Intra-arterial MR-angiography on an open-bore MR-scanner compared to digital-subtraction angiography of the infra-popliteal runoff in patients with peripheral arterial occlusive disease.
OBJECTIVE
To evaluate the diagnostic value of contrast-enhanced intra-arterial 3D-MR-angiography (IA-MRA) of the infra-popliteal arteries in an open-bore magnet. Number, severity of arterial lesions, and artefacts were compared to routinely performed intra-arterial digital-subtraction angiography (IA-DSA) in patients suffering from symptomatic peripheral arterial occlusive disease (PAOD).


METHODS
Fifteen patients admitted for PAOD underwent percutaneous transluminal angioplasty (PTA) by IA-DSA. After PTA, IA-MRA of the infra-popliteal station was performed on an open-bore 1.5T MR-scanner applying a low dose intra-arterial contrast-enhanced 3D-gradient-echo-MRA with gadopentate dimeglumine. The reading was performed by three blinded readers distinguishing moderate (< or =50%), significant stenoses (51-99%) and vessel occlusions. Imaging artefacts were recorded and binary classified as not disturbing or compromising the observation of the arterial tree.


RESULTS
Overall IA-DSA revealed 36 moderate stenoses (< or =50%), 38 significant stenoses (51-99%), and 10 vessel occlusions. For the detection of significant stenoses and occlusions, the overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of IA-MRA were 96%, 83%, 88%, 94% and 90%. The only observed artefact was venous overlay in four stations. The readout was not hampered in any case.


CONCLUSIONS
Intra-arterial contrast-enhanced 3D-gradient-echo-MRA on an open-bore MR-scanner offers an acceptable diagnostic accuracy in diagnosing peripheral arterial occlusive disease in the infra-popliteal region and correlates well with DSA.
Huegli
Rolf W
RW
Department of Radiology University Hospital of Basel, Petersgraben 4, 4031 Basel, Switzerland. rhuegli@uhbs.ch
Thalhammer
Christoph
C
Jacob
Augustinus L
AL
Jaeger
Kurt
K
Bilecen
Deniz
D
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D016477:Artifacts; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D021621:Imaging, Three-Dimensional; D007866:Leg / Q000098:blood supply*; D018810:Magnetic Resonance Angiography / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D011150:Popliteal Artery; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D003287:Contrast Media; D019786:Gadolinium DTPA