Lower extremity occlusive disease: diagnostic imaging with a combination of cardiac-gated 2D phase-contrast and cardiac-gated 2D time-of-flight MRA.
OBJECTIVE
The goal of this work was to test the ability of a combination of 2D phase-contrast MR angiography (2D-PC-MRA) and triggered 2D time-of-flight MRA (2D-TOF-MRA) in comparison to intraarterial digital subtraction angiography (DSA) to correctly diagnose the location and shape of occlusive lesions in the iliac and femoral arteries and to determine whether 2D-TOF-MRA is helpful to clarify questionable lesions demonstrated by 2D-PC-MRA.


METHODS
In 50 patients with claudication, 2D-PC-MRA was performed in three consecutive coronal positions from the aortic bifurcation to below the trifurcation. Axial 2D-TOF-MRA was performed additionally at the site of detected lesions of >50% and lesions in doubt to obtain more precise information about the stenosis. Lesions were classified as follows: low grade occlusion, <50%; high grade occlusion, >50%. MRA was performed within 24 h of a DSA examination.


RESULTS
In all patients, the arterial tree from the aortic bifurcation to the trifurcation could be visualized. One hundred twelve lesions were detected by MRA. Sensitivity was 96% and specificity was 92%. Sixty-two lesions were classified as high grade occlusion and reevaluated. In this category, sensitivity was 100% and specificity was 96%.


CONCLUSIONS
The combination of 2D-PC-MRA with triggered 2D-TOF-MRA detects stenotic lesions in the lower extremity arterial system with high sensitivity and specificity.
Department of Radiology, Christian Albrechts University Kiel, Germany.
J C
JC
Steffens
J
J
Link
H
H
Schwarzenberg
S
S
Mueller-Huelsbeck
G
G
Brinkmann
M
M
Heller
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000473:pathology; D007383:Intermittent Claudication / Q000175:diagnosis / Q000000981:diagnostic imaging; D007866:Leg / Q000098:blood supply*; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity