Time-resolved contrast-enhanced MR angiography: Value of hemodynamic information in the assessment of vascular diseases

BACKGROUND: To assess the quality of images obtained from time-resolved MRA together with the accuracy of this technique in diagnosing vascular diseases and the usefulness of haemodynamic information provided by this method. MATERIAL/METHODS: The study group included 120 patients with different vascular pathologies excluding of intracranial vessels. All patients underwent time-resolved MRA on 1.5T unit. Results were correlated with other imaging techniques: DSA (n=36), CTA (n=28), Doppler ultrasound (n=71) and intraoperative findings (n=10). Independently, two radiologists evaluated the MRA studies assessing the quality of the images in a 3 point scale (3 – good, 1 – poor), as well as the presence or absence of haemodynamic information (3 – relevant dynamic information, 2 – irrelevant dynamic information, 1 – lack of dynamic information) for different vascular pathologies. RESULTS: Mean quality of MRA examinations was 2.94 (reader A and B) and was similar for different pathologies (kappa value =0.757). The mean grading (reader A and B) for the presence of dynamic information was above 2 for the following pathologies: celiac artery branch pseudoaneurysm (3), vascular malformation (3), subclavian steal syndrome (2.5), Leriche’s syndrome (2.25), aortic dissection (2.06), renal artery stenosis (2.03); and below 2 for: pelvic arterial occlusive disease (1.75), abdominal aortic aneurysm (1.31), carotid artery stenosis (1.1), thoracic aortic aneurysm (1.0). Kappa value was 0.802. The sensitivity was 95%, specificity 96% and positive predictive value 98%. CONCLUSIONS: Time-resolved MRA provides good quality images and enables reliable diagnosis of vascular pathologies.