Gadobenate dimeglumine-enhanced MR angiography: Diagnostic performance of four doses for detection and grading of carotid, renal, and aorto-iliac stenoses compared to digital subtraction angiography
✍ Scribed by Günther Schneider; Claudio Ballarati; Luigi Grazioli; Riccardo Manfredi; Siegfried Thurnher; Thomas J. Kroencke; Matthias Taupitz; Biagio Merlino; Lorenzo Bonomo; Ningyan Shen; Gianpaolo Pirovano; Miles A. Kirchin; Alberto Spinazzi
- Book ID
- 102907030
- Publisher
- John Wiley and Sons
- Year
- 2007
- Tongue
- English
- Weight
- 590 KB
- Volume
- 26
- Category
- Article
- ISSN
- 1053-1807
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✦ Synopsis
Abstract
Purpose
To determine the diagnostic performance of contrast‐enhanced MR angiography (CE‐MRA) with four doses of gadobenate dimeglumine for detection of significant steno‐occlusive disease of the carotid, renal, and pelvic vasculature.
Materials and Methods
Eighty‐four patients with suspected disease of the renal (n = 16), pelvic (n = 41), or carotid (n = 27) arteries underwent CE‐MRA (3D‐spoiled gradient‐echo sequences) at 1.5T. CE‐MRA was performed with gadobenate dimeglumine at 0.025, 0.05, 0.1, or 0.2 mmol/kg (23, 24, 19, and 18 patients, respectively) administered at 2 mL/sec. Accuracy, sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively) for detection of significant disease (>50% stenosis or occlusion for renal/pelvic arteries; >70% stenosis or occlusion for carotid arteries) was determined by three fully blinded, independent radiologists using conventional digital subtraction angiography (DSA) as reference standard. All comparisons were tested statistically (ANOVA, chi‐square, and Mantel–Haenszel tests as appropriate) and reader agreement (kappa) was assessed.
Results
Values for accuracy, sensitivity, specificity, PPV, and NPV on CE‐MRA were consistently higher for 0.1 mmol/kg gadobenate dimeglumine (accuracy = 95.2–97.3%, sensitivity = 84.2% (all readers), specificity = 96.9–99.2%, PPV = 80.0–94.1%, NPV = 97.6–97.7%). The greater accuracy of the 0.1 mmol/kg dose was significant (P < 0.01, all readers) compared to all other dose groups. Agreement between the three readers was good for all dose groups (kappa ≥0.58), with the highest percent agreement (85.7%) noted for the 0.1 mmol/kg dose.
Conclusion
Significantly better diagnostic performance on CE‐MRA of the renal, pelvic, and carotid arteries is achieved with a gadobenate dimeglumine dose of 0.1 mmol/kg bodyweight. J. Magn. Reson. Imaging 2007;26:1020–1032. © 2007 Wiley‐Liss, Inc.