Jc. Steffens et al., Lower extremity occlusive disease: Diagnostic imaging with a combination of cardiac-gated 2D phase-contrast and cardiac-gated 2D time-of-flight MRA, J COMPUT AS, 23(1), 1999, pp. 7-12
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
Purpose: The goal of this work was to test the ability of a combination of
2D phase-contrast MR angiography (2D-PC-MRA) and triggered 2D time-of-fligh
t MRA (2D-TOF-MRA) in comparison to intraarterial digital subtraction angio
graphy (DSA) to correctly diagnose the location and shape of occlusive lesi
ons in the iliac and femoral arteries and to determine whether 2D-TOF-MRA i
s helpful to clarify questionable lesions demonstrated by 2D-PC-MRA.
Methods: In 50 patients with claudication, 2D-PC-MRA was performed in three
consecutive coronal positions from the aortic bifurcation to below the tri
furcation. Axial 2D-TOF-MRA was performed additionally at the site of detec
ted lesions of >50% and lesions in doubt to obtain more precise information
about the stenosis. Lesions were classified as follows: low grade occlusio
n, <50%; high grade occlusion, >50%. MRA was performed within 24 h of a DSA
Results: In all patients, the arterial tree from the aortic bifurcation to
the trifurcation could be visualized. One hundred twelve lesions were detec
ted by MRA. Sensitivity was 96% and specificity was 92%. Sixty-two lesions
were classified as high grade occlusion and reevaluated. In this category,
sensitivity was 100% and specificity was 96%.
Conclusion: The combination of 2D-PC-MRA with triggered 2D-TOF-MRA detects
stenotic lesions in the lower extremity arterial system with high sensitivi
ty and specificity.