Reliability of contrast-enhanced MR angiography in evaluation of nitinol stent restenosis in iliac arteries

Reliability of contrast-enhanced MR angiography in evaluation of nitinol stent restenosis in iliac arteries | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Reliability of contrast-enhanced MR angiography in evaluation of nitinol stent restenosis in iliac arteries Miroslav Malík, Iveta Waczulíková, Peter Mikula, Magdaléna Mižičková, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7716240/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Objective : In this observational study, contrast-enhanced MR angiography (MRA) was evaluated against digital subtraction angiography (DSA) in the stented segments of the iliac arteries to determine MRA's accuracy in diagnosing restenosis following stent placement. Patients and Methods : Six radiologists independently evaluated the degree of restenosis in the MRA and DSA images of 87 nitinol stents implanted in 53 patients with peripheral arterial disease. The differences in restenosis assessment between these two modalities, along with inter-observer agreement, were analysed using DSA as a reference. Discrepancy between methods was quantified by the MRA-DSA difference in % restenosis. Correlation, regression, and agreement analysis tools were used for evaluation. Results : A significant mean MRA-DSA difference of 14.0 % (P ˂ 0.001) in the assessment of restenosis severity between the MRA and DSA was found. In isolated cases, the discrepancy reached 50-60 %. The discrepancy negatively correlated with the degree of restenosis, showing a systematic proportional bias. The agreement analysis revealed a good-to-excellent inter-observer reliability measured by the intraclass correlation coefficient ICC. In general, the DSA observers were more similar and consistent in their ratings compared to the MRA observers (0.876 and 0.651, respectively). Diagnostic performance of the MRA in detecting high-grade (≥50 %) restenosis yielded a sensitivity of 78.57 % and a specificity of 67.12 %. Conclusion: MRA showed an acceptable-to-good sensitivity and specificity for diagnosing restenosis after placement of nitinol stent in iliac arteries, though it significantly overestimated lumen diameter narrowing at low-grade restenosis. In disputed cases, we recommend verification using Doppler sonography. Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 22 Oct, 2025 Reviews received at journal 22 Oct, 2025 Reviews received at journal 17 Oct, 2025 Reviewers agreed at journal 09 Oct, 2025 Reviewers agreed at journal 08 Oct, 2025 Reviewers agreed at journal 02 Oct, 2025 Reviewers invited by journal 29 Sep, 2025 Editor assigned by journal 29 Sep, 2025 Submission checks completed at journal 29 Sep, 2025 First submitted to journal 25 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7716240","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":527063131,"identity":"65db7e75-e95d-4c6f-8c26-6d93a9c849ce","order_by":0,"name":"Miroslav Malík","email":"","orcid":"","institution":"University Hospital Bratislava","correspondingAuthor":false,"prefix":"","firstName":"Miroslav","middleName":"","lastName":"Malík","suffix":""},{"id":527063132,"identity":"5a62c27c-ddfd-4fa8-bf15-be3e9f39b855","order_by":1,"name":"Iveta Waczulíková","email":"","orcid":"","institution":"Comenius University 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The differences in restenosis assessment between these two modalities, along with inter-observer agreement, were analysed using DSA as a reference. Discrepancy between methods was quantified by the MRA-DSA difference in % restenosis. Correlation, regression, and agreement analysis tools were used for evaluation.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e: A significant mean MRA-DSA difference of 14.0 % (P ˂ 0.001) in the assessment of restenosis severity between the MRA and DSA was found. In isolated cases, the discrepancy reached 50-60 %. The discrepancy negatively correlated with the degree of restenosis, showing a systematic proportional bias. The agreement analysis revealed a good-to-excellent inter-observer reliability measured by the intraclass correlation coefficient ICC. In general, the DSA observers were more similar and consistent in their ratings compared to the MRA observers (0.876 and 0.651, respectively). Diagnostic performance of the MRA in detecting high-grade (≥50 %) restenosis yielded a sensitivity of 78.57 % and a specificity of 67.12 %.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e MRA showed an acceptable-to-good sensitivity and specificity for diagnosing restenosis after placement of nitinol stent in iliac arteries, though it significantly overestimated lumen diameter narrowing at low-grade restenosis. In disputed cases, we recommend verification using Doppler sonography.\u003c/em\u003e\u003c/p\u003e","manuscriptTitle":"Reliability of contrast-enhanced MR angiography in evaluation of nitinol stent restenosis in iliac arteries","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-10 14:17:32","doi":"10.21203/rs.3.rs-7716240/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-22T13:28:34+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-22T11:10:12+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-17T09:15:15+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"241424384206299659392914531558700186231","date":"2025-10-09T06:32:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"161886679130569409312432509321190284649","date":"2025-10-08T18:39:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"131494307801576045564459140102408283033","date":"2025-10-02T16:45:36+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-29T10:54:48+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-29T05:00:22+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-29T04:59:48+00:00","index":"","fulltext":""},{"type":"submitted","content":"Bratislava Medical Journal","date":"2025-09-25T22:06:43+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bratislava-medical-journal","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Bratislava Medical Journal](https://link.springer.com/journal/44411)","snPcode":"44411","submissionUrl":"https://submission.springernature.com/new-submission/44411/3","title":"Bratislava Medical Journal","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"4b87dcbb-919e-487d-bbc9-d06f6cd77d05","owner":[],"postedDate":"October 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-11-13T13:38:21+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-10 14:17:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7716240","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7716240","identity":"rs-7716240","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}