title: Prospective double-blinded comparison of MR imaging and aortography in the preoperative evaluation of abdominal aortic aneurysms.
abstract: The authors conducted a prospective double-blind study comparing spin-echo axial and coronal magnetic resonance (MR) imaging with aortography in the preoperative evaluation of 20 patients with abdominal aortic aneurysms. Receiver-operating-characteristic (ROC) analysis was used to evaluate the performance of MR imaging versus aortography in assessing arterial stenotic disease. Both modalities were equivalent in demonstrating the upper extent of the abdominal aortic aneurysms with respect to the renal and visceral arteries. MR imaging was superior in demonstrating aneurysmal iliac arteries and intraluminal thrombus. Although aberrant venous anatomy, associated pathologic changes, and other concomitant lesions were demonstrated with MR imaging, it performed poorly in assessing arterial stenoses and occlusions. Thus, the authors caution against the routine substitution of spin-echo MR imaging for aortography in the evaluation of abdominal aortic aneurysms. Conventional angiography should continue to be performed in patients with suspected mesenteric ischemia, significant hypertension, and symptomatic iliofemoral atherosclerosis, at least until robust MR angiographic techniques have proved themselves under similar rigorous clinical evaluation.
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.
authors.forename: K
authors.initials: K
authors.lastname: Kandarpa
authors.forename: D
authors.initials: D
authors.lastname: Piwnica-Worms
authors.forename: P S
authors.initials: PS
authors.lastname: Chopra
authors.forename: D F
authors.initials: DF
authors.lastname: Admas
authors.forename: M G
authors.initials: MG
authors.lastname: Hunink
authors.forename: M C
authors.initials: MC
authors.lastname: Donaldson
authors.forename: A D
authors.initials: AD
authors.lastname: Whittemore
authors.forename: J A
authors.initials: JA
authors.lastname: Mannick
authors.forename: D P
authors.initials: DP
authors.lastname: Harrington
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal; D001014:Aortic Aneurysm / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D001027:Aortography; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011300:Preoperative Care; D011446:Prospective Studies; D012372:ROC Curve