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Diagnostic Performance of Gadobenate Dimeglumine–Enhanced MR Angiography of the Iliofemoral and Calf Arteries: A Large-Scale Multicenter Trial

¹ Department of Radiology and Nuclear Medicine, Hospital Brothers of St. John of God, Grosse Mohrengasse 9, Vienna, Austria A-1020.
² Department of Diagnostic Radiology, Eberhardt Karls University, Tuebingen, Germany.
³ Department of Diagnostic Radiology, Homburg University Hospital, Homburg/Saar, Germany.
⁴ Department of Radiology, Hospital Valduce, Como, Italy.
⁵ Institute for Diagnostic Radiology, University Hospital, Basel, Switzerland.
⁶ Medical Prevention Center, University Mxedical Center, Hamburg-Eppendorf, Germany.
⁷ Institute of Clinical Radiology, Ludwig Maximilians University, Munich, Germany.
⁸ U.C.O. di Radiologia, Ospedale di Cattinara, Trieste, Italy.
⁹ Department of Radiology, Ospedale Cà Foncello, Treviso, Italy.
¹⁰ Crawford Long Hospital, Atlanta, GA.
¹¹ Department of Radiology, Università G. D'Annunzio, Chieti, Italy.
¹² Institut für Radiologie, Charité-Universitäts medizin, Berlin, Germany.
¹³ Department of Radiology, Johns Hopkins Medical Center, Baltimore, MD.
¹⁴ Klinikum der Johannes, Gutenberg Universität, Mainz, Germany.
¹⁵ Worldwide Medical and Regulatory Affairs, Bracco Imaging SpA, Milan, Italy.
¹⁶ Worldwide Medical and Regulatory Affairs, Bracco Diagnostics Inc., Princeton, NJ.

View larger version (38K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —52-year-old man with Leriche syndrome. Contrast-enhanced MR angiography (CE-MRA) with 0.1 mmol/kg of gadobenate dimeglumine displays entire peripheral runoff vasculature to calf arteries. Short segment occlusion of right common iliac artery and high-grade stenosis of left common iliac artery are evident (arrows, B).

View larger version (99K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —52-year-old man with Leriche syndrome. Contrast-enhanced MR angiography (CE-MRA) with 0.1 mmol/kg of gadobenate dimeglumine displays entire peripheral runoff vasculature to calf arteries. Short segment occlusion of right common iliac artery and high-grade stenosis of left common iliac artery are evident (arrows, B).

View larger version (45K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —52-year-old man with Leriche syndrome. Unenhanced time-of-flight MR angiography shows occlusion of both common iliac arteries and suggests segmental occlusion of calf arteries. However, image quality is compromised by venous overlay.

View larger version (182K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1D —52-year-old man with Leriche syndrome. Digital subtraction angiography confirms findings of CE-MRA examination.

View larger version (49K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —54-year-old man with mild upper right leg claudication. Contrast-enhanced MR angiography (CE-MRA) with 0.1 mmol/kg of gadobenate dimeglumine displays entire peripheral runoff vasculature to calf arteries. Moderate stenoses are apparent in right common iliac artery (arrow, B) and right superficial femoral artery (arrow, C).

View larger version (129K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —54-year-old man with mild upper right leg claudication. Contrast-enhanced MR angiography (CE-MRA) with 0.1 mmol/kg of gadobenate dimeglumine displays entire peripheral runoff vasculature to calf arteries. Moderate stenoses are apparent in right common iliac artery (arrow, B) and right superficial femoral artery (arrow, C).

View larger version (52K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —54-year-old man with mild upper right leg claudication. Contrast-enhanced MR angiography (CE-MRA) with 0.1 mmol/kg of gadobenate dimeglumine displays entire peripheral runoff vasculature to calf arteries. Moderate stenoses are apparent in right common iliac artery (arrow, B) and right superficial femoral artery (arrow, C).

View larger version (102K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2D —54-year-old man with mild upper right leg claudication. Unenhanced time-of-flight MR angiography overestimates extent of stenosis in right common iliac artery (arrow, D) and underestimates stenosis in right superficial femoral artery (arrow, E).

View larger version (30K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2E —54-year-old man with mild upper right leg claudication. Unenhanced time-of-flight MR angiography overestimates extent of stenosis in right common iliac artery (arrow, D) and underestimates stenosis in right superficial femoral artery (arrow, E).

View larger version (148K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2F —54-year-old man with mild upper right leg claudication. Digital subtraction angiography confirms findings of CE-MRA examination: Moderate stenoses are apparent in right common iliac artery (arrow, F) and right superficial femoral artery (arrow, G).

View larger version (81K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2G —54-year-old man with mild upper right leg claudication. Digital subtraction angiography confirms findings of CE-MRA examination: Moderate stenoses are apparent in right common iliac artery (arrow, F) and right superficial femoral artery (arrow, G).

View larger version (39K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —59-year-old man with moderate to severe upper left leg claudication. Contrast-enhanced MR angiography (CE-MRA) with 0.1 mmol/kg of gadobenate dimeglumine reveals aneurysm, high-grade stenosis of left common iliac artery (arrow, B), and high-grade stenosis of left superficial femoral artery (arrow, C).

View larger version (109K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —59-year-old man with moderate to severe upper left leg claudication. Contrast-enhanced MR angiography (CE-MRA) with 0.1 mmol/kg of gadobenate dimeglumine reveals aneurysm, high-grade stenosis of left common iliac artery (arrow, B), and high-grade stenosis of left superficial femoral artery (arrow, C).

View larger version (54K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —59-year-old man with moderate to severe upper left leg claudication. Contrast-enhanced MR angiography (CE-MRA) with 0.1 mmol/kg of gadobenate dimeglumine reveals aneurysm, high-grade stenosis of left common iliac artery (arrow, B), and high-grade stenosis of left superficial femoral artery (arrow, C).

View larger version (113K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —59-year-old man with moderate to severe upper left leg claudication. Unenhanced time-of-flight MR angiography (TOF MRA) fails to adequately show vascular disease in left common iliac artery because of artifacts caused by turbulent flow (arrow, D). High-grade stenosis in left superficial femoral artery is underestimated on TOF MRA (arrow, E).

View larger version (41K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3E —59-year-old man with moderate to severe upper left leg claudication. Unenhanced time-of-flight MR angiography (TOF MRA) fails to adequately show vascular disease in left common iliac artery because of artifacts caused by turbulent flow (arrow, D). High-grade stenosis in left superficial femoral artery is underestimated on TOF MRA (arrow, E).

View larger version (146K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3F —59-year-old man with moderate to severe upper left leg claudication. Digital subtraction angiography confirms findings of CE-MRA examination: Note aneurysm, high-grade stenosis of left common iliac artery (arrow, F), and high-grade stenosis of left superficial femoral artery (arrow, G).

View larger version (55K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3G —59-year-old man with moderate to severe upper left leg claudication. Digital subtraction angiography confirms findings of CE-MRA examination: Note aneurysm, high-grade stenosis of left common iliac artery (arrow, F), and high-grade stenosis of left superficial femoral artery (arrow, G).

View larger version (35K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —66-year-old man with diabetes. Contrast-enhanced MR angiography (CE-MRA) with 0.1 mmol/kg of gadobenate dimeglumine reveals severe stenosis (arrow) of left popliteal artery. In addition, bilateral occlusion of posterior tibial artery and segmental stenoses of anterior tibial artery and tibiofibular trunk are apparent.

View larger version (53K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —66-year-old man with diabetes. Digital subtraction angiography confirms high-grade stenosis (arrow) of left popliteal artery and arterial disease of calf arteries.

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