Title | Diagnostic accuracy of time-resolved 2D projection MR angiography for symptomatic infrapopliteal arterial occlusive disease. |
Publication Type | Journal Article |
Year of Publication | 2005 |
Authors | Zhang HLei, Khilnani NM, Prince MR, Winchester PA, Golia P, Veit P, Watts R, Wang Y |
Journal | AJR Am J Roentgenol |
Volume | 184 |
Issue | 3 |
Pagination | 938-47 |
Date Published | 2005 Mar |
ISSN | 0361-803X |
Keywords | Adult, Aged, Aged, 80 and over, Arterial Occlusive Diseases, Female, Humans, Magnetic Resonance Angiography, Male, Middle Aged, Popliteal Artery, Reproducibility of Results, Retrospective Studies, Time Factors |
Abstract | OBJECTIVE: Our objective was to evaluate the diagnostic accuracy of time-resolved 2D projection MR angiography in detecting calf and pedal artery occlusive disease. MATERIALS AND METHODS: Time-resolved MR angiography of calf and pedal arteries was performed on 59 symptomatic legs of 52 patients using the head coil and bolus injections of 6 mL of gadolinium contrast medium. Selective X-ray digital subtraction angiography was performed within 30 days after MR angiography. Calf and pedal arteries were divided into 10 segments. X-ray digital subtraction angiography and MR angiography images were retrospectively interpreted by three expert observers, who graded segments as having no significant stenosis, significant stenosis (> 50%), or occlusion. The accuracy of MR angiography interpretations was compared with the accuracy of consensus X-ray digital subtraction angiography interpretations as the standard of reference. Arterial segments with discrepant grading on X-ray digital subtraction angiography and MR angiography were reviewed again to determine the reasons for disagreement. RESULTS: Arterial phase MR angiography images free of venous contamination were obtained in every case. The agreement between MR angiography and X-ray digital subtraction angiography in depicting infrapopliteal arterial disease was fair to good (kappa = 0.44-0.92). Overall sensitivity and specificity were 83% and 87%, respectively, for detecting significant stenosis of calf and pedal arteries and 86% and 93%, respectively, for detecting occlusions. Accuracy was higher in the larger vessels-for example, calf (84%) compared with foot (71%). In 21% (22/105) of the segments graded differently on MR angiography than on X-ray digital subtraction angiography, it was believed that MR angiography was more likely to be correct than X-ray digital subtraction angiography because of visualization of late-filling arteries on MR angiography that did not opacify on X-ray digital subtraction angiography. CONCLUSION: Time-resolved 2D projection MR angiography accurately evaluates calf and pedal arteries without degradation from venous contamination. |
DOI | 10.2214/ajr.184.3.01840938 |
Alternate Journal | AJR Am J Roentgenol |
PubMed ID | 15728621 |
Related Institute:
MRI Research Institute (MRIRI)