Magnetic resonance angiography of the peripheral vessels in patients with peripheral arterial occlusive disease: when is an additional conventional angiography required?
The purpose of this work was to find out how often the clinician asks for a conventional angiography (CA) in patients with peripheral arterial occlusive disease (PAOD) after a magnetic resonance angiography (MRA) has been performed and how often the CA reveals additional information for therapy planning. Quality criteria for the MRA were defined and tested to see whether they can predict the need for an additional CA. In this prospective study, 81 patients suffering from PAOD (Fontaine classification IIa, n = 13; IIb, n = 33; III, n = 10; IV, n = 25) were examined with a 1.5-T MR-scanner with dedicated coils using a step-by-step technique. The vascular surgeon decided whether he could plan the therapy on the basis of the MRA or if he needed an additional CA. The MRA was assessed in terms of the image quality of the MRA and regarding therapeutic management of the patient in a two-grade scale: sufficient and insufficient. In 27/81 (33%) patients, the clinician asked for a CA, which revealed new information in only 11 patients. The relative number of MRAs with insufficient image quality was significantly higher (p < 0.01) in the group with additional information on CA (8/11) compared to the group without additional information (0/16). The assessment of an MRA based on image quality and regarding therapeutic management of the patient might reduce the number of CAs for therapy planning in patients with PAOD.
Janka
R
R
Institute of Radiology, Friedrich-Alexander-University, Erlangen-Nürnberg, Erlangen, Germany. rolf.janka@idr.imed.uni-erlangen.de
Wenkel
E
E
Fellner
C
C
Lang
W
W
Bautz
W
W
Uder
M
M
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007866:Leg / Q000098:blood supply*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D011446:Prospective Studies; D016896:Treatment Outcome
D003287:Contrast Media; D019786:Gadolinium DTPA