Gadolinium-enhanced magnetic resonance angiography, digital subtraction angiography and duplex of the iliac arteries compared with intra-arterial pressure gradient measurements.
OBJECTIVE
to compare gadolinium-enhanced magnetic resonance angiography (Gd-MRA), digital subtraction angiography (DSA) and duplex of the iliac arteries with intra-arterial pressure gradient measurement as the reference method.


METHODS
Gd-MRA, DSA and duplex examinations of the iliac arteries were performed in 30 patients (60 arteries) with lower-limb arterial occlusive disease. In 29 arteries, pressure measurements were made (n=25) or the artery was found to be occluded on catheterisation (n=4). An aortofemoral peak systolic pressure gradient of 20 mmHg or more was regarded as haemodynamically significant. Stenoses with a diameter reduction of 50% or more on MRA or DSA, or an increase in peak systolic velocity greater than 150% (duplex) were considered significant. MRA examinations were evaluated by means of maximum intensity projections (MRA-MIP) and using source images and curved multiplanar reconstruction (MRA-MPR).


RESULTS
the sensitivity (specificity) for a significant iliac artery stenosis were 81% (75%) for MRA-MIP, 76% (75%) for MRA-MPR, 86% (88%) for DSA, and 72% (88%) for duplex.


CONCLUSIONS
with intra-arterial pressure measurements as the reference method, similar results were achieved with Gd-MRA, DSA and duplex concerning the detection of haemodynamically significant iliac artery stenoses. The use of source images and multiplanar reconstructions resulted in higher accuracy for the detection of occlusions.
Wikström
J
J
Department of Diagnostic Radiology, Uppsala University Hospital, Uppsala, Sweden.
Holmberg
A
A
Johansson
L
L
Löfberg
A M
AM
Smedby
O
O
Karacagil
S
S
Ahlström
H
H
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000503:physiopathology; D001794:Blood Pressure; D001795:Blood Pressure Determination; D002406:Catheterization, Peripheral; D003287:Contrast Media / Q000008:administration & dosage; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D007275:Injections, Intravenous; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018616:Ultrasonography, Doppler, Duplex
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA