Peripheral vascular surgery and magnetic resonance arteriography--a review.
OBJECTIVE
to review the current status of lower limb MRA.


METHODS
a literature review based predominantly on a MEDLINE database search of English-language publications from January 1991 to October 2000.


METHODS
twenty-eight articles, concerning non-enhanced MRA (13), gadolinium-enhanced MRA (14) or both (1), met the predefined requirement for quality. Results gadolinium-enhanced MRA (CE-MRA) seems to be more accurate, quicker and associated with fewer problems than non-enhanced (TOF) MRA. TOF-MRA has a sensitivity and specificity of 93% (range 64-100%) and 88% (range 57-100%) respectively, and CE-MRA presents values of 96% (range 71-100%) and 96% (63-100%), respectively, using conventional arteriography as the gold standard. Some articles report a substantial incidence of runoff vessels suitable for distal bypass visible on MRA but invisible on conventional arteriography. Gadolinium contrast is given intravenously and is generally well tolerated and has no known nephrotoxicity.


CONCLUSIONS
CE-MRA is accurate compared to conventional arteriography, has the potential to increase the limb salvage rate for selected patients, is non-invasive and well tolerated.
Eiberg
J P
JP
Department of Vascular Surgery RK, Rigshospitalet 3111, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
Lundorf
E
E
Thomsen
C
C
Schroeder
T V
TV
D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000601:surgery; D003287:Contrast Media; D005682:Gadolinium; D006801:Humans; D007866:Leg / Q000098:blood supply*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000601:surgery; D012680:Sensitivity and Specificity
D003287:Contrast Media; D005682:Gadolinium