Aortic and lower-extremity arterial disease: evaluation with MR angiography versus conventional angiography.
OBJECTIVE
To compare magnetic resonance (MR) angiography with conventional angiography in evaluation of the aorta and lower-extremity arterial system.


METHODS
Fifty-seven patients were evaluated with femoral conventional and MR angiography. Iliac artery segments were evaluated with two-dimensional and contrast material-enhanced three-dimensional time-of-flight MR angiography. Infrainguinal regions were evaluated with two-dimensional time-of-flight MR angiography with a dedicated lower-extremity coil. Arteries depicted on femoral images were separately interpreted as 20 anatomic segments. Disease classification included normal to moderate disease (0%-50% stenosis), severe stenosis (> 50% stenosis), diffuse disease (more than one severe stenosis), and occlusion. Four readers interpreted the images and rendered treatment recommendations.


RESULTS
Substantial to almost perfect interobserver agreement (kappa, 0.66-1.00) was achieved in most cases for MR angiogram interpretation. The three most experienced readers achieved substantial to almost perfect intraobserver agreement (kappa, 0.61-1.00) between conventional and MR angiogram interpretation in most cases. Among three readers, moderate agreement (kappa, 0.43-0.53) was found between treatment recommendations based on conventional versus MR angiographic findings; for the most experienced reader, this agreement was almost perfect (kappa, 0.90).


CONCLUSIONS
For experienced readers, there was substantial to almost perfect agreement between conventional and MR angiographic image interpretations of the aorta and lower-extremity arterial system.
Quinn
S F
SF
Department of Radiology, Legacy Good Samaritan Hospital and Medical Center, Portland, OR 97210, USA.
Sheley
R C
RC
Semonsen
K G
KG
Leonardo
V J
VJ
Kojima
K
K
Szumowski
J
J
D000368:Aged; D000792:Angiography; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology; D001018:Aortic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology; D003287:Contrast Media; D005260:Female; D005263:Femoral Artery / Q000473:pathology*; D019786:Gadolinium DTPA; D006801:Humans; D007083:Iliac Artery / Q000473:pathology; D007275:Injections, Intravenous; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D015588:Observer Variation; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA