Non-Contrast-Enhanced MR Angiography (NCE-MRA) of the Hand Using Flow-Sensitive Dephasing (FSD)-Prepared Steady-State Free Precession (SSFP) in Patients with Rheumatoid Arthritis

Abstract

To evaluate the clinical potential of a non-contrast-enhanced magnetic resonance angiography (NCE-MRA) technique using flow-sensitive dephasing (FSD)-prepared steady-state free precession (SSFP), FSD-NCE-MRA, for hand arterial angiography in patients with rheumatoid arthritis. Twenty-four patients were recruited and underwent FSD-NCE-MRA on a 1.5T MR system. For comparison, conventional dynamic CE-MRA was also conducted after the FSD-NCE-MRA scan. Images obtained by both FSD-NCE-MRA and CE-MRA were independently evaluated by two experienced radiologists using a four-point scale and the hand arteries were divided into wrist, palm and finger segments for image quality assessment. Signal-to-noise ratio (SNR), artery-to-muscle contrast-to-noise ratio (CNR), and vessel sharpness of superficial/deep palmar arch and common digital artery were also measured by a physician. Experimental results demonstrated that FSD-NCE-MRA yielded a higher percentage of diagnostic value arterial segments than CE-MRA (96 vs. 83 %, P < 0.05). Besides, average SNR, CNR, and vessel sharpness were also higher on FSD-NCE-MRA images than CE-MRA ones (SNR: 57 ± 13 vs. 15 ± 4; CNR: 54 ± 13 vs. 13 ± 4; sharpness: 1.1 ± 0.1 vs. 0.9 ± 0.1; all P < 0.05). Thus, FSD-NCE-MRA allows a higher image quality in the depiction of the hand arterial tree for the patients with rheumatoid arthritis compared to CE-MRA. The technique, FSD-NCE-MRA, may be a safe and improved clinical screening tool for the assessment of the hand arteries in rheumatoid arthritis patients without using any contrast agents.