EVALUATION OF THE ILIAC ARTERIES - COMPARISON OF 2-DIMENSIONAL TIME-OF-FLIGHT MAGNETIC-RESONANCE ANGIOGRAPHY WITH CARDIAC COMPENSATED FAST GRADIENT RECALLED ECHO AND CONTRAST-ENHANCED 3-DIMENSIONAL TIME-OF-FLIGHT MAGNETIC-RESONANCE ANGIOGRAPHY

We compared dynamic contrast-enhanced three-dimensional time of night (3DTOF) magnetic resonance angiography (MRA) with two-dimensional time of flight (2DTOF) MRA with cardiac compensated fast gradient recalled echo (C-MON) and conventional angiography (CA) when it was available, C-MON re-orders the normal data acquisition to minimize ghosting arti facts generated by pulsatile now, The initial phase of the study invol ved optimization of parameters and comparison C-MON with no C=MON in e ight patients and volunteers, The final phase of the study involved 53 patients who were imaged with contrast-enhanced 3DTOF MRA and 2DTOF M RA with C-MON. Thirty of these patients also had CA. In the initial ph ase, 2DTOF MRA with C-MON was found to be equal (n = 3) or superior (n = 5) to 2DTOF without C-MON. In the final phase, the agreement among all imaging modalities varied from substantial to almost perfect (Cohe n's kappa = .6-.83). The lowest agreement was using 2DTOF to evaluate the external iliac segments. The among suggested treatments varied fro m substantial to almost perfect for all imaging modalities (Cohen's ka ppa = .73-93). The diagnostic efficacies of 2DTOF with C-MON and contr ast-enhanced 3DTOF were high overall, with the lowest value being a sp ecificity of 63% for one reader in the evaluation of an external iliac segment using 2DTOF. In summary, 2DTOF with C-MON helped to eliminate artifacts due to pulsatility in the iliac arterial segments. In our e xperience, both dynamic contrast-enhanced 3DTOF MRA and 2DTOF MRA with . C-MON performed well in the evaluation of the iliac arteries. Both s tudies have high interobserver agreement and high diagnostic efficacy. Contrast-enhanced 3DTOF MRA should be reserved for situations in whic h the iliac vessels are extremely tortuous or occluded or the external Mac segments are poorly seen.