MR Angiography to Evaluate Peripheral Vascular Disease

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Summary and Comment

MR Angiography to Evaluate Peripheral Vascular Disease.

Peripheral arterial magnetic resonance (MR) angiography is still evolving and undergoing refinement, but in some hands its accuracy is already impressive.

In a study from the Netherlands, researchers evaluated several MR angiographic techniques in 28 patients with claudication who on Doppler ultrasound were suspected to have iliac or femoral artery stenoses. On conventional angiography, used as the gold standard, these patients had 37 stenoses of 50 percent or more. With subtracted gadolinium-enhanced MR angiography, two readers achieved sensitivities of 92 percent and 95 percent, respectively, and specificities of 93 percent, for identifying these stenoses.

In a second study, the same group used a technique called "moving-bed infusion-tracking MR angiography" to image the entire peripheral arterial system from aorta to lower leg in just four minutes. With conventional angiography as the standard, two readers achieved sensitivities of 91 percent and 95 percent, and specificities of 98 percent, for detecting significant stenoses among 28 patients using MR angiography.

Comment: An editorialist suggests that "the time has come" to allow MR to replace conventional angiography in certain cases. However, another study in the same issue of Radiology reminds us that the accurate interpretation of MR images should not be taken for granted: among four readers, accuracy varied considerably and correlated clearly with experience.

— AS Brett

Published in Journal Watch General Medicine March 20, 1998

Citation(s):

Ho KY et al. Peripheral vascular tree stenoses: Detection with subtracted and nonsubtracted MR angiography. Radiology 1998 Mar 206 673-681.

Medline abstract (Free)

Ho KY et al. Peripheral vascular tree stenoses: Evaluation with moving-bed infusion-tracking MR angiography. Radiology 1998 Mar 206 683-692.

Medline abstract (Free)

Prince MR. Peripheral vascular MR angiography: The time has come. Radiology 1998 Mar 206 592-593.

Medline abstract (Free)

Quinn SF et al. Aortic and lower-extremity arterial disease: Evaluation with MR angiography versus conventional angiography. Radiology 1998 Mar 206 693-701.