| Critical lower-limb ischemia: the diagnostic performance of dual-phase injection MR angiography (including high-resolution distal imaging) compared with digital subtraction angiography. | |
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MedLine Citation:
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PMID: 19081736 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To prospectively compare contrast-enhanced (CE) magnetic resonance (MR) angiography against digital subtraction angiography (DSA) in patients with critical lower-limb ischemia. MATERIALS AND METHODS: Thirty patients with critical lower limb ischemia underwent both CE MR angiography and DSA. CE MR angiography commenced with a dedicated high-resolution study of the below-knee arteries followed by a three-station bolus-chase examination. Two blinded observers recorded the severity of the most significant stenosis within each arterial segment. Interobserver agreement was calculated and, with DSA as the reference standard, the sensitivity and specificity of CE MR angiography for the detection of significant stenosis (>or=50% luminal narrowing) or occlusion was calculated. RESULTS: All 390 arterial segments were scored by both observers. Sensitivity was higher in the distal segments (92%-96%) compared with the proximal segments (69%-79%). Specificity was similar in distal (90%-91%) and more proximal segments (86%-96%). Overall, interobserver agreement was excellent (kappa = 0.95 for CE MR angiography and DSA) and was superior within the distal segments. Twenty-eight segments that were considered occluded on DSA were shown to be patent on CE MR angiography and 16 segments that were considered occluded on CE MR angiography were shown to be patent on DSA. CONCLUSIONS: In patients with critical lower-limb ischemia, CE MR angiography with high-resolution distal imaging is highly accurate for assessment of the below-knee arteries. Both DSA and CE MR angiography may identify patent vessels that are considered occluded based on the other modality. |
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Authors:
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Andrew R Owen; Iain R Robertson; Ganesan Annamalai; Giles H Roditi; Richard D Edwards; Lilian S Murray; Jon G Moss |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't Date: 2008-12-10 |
Journal Detail:
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Title: Journal of vascular and interventional radiology : JVIR Volume: 20 ISSN: 1535-7732 ISO Abbreviation: J Vasc Interv Radiol Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-01-26 Completed Date: 2009-04-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203369 Medline TA: J Vasc Interv Radiol Country: United States |
Other Details:
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Languages: eng Pagination: 165-72 Citation Subset: IM |
Affiliation:
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Department of Interventional Radiology, Austin Health, 145 Studley Road, Heidelberg, Melbourne, Australia. andrewowen@doctors.org.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Angiography, Digital Subtraction / methods* Contrast Media Female Gadolinium DTPA / diagnostic use* Humans Ischemia / diagnosis* Leg / blood supply*, pathology, radiography Magnetic Resonance Angiography / methods* Male Middle Aged Observer Variation Reproducibility of Results Sensitivity and Specificity |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 122795-43-1/gadodiamide; 80529-93-7/Gadolinium DTPA |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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