First clinical results in a study of contrast enhanced magnetic resonance angiography with the 1.0 molar gadobutrol in peripheral arterial occlusive disease - comparison to intraarterial DSA

Purpose: To assess the value of contrast enhanced (CE)-MR angiography (MRA) with 1.0 molar Gadobutrol (Schering, Germany) in comparison to intraarterial DSA in peripheral arterial occlusive disease (PAOD). Materials and Methods: Within 48 hours, 30 symptomatic patients with PAOD were examined by CE-MRA (Gadobutrol dose 0.2-0.3 mmol/kg body weight) and DSA. For CE-MRA, a 1.5 T magnet (Vision, Siemens, Germany) was used (FA 35 , TR/TE 4.6/1.8 ms, FOV 400 mm, matrix 230 x 512, total acquisition time 81 sec). Two radiologists evaluated a total of 600 vessel segments for stenotic lesions and image quality (1 = not visible to 5 = excellent). Treatment was independently planned on the basis of the MRA and DSA findings. Results: The Kendall's tau-b coefficient was 0.92 for overall stenotic grading, and 0.92, 0.93 and 0.92, respectively, for the vascular flow in the iliac, femoropopliteal and crural arteries. Sensitivity, specificity, negative and positive predictive value, and accuracy were, respectively, 94, 97, 98 and 92, 96% for > 50% stenoses, 95, 99, 99, 95 and 99% for iliac arteries, 96, 98, 98%, 94 and 97% for femoropopliteal arteries, and 92, 94, 96, 89 and 94% for crural arteries. Therapy planning by MRA and DSA coincided in 51 of 54 cases. No relevant adverse event occurred. Conclusion: CE-MRA with 1.0 molar Gadobutrol is highly efficient in diagnosing peripheral arterial occlusive disease and correlates excellently with DSA. (orig.)