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Non-contrast MR angiography of pelvic arterial vasculature using the Quiescent interval slice selective (QISS) sequence

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Abstract

To evaluate Quiescent Interval Slice Selective (QISS) balanced steady-state free precession (bSSFP) and QISS fast low-angle shot (FLASH) sequences for non-contrast Magnetic Resonance Angiography (MRA) of iliac arteries regarding image quality and diagnostic confidence in order to establish these sequences in daily clinical practice. A prospective study of healthy subjects (n = 10) was performed. All subjects underwent the QISS MRI protocol with bSSFP und FLASH sequences. Vessel contrast-to-background ratio (VCBR) were measured in pre-defined vessel segments. Image quality and diagnostic confidence was assessed using a Likert scale (five-point scale). Inter-reader agreement was determined using Cohen’s kappa coefficient (κ). Ten healthy subjects (median age 29 years, IQR: 26.25 to 30 years) were included in this prospective study. Median MR examination time was 2:05 min (IQR 1:58 to 2:16) for QISS bSSFP and 4:11 min (IQR 3:57 to 4:32) for QISS FLASH. Both sequences revealed good VCBR in all examined vessel segments. VCBR (muscle tissue) were marginally higher for FLASH sequences (e.g., 0.82 vs. 0.78 in the right femoral artery, p = 0.035*), while bSSFP sequence showed significantly higher VCBR (fat tissue) in the majority of examined arterials vessels (e.g., 0.78 vs. 0.62 in right femoral artery, p = 0.001*). The image quality and diagnostic confidence of both sequences were rated as good to excellent. Moderate to good inter-reader agreement was found. QISS MRA using bSSFP and FLASH sequences are diagnostic for visualization of iliac arterial vasculature. The QISS bSSFP sequence might offer advantages due to the markedly shorter exam time and superior visualization of smaller vessels. The QISS FLASH sequence seems to be a robust alternative for non-contrast MRA since it is less sensitive to magnetic field inhomogeneities.

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Authors and Affiliations

  1. Department for Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany

    Patrick Ghibes, Christoph Artzner, Gerd Grözinger & Florian Hagen

  2. Interventional Radiology Section, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, OH, USA

    Sasan Partovi

  3. Department of Cardiovascular Surgery, German Heart Center Munich at the Technical University of Munich, Munich, Germany

    Carl-Mattheis Wahl

  4. Section on Experimental Radiology, University Hospital Tübingen, Tübingen, Germany

    Petros Martirosian

  5. Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany

    Patrick Ghibes

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Correspondence to Patrick Ghibes.

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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

The authors have no relevant financial or non-financial interests to disclose.

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Patrick Ghibes and Florian Hagen. The first draft of the manuscript was written by Patrick Ghibes and Sasan Partovi and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University of Tuebingen.

Informed consent was obtained from all individual participants included in the study.

The authors affirm that human research participants provided informed consent for publication of the images in Figs. 1, 2 and 3.

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Ghibes, P., Partovi, S., Artzner, C. et al. Non-contrast MR angiography of pelvic arterial vasculature using the Quiescent interval slice selective (QISS) sequence. Int J Cardiovasc Imaging 39, 1023–1030 (2023). https://doi.org/10.1007/s10554-023-02798-x

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