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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
Author(s) -
Schneider Günther,
Ballarati Claudio,
Grazioli Luigi,
Manfredi Riccardo,
Thurnher Siegfried,
Kroencke Thomas J.,
Taupitz Matthias,
Merlino Biagio,
Bonomo Lorenzo,
Shen Ningyan,
Pirovano Gianpaolo,
Kirchin Miles A.,
Spinazzi Alberto
Publication year - 2007
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.21127
Subject(s) - medicine , digital subtraction angiography , stenosis , nuclear medicine , radiology , magnetic resonance angiography , occlusion , kappa , angiography , magnetic resonance imaging , linguistics , philosophy
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.