Background suppression single-shot electrocardiogram trigger non-enhanced magnetic resonance angiography in lower extremity blood vessels: a comparative study.

Abstract

Background: Background suppression single-shot electrocardiogram trigger non-contrast-enhanced magnetic resonance angiography (BASS-TRANCE) is a recently introduced non-contrast-enhanced magnetic resonance angiography (NCE-MRA) technique. It was reported to be a practical test for the evaluation of peripheral artery disease (PAD) with an imaging performance comparable to that of the known NCE-MRA technique quiescent interval single-shot (QISS). However, its performance compared to the most commonly used diagnostic methods for digital subtraction angiography (DSA) and computed tomography angiography (CTA) remains unclear. Using DSA as the test standard, this study evaluated the image quality and clinical diagnostic accuracy of BASS-TRANCE and CTA in PAD patients.

Methods: BASS-TRANCE, CTA, and DSA were examined successively in 30 patients with PAD. Two senior physicians scored the image quality of CTA and BASS-TRANCE using the 3-point method, and the images of both were evaluated according to the 5-level stenosis evaluation method. Either paired t-test or Wilcoxon signed-rank test was used to compare the difference of image quality between the two groups. Using DSA results as the gold standard, the sensitivity and specificity of CTA and BASS-TRANCE for lower limb artery stenosis >50% were calculated by McNemar's test.

Results: Of 570 segments, 12 (2.1%) and 42 (7.4%) inconclusive segments were excluded from BASS-TRANCE and CTA analysis, respectively (P<0.05). The DSA results were available for 392 of the remaining segments. Among the 516 vessels with reliable image quality, there was no significant difference in scores between BASS-TRANCE {2.42 [95% confidence interval (CI): 2.36-2.47]} and CTA [2.39 (95% CI: 2.33-2.45); P>0.05]. Furthermore, BASS-TRANCE demonstrated significant efficacy in detecting vascular stenosis with a sensitivity of 92.8% and specificity of 96.1%, which were comparable to those achieved by CTA (94.9% and 96.8%, respectively).

Conclusions: As an NCE-MRA technique, BASS-TRANCE can display the lower extremity vessels in a short time; it is expected to replace CTA as a safe and effective examination method for PAD patients in the future.