Thomas Josef Vogl MD, PhD, Presenter: Nothing to Disclose

Clemens Wurz BA, Abstract Co-Author: Nothing to Disclose

Stefan Zangos MD, Abstract Co-Author: Nothing to Disclose

Axel Thalhammer MD, Abstract Co-Author: Nothing to Disclose

Thomas Schmitz-Rixen MD, PhD, Abstract Co-Author: Nothing to Disclose

To compare contrast-enhanced magnetic resonance angiography (MRA) with conventional digital subtraction angiography (DSA) for detecting stenoses and planning of therapy in patients with peripheral artery occlusion disease (PAOD).

In this retrospective study 71 patients (20 women / 51 men; mean: 68 years) with established PAOD underwent both imaging modalities in a maximum interval of 40 days. DSA was the standard of reference. The pelvic and leg arteries were divided into 31 anatomic segments, which were graded on a scale from 1-4 (1=no stenosis; 2=stenoses < 70%; 3=stenoses≥70%; 4=occlusion). The pelvic and leg vessel systems were categorized with the TASC II-score into five grades (none, TASC-A, TASC-B, TASC-C, TASC-D) for detecting whether the therapeutic consequences would be the same for both imaging modalities.

Evaluation was possible for 1,937 vessel segments. MRA and DSA agreed in the grading of 1,802 segments (93.03%), and differed in 69 cases in one category, in 28 cases in two and in 38 cases in three categories. In discriminating between hemodynamically relevant (≥70% / occlusion) and non-hemodynamically relevant findings (< 70% / nonstenosis) MRA achieved a sensitivity of 90.59% and a specificity of 96.61%. Evaluation of TASC II-classification for the aorto-iliacal region was possible in 56 patients. In 52 patients TASC II-class was the same for DSA and MRA (92.86%; κ=0.88), for the femoral-popliteal region the result was nearly the same, the evaluation of 56 patients showed agreement in 52 patients (92.86%; κ=0.90).

There was almost perfect agreement between MRA and DSA in the TASC classification. Thus, the therapeutic consequences are predominantly the same, irrespective of the modality used.

Contrast-enhanced MRA is a valid method for detecting and grading stenoses in patients with PAOD.

Vogl, T, Wurz, C, Zangos, S, Thalhammer, A, Schmitz-Rixen, T, Contrast-enhanced Magnetic Resonance Angiography (MRA) vs. Digital Subtraction Angiography (DSA): Grading of Stenosis and Therapy Planning in Peripheral Artery Occlusion Disease (PAOD).  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005974.html