Non- contrast MR angiography with balanced steady- state free precession based on flow- sensitive dephasing: a preliminary study in hand arterial diseases

Objective To evaluate the diagnostic value of non- enhanced MR angiography with balanced steady- state free precession based on flow- sensitive dephasing (FSD- bSSFP) in hand arterial diseases of patients with rheumatoid arthritis. Methods Non-enhanced MR with FSD-bSSFP sequence and enhanced MR with CEMRA sequence were used to scan the hand arteries of 24 patients with clinically confirmed rheumatoid arthritis in Guangzhou Panyu District Central Hospital and Peking University Shenzhen Hospital between October 2014 and October 2015. The quality of scanned images, severity of arterial stenosis, signal to noise ratio (SNR) and contrast- noise ratio (CNR) in these patients were compared prospectively. Results Twenty - four patients underwent successful MR scan with FSD and CEMRA sequences of totally 192 vascular segments. FSD scan visualized 165 (165/192, 86% ) blood vessels, compared with 125 (125/192, 65%) by CEMRA scan, with statistically significant difference between the two sequences (P=0.000). Evaluation of image quality showed that a mean score of 2.33±1.05 by FSD scan vs 3.56±0.90 by CEMRA scan, and a lower score at each vessel segments by FSD sequence compared with CEMRA sequence (P=0.001). There was a significant difference in SNR between FSD and CEMRA sequence at each vessel branches (P=0.019). Conclusion In patients with rheumatoid arthritis, the value of the newly- introduced non- enhanced MR angiography with FSD- bSSFP sequence is superior to CEMRA in diagnosing hand arterial diseases, and can be a useful alternative MRA method in patients with renal insufficiency. Key words: Magnetic resonance angiography; Arthritis, rheumatoid; Angiography