 3: severe stenosis; grade 4: occlusion). Findings were compared with those of DSA. RESULTS: In the 731 vessel segments analysed, intra-arterial DSA revealed 283 stenoses: 33.6% moderate, 16.6% severe and 49.8% occlusions. TRANCE yielded a mean sensitivity, specificity, positive and negative predictive value and diagnostic accuracy to detect severe stenoses or occlusions of 95.6%, 97.4%, 87.2%, 99.2%, 97.1% for the thigh segments and 95.2%, 87.5%, 83.2%, 96.6%, 90.5% for the calf segments. Excellent overall image quality was observed for TRANCE in 91.4% versus 95.7% (DSA) for the thigh and in 60.7% versus 91.0% for the calves, while diagnostic quality of the pedal arteries was rated as insufficient. CONCLUSION: TRANCE achieves high diagnostic accuracy in the thigh and calf regions, whereas the pedal arteries showed limited quality.
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