The Diagnostic Value of Time-resolved MR Angiography with Gadobutrol at 3 T for Preoperative Evaluation of Lower Extremity Tumors: Comparison with Computed Tomography Angiography

Overview

Journal Eur J Radiol Open

Specialty Radiology

Date 2016 Sep 14

PMID 27622202

Authors

Gang Wu

Teng Jin

Ting Li

Xiaoming Li

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the diagnostic value of time resolved magnetic resonance angiography with interleaved stochastic trajectory (TWIST) using Gadobutrol for preoperative evaluation of lower extremity tumors.

Materials And Methods: This prospective study was approved by the local Institutional Review Board. 50 consecutive patients (31 men, 19 women, age range 18-80 years, average age 42.7 years) with lower extremity tumors underwent TWIST and computed tomography angiography (CTA). Image quality of TWIST and CTA were evaluated by two radiologists according to a 4-point scale. The degree of arterial stenosis caused by tumor was assessed using TWSIT and CTA separately, and the intra-modality agreement was determined using a kappa test. The number of feeding arteries identified by TWIST was compared with that by CTA using Wilcoxon signed rank test. The ability to identify arterio-venous fistulae (AVF) were compared using a chi-square test.

Results: Image quality of TWIST and CTA were rated as 3.88 ± 0.37 and 3.97 ± 0.16, without statistically significant difference (P = 0.135). Intra-modality agreement was excellent for the assessment of arterial stenosis (kappa = 0.806 ± 0.073 for Reader 1, kappa = 0.805 ± 0.073 for Reader 2). Readers identified AVF with TWIST in 27 of 50 cases, and identified AVF with CTA in 14 of 50 (P < 0.001). Mean feeding arteries identified with TWIST was significantly more than that with CTA (2.08 ± 1.72 vs 1.62 ± 1.52, P = 0.02).

Conclusion: TWIST is a reliable imaging modality for the assessment of lower extremity tumors. TWIST is comparable to CTA for the identification of AVF and feeding arteries.

References

Anzidei M, Cavallo Marincola B, Napoli A, Saba L, Zaccagna F, Lucatelli P . Low-dose contrast-enhanced time-resolved MR angiography at 3T: diagnostic accuracy for treatment planning and follow-up of vascular malformations. Clin Radiol. 2011; 66(12):1181-92. DOI: 10.1016/j.crad.2011.08.003. View

Wang H, Zheng L, Feng Y, Xie X, Zhao J, Wang X . A comparison of 3D-CTA and 4D-CE-MRA for the dynamic monitoring of angiogenesis in a rabbit VX2 tumor. Eur J Radiol. 2010; 81(1):104-10. DOI: 10.1016/j.ejrad.2010.03.022. View

Ekelund L, Herrlin K, Rydholm A . Comparison of computed tomography and angiography in the evaluation of soft tissue tumors of the extremities. Acta Radiol Diagn (Stockh). 1982; 23(1):15-27. DOI: 10.1177/028418518202300103. View

Vigen K, Peters D, Grist T, Block W, Mistretta C . Undersampled projection-reconstruction imaging for time-resolved contrast-enhanced imaging. Magn Reson Med. 2000; 43(2):170-6. DOI: 10.1002/(sici)1522-2594(200002)43:2<170::aid-mrm2>3.0.co;2-p. View

Murakami A, Chang A, Foo L . Traumatic Lateral Plantar Artery Pseudoaneurysm and the Use of Time-Resolved MR Angiography. HSS J. 2011; 6(2):214-8. PMC: 2926369. DOI: 10.1007/s11420-010-9170-3. View

Wang Y, Chen C, Chabra S, Winchester P, Khilnani N, Watts R . Bolus arterial-venous transit in the lower extremity and venous contamination in bolus chase three-dimensional magnetic resonance angiography. Invest Radiol. 2002; 37(8):458-63. DOI: 10.1097/00004424-200208000-00007. View

Lohan D, Tomasian A, Saleh R, Krishnam M, Finn J . Hypervascular thyroid nodules on time-resolved MR angiography at 3 T: radiologic-pathologic correlation. AJR Am J Roentgenol. 2008; 190(4):W255-60. DOI: 10.2214/AJR.07.3137. View

Morelli J, Runge V, Ai F, Zhang W, Li X, Schmitt P . Magnetic resonance evaluation of renal artery stenosis in a swine model: performance of low-dose gadobutrol versus gadoterate meglumine in comparison with digital subtraction intra-arterial catheter angiography. Invest Radiol. 2012; 47(6):376-82. DOI: 10.1097/RLI.0b013e3182539554. View

Willinek W, Hadizadeh D, von Falkenhausen M, Urbach H, Hoogeveen R, Schild H . 4D time-resolved MR angiography with keyhole (4D-TRAK): more than 60 times accelerated MRA using a combination of CENTRA, keyhole, and SENSE at 3.0T. J Magn Reson Imaging. 2008; 27(6):1455-60. DOI: 10.1002/jmri.21354. View

10.

Carter J, Evans T, Tucker J . Cytologic diagnosis of alveolar soft part sarcoma of the lower extremity by fine needle aspiration and correlation with core biopsy: a case report. Acta Cytol. 2008; 52(4):459-63. DOI: 10.1159/000325553. View

11.

Farb R, Agid R, Willinsky R, Johnstone D, terBrugge K . Cranial dural arteriovenous fistula: diagnosis and classification with time-resolved MR angiography at 3T. AJNR Am J Neuroradiol. 2009; 30(8):1546-51. PMC: 7051603. DOI: 10.3174/ajnr.A1646. View

12.

Blackham K, Passalacqua M, Sandhu G, Gilkeson R, Griswold M, Gulani V . Applications of time-resolved MR angiography. AJR Am J Roentgenol. 2011; 196(5):W613-20. DOI: 10.2214/AJR.10.4227. View

13.

Wu J, Hochman M . Soft-tissue tumors and tumorlike lesions: a systematic imaging approach. Radiology. 2009; 253(2):297-316. DOI: 10.1148/radiol.2532081199. View

14.

Hadizadeh D, Jost G, Pietsch H, Weibrecht M, Perkuhn M, Boschewitz J . Intraindividual quantitative and qualitative comparison of gadopentetate dimeglumine and gadobutrol in time-resolved contrast-enhanced 4-dimensional magnetic resonance angiography in minipigs. Invest Radiol. 2014; 49(7):457-64. DOI: 10.1097/RLI.0000000000000036. View

15.

Katayama H, Yamaguchi K, Kozuka T, Takashima T, Seez P, Matsuura K . Adverse reactions to ionic and nonionic contrast media. A report from the Japanese Committee on the Safety of Contrast Media. Radiology. 1990; 175(3):621-8. DOI: 10.1148/radiology.175.3.2343107. View

16.

Kertesz J, Anderson S, Murakami A, Pieroni S, Rhea J, Soto J . Detection of vascular injuries in patients with blunt pelvic trauma by using 64-channel multidetector CT. Radiographics. 2009; 29(1):151-64. DOI: 10.1148/rg.291085508. View

17.

Mascalchi M, Bianchi M, Quilici N, Mangiafico S, Ferrito G, Padolecchia R . MR angiography of spinal vascular malformations. AJNR Am J Neuroradiol. 1995; 16(2):289-97. PMC: 8338322. View

18.

Schernthaner R, Stadler A, Lomoschitz F, Weber M, Fleischmann D, Lammer J . Multidetector CT angiography in the assessment of peripheral arterial occlusive disease: accuracy in detecting the severity, number, and length of stenoses. Eur Radiol. 2007; 18(4):665-71. DOI: 10.1007/s00330-007-0822-8. View

19.

Morsey H, Aslam M, Standfield N . Patients with critical ischemia of the lower limb are at risk of developing kidney dysfunction. Am J Surg. 2003; 185(4):360-3. DOI: 10.1016/s0002-9610(02)01406-x. View

20.

Reisinger C, Gluecker T, Jacob A, Bongartz G, Bilecen D . Dynamic magnetic resonance angiography of the arteries of the hand. A comparison between an extracellular and an intravascular contrast agent. Eur Radiol. 2008; 19(2):495-502. DOI: 10.1007/s00330-008-1149-9. View