Subtractionless first-pass single contrast medium dose peripheral MR angiography using two-point Dixon fat suppression

To investigate the feasibility of subtractionless first-pass single contrast medium dose (0.1 mmol/kg) peripheral magnetic resonance angiography (MRA) at 1.5 T using two-point Dixon fat suppression and compare it with conventional subtraction MRA in terms of image quality. Twenty-eight patients (13 male, 15 female; mean age +/- standard deviation, 66 +/- 16 years) with known or suspected peripheral arterial disease underwent subtractionless and subtraction first-pass MRA at 1.5 T using two-point Dixon fat suppression. Results were compared with regard to vessel-to-background contrast. A phantom study was performed to assess the signal-to-noise ratio (SNR) of both MRA techniques. Two experienced observers scored subjective image quality. Agreement regarding subjective image quality was expressed in quadratic weighted kappa values. Vessel-to-background contrast improved in all anatomical locations with the subtractionless method versus the subtraction method (all P <0.001). Subjective image quality was uniformly higher with the subtractionless method (all P <0.03, except for the aorto-iliac arteries for observer 1, P = 0.052). SNR was 15 % higher with the subtractionless method (31.9 vs 27.6). This study demonstrates the feasibility of subtractionless first-pass single contrast medium dose lower extremity MRA. Moreover, both objective and subjective image quality are better than with subtraction MRA. aEuro cent MRA is increasingly used for vascular applications. aEuro cent Dixon imaging offers an alternative to image subtraction for fat suppression. aEuro cent Subtractionless first-pass peripheral MRA is possible using two-point Dixon fat suppression. aEuro cent Subtractionless peripheral MRA is possible at 1.5 T a single contrast medium dose. aEuro cent Subtractionless first-pass peripheral MRA provides good image quality with few non-diagnostic studies.