title: Contrast-enhanced magnetic resonance angiography in diabetic patients with infra-genicular peripheral arterial disease: systematic review.
abstract: OBJECTIVE
  Diabetes is a leading risk factor for the development of peripheral arterial disease (PAD). The optimal imaging modality for patients with diabetes and PAD is uncertain. We sought to analyse the literature to determine the accuracy of contrast enhanced magnetic resonance angiography (CE-MRA) in differentiating extent of disease in patients with infragenicular PAD and diabetes, using digital subtraction angiography (DSA) as the gold standard.
  
  
  METHODS
  Online databases were searched for relevant keywords (January 1998-June 2012). Eligible studies prospectively compared CE-MRA and DSA of infragenicular vessels and provided data to construct contingency tables in at least 10 patients with diabetes and PAD symptoms. Pooled sensitivity and specificity values were calculated using random effects modelling.
  
  
  RESULTS
  Only three studies (83 patients) provided data regarding the infragenicular vessels. The pooled sensitivity of MRA was 86% while the pooled specificity of MRA was 93%.
  
  
  CONCLUSIONS
  The assumptions regarding CE-MRA's efficacy for infragenicular disease in diabetics are based upon low patient numbers. Inadequate diagnostic imaging in this high-risk group risks adoption of incorrect revascularisation strategies. Further studies are required.
authors: Department of Vascular Surgery and Radiology, Vascular Research Unit, University Hospital Limerick, Limerick, Ireland.
authors: D A
authors: DA
authors: Healy
authors: E M
authors: EM
authors: Boyle
authors: M
authors: M
authors: Clarke Moloney
authors: P A
authors: PA
authors: Hodnett
authors: T
authors: T
authors: Scanlon
authors: P A
authors: PA
authors: Grace
authors: S R
authors: SR
authors: Walsh
mesh_terms: D048909:Diabetes Complications / Q000473:pathology*; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000473:pathology