Arterial stenosis of the lower extremities is the most common cause of amputation in diabetic patients [1]. Contrast-enhanced (CE) MR angiography (MRA) is routinely used for imaging of lower extremity arteries, but the images suffer from poor spatial resolution and venous contamination, which is due to the short first pass window of contrast agents. Recently an optimized non-contrast-enhanced (NCE) MRA technique using iMSDE prepared bSSFP acquisition was proposed and showed great potential for lower extremity stenosis examination in healthy volunteers [2]. The purpose of this study was to assess the image quality of the iMSDE prepared NCE-MRA technique and evaluate its feasibility of arterial stenosis detection in diabetic patients, with the CE-MRA method as a reference.The study was approved by local institutional review board. 14 type 2 diabetes (11 males, 49-75 years) were recruited and scanned with our NCE-MRA and CE-MRA techniques on a Achieva 1.5T scanner (Philips Medical System, Best, Netherlands). MR Imaging For NCE-MRA, imaging parameters were: TR/TE=4.1/2.1 ms, Flip angle 90°, FOV=340×359×80 mm3, acquisition matrix: 284×298, 67 slices, resolution 1.2 mm3 isotropic, SENSE factor 2, scan time 4-6min/station; CE-MRA imaging: TR/TE=2.7/0.96 ms, FOV=360×360×112 mm3, acquisition matrix: 256×200, 70 slices, resolution 1.4×1.8 mm2, scan time:≈29.4 sec-1.54min/station. Image analysis Image quality of all images were assessed on Philips MR WorkSpace (Extended MR WorkSpace, 2.6.3.3, 2011) by a radiologist with 10 years’ experience in cardiovascular imaging. Location and extent of arterial stenosis were reviewed by another two radiologist with prior information blinded to each other. Statistical analysis A paired t-test was used to compare the differences of signal to noise ratio (SNR) and artery-muscle contrast to noise ratio (CNR) between NCE-MRA and CE-MRA techniques (SPSS 20, IBM, Armonk, NY, USA ). a p value of 0.05 or less was considered to be statistically significant. All subjects successfully underwent NCE-MRA and CE-MRA of the lower extremities. Of all the patients, a high percentage of arterial segments with stenosis was confirmed on the NCE-MRA techniques (185/196=94%, p = 0.185). The average SNR on NCE-MRA was higher than those on CE-MRA (161.0±136.6 vs 111.4±72.9, p=0.013, Table 1) and no significant difference of the average CNR on NCE-MRA and CE-MRA was found (p=0.068).In this study, the feasibility of the optimized iMSDE prepared NCE-MRA technique, which allows for easier and faster scan, was evaluated using the CE-MRA as a reference. Our NCE-MRA showed a high percentage of stenosis segments and provides higher image quality than the CE-MRA. The NCE-MRA technique is capable of clear depiction and accurate detection of the whole lower extremity arterial tree in patients with diabetes.