Treatment planning in patients with PAOD:Comparison of CE-MRA employing a dedicated peripheral MRA coil and high dose single volume contrast material application with i.a. DSA.
OBJECTIVE
To evaluate whether contrast enhanced MRA (CE-MRA), including a dedicated MRA coil and a high dose of contrast material, correlates to i.a. digital subtraction angiography (DSA) when used for treatment planning in patients with peripheral arterial obstructive disease (PAOD).


RESULTS
A retrospective CE-MRA and i.a. DSA comparison was used to evaluate 2200 vessel segments with stenosis or occlusion in the pelvic or lower extremity arteries in 100 patients. A 1.5T MR unit (Magnetom Symphony Quantum, Siemens) employing a peripheral angiography array surface coil and automatic table movement was used. The interventional approach was planned according to both CE-MRA and DSA findings. Visual material was blinded and reviewed by two experienced radiologists.In 98.95% (Observer 1) and 98.1% (Observer 2) CE-MRA revealed an exact correlation of the grade as well as length of stenosis compared to DSA. The sensitivity was 100% and 95.3% for observers 1 and 2 and its specificity 98.3% and 100%, respectively. The interobserver agreement between was 0.98 and 0.96 for observers 1 and 2, respectively. Suggested treatment and interventional approach based on the CE-MRA findings corresponded to DSA in 97%.


CONCLUSIONS
CE-MRA is an excellent modality for treatment planning in patients with PAOD. Especially in patients with restenosis or reocclusion, CE-MRA enables an accurate, non-invasive diagnosis and facilitates treatment planning.
Balzer
Jörn O
JO
Dept. of Diagnostic and Interventional Radiology, Univ. Clinic, Johann Wolfgang Goethe-University Frankfurt/Main, Germany.
Gundelsheimer
Verena
V
Khan
Verena
V
Mack
Martin G
MG
Peters
Jutta
J
Schmitz-Rixen
Thomas
T
Vogl
Thomas J
TJ