Rapid magnetic resonance angiography for detection of atherosclerosis

Background Choice of treatment for atherosclerosis depends on various clinical factors and radiological techniques. We aimed to assess the diagnostic accuracy of a new three-dimensional magnetic resonance angiography (3D MRA) strategy for the display of arterial vasculature from supraaortic arteries to distal runoff vessels in 72 s. Methods We examined five healthy volunteers and six patients over 6 weeks. Conventional digital subtraction angiography (DSA) was available as reference standard in all six patients. Magnetic resonance imaging was done on a commercially available 1.5 Tesla scanner. The imaging technique was based on the acquisition of five 3D data sets in rapid succession with an optimum single injection protocol. Findings Compared with conventional catheter angiography, according to the findings of two independent and masked readers, whole-body MRA had overall sensitivities of 91% (95% CI 0.76-0.98) and 94% (0.8-0.99), and specificities of 93% (0.85-0.97) and 90% (0.82-0.96) for the detection of substantial vascular disease (luminal narrowing >50%). Interobserver agreement for assessment of whole-body magnetic angiograms was very good (kappa =0.94: 95% CI 0.9-0.98). Interpretation The technique provides a comprehensive noninvasive approach for morphological screening assessment of the arterial vasculature from supra-aortic arteries to the distal runoff arteries.