title: Magnetic resonance imaging of angiographically occult runoff vessels in peripheral arterial occlusive disease.
abstract: BACKGROUND
  Bypass grafting to arteries of the lower leg has become standard surgical management of advanced peripheral vascular disease. Its success depends on identifying suitable distal vessels. Preoperative preparation includes imaging of the arteries of the lower leg, usually by conventional contrast arteriography. An alternative procedure, magnetic resonance (MR) angiography, has been successfully employed in patients with various cardiovascular diseases, but its possible value in patients with peripheral vascular disease has received little attention.
  
  
  METHODS
  We used both conventional and MR angiography in preoperative studies of the lower-leg vessels of 23 patients (25 legs) with peripheral arteriosclerosis and arterial insufficiency, and developed independent therapeutic plans based on the information provided by each technique. When the plans differed, the interventional procedure judged more likely to save the limb was performed. The findings of conventional and MR angiography were verified by intraoperative arteriography, postinterventional arteriography, or direct operative exploration.
  
  
  RESULTS
  MR angiography detected all vessels identified by conventional angiography, whereas conventional arteriography failed to detect 22 percent of the runoff vessels identified by MR angiography. The detection by MR angiography of vessels not identified by conventional angiography altered the surgical management of the disorders of four patients (17 percent) and guided successful bypass procedures.
  
  
  CONCLUSIONS
  MR angiography is a noninvasive technique with greater sensitivity than conventional contrast arteriography for detecting distal runoff vessels in patients with peripheral arterial occlusive disease.
authors.affiliation: Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia.
authors.forename: R S
authors.initials: RS
authors.lastname: Owen
authors.forename: J P
authors.initials: JP
authors.lastname: Carpenter
authors.forename: R A
authors.initials: RA
authors.lastname: Baum
authors.forename: L J
authors.initials: LJ
authors.lastname: Perloff
authors.forename: C
authors.initials: C
authors.lastname: Cope
mesh_terms: D000368:Aged; D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D008279:Magnetic Resonance Imaging; D008297:Male; D011300:Preoperative Care; D012680:Sensitivity and Specificity