Diagnostic accuracy of contrast-enhanced magnetic resonance angiography and duplex ultrasound in patients with peripheral vascular disease.
BACKGROUND
Noninvasive techniques such as duplex ultrasound (DU) and contrast-enhanced magnetic resonance angiography (CE-MRA) are valid alternatives in the preoperative evaluation of such patients. Our aim is to assess the diagnostic accuracy of CE-MRA and DU in patients with peripheral arterial disease (PAD).


METHODS
Forty consecutive patients underwent DU, hybrid CE-MRA, and digital subtraction angiography (DSA). Magnetic resonance angiography and DSA images were evaluated independently and in a blinded fashion. Every segment was graded as normal, stenosed less than 50%, stenosed more than 50%, or occluded.


RESULTS
There were 1720 segments for analysis. Duplex ultrasound depicting stenosis >50% demonstrated a sensitivity (S) 81.4%, specificity (E) 99%, positive predictive value (PPV) 96.2%, and negative predictive value (NPV) 94.8%. Occlusions showed S 90%, E 97%, PPV 98.1%, and NPV 88.4%. Magnetic resonance angiography depicting stenosis >50% demonstrated a S 91%, E 99%, PPV 96.7%, and NPV 97.6%. Occlusions showed S 95.4%, E 98%, PPV 98.4%, and NPV 94.7%.


CONCLUSIONS
Combined CE-MRA and DU is the first diagnostic approach in the preoperative assessment of PAD, leading to the use of DSA for selected cases.
Bueno
Alicia
A
Vascular Surgery Department, Hospital Universitario de Getafe, Madrid, Spain. abueno10@gmail.com
Acín
Francisco
F
Cañibano
Cristina
C
Fernandez-Casado
Jose L
JL
Castillo
E
E
D015901:Angiography, Digital Subtraction; D003251:Constriction, Pathologic; D003287:Contrast Media; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D018810:Magnetic Resonance Angiography; D008536:Meglumine / Q000031:analogs & derivatives*; D015588:Observer Variation; D009942:Organometallic Compounds; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging* / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013030:Spain; D018616:Ultrasonography, Doppler, Duplex
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine