Institute for Diagnostic, Interventional and Pediatric Radiology and Division of Angiology, Swiss Cardiovascular Center, University of Bern-Inselspital, Freiburgstrasse 10, 3010 Bern, Switzerland.
Radiology. 2009 Dec;253(3):879-90. doi: 10.1148/radiol.2533081627. Epub 2009 Oct 28.
To prospectively compare the diagnostic accuracy of steady-state, high-spatial-resolution magnetic resonance (MR) angiography of the lower leg, performed with a blood pool contrast agent, with selective digital subtraction angiography (DSA) as the reference standard in patients with symptomatic peripheral arterial disease.
Local ethics committee approval and written informed consent were obtained. In a nonrandomized trial, selective DSA and MR angiography were performed at 3.0 T with a blood pool contrast agent on 22 calves in 20 patients (mean age, 69.4 years +/- 11.3 [standard deviation]), 16 men (mean age, 67.8 years +/- 12.4) and four women (mean age, 75.6 years +/- 3.6 years), to evaluate 352 arterial segments. DSA and MR angiography were performed within 24 hours of each other and directly compared by three experienced, blinded radiologists by using high-spatial-resolution steady-state MR angiograms. Consensus reading for both DSA and MR angiography served as the reference standard.
MR angiography was successful and occurred without serious adverse events in all patients. Seven significantly stenosed and 40 occluded segments were rated equally in both modalities. In three cases, the tibial arteries were shown to be occluded or significantly stenosed at DSA but appeared normal or significantly stenosed at MR angiography. The respective average segment sensitivity, specificity, and accuracy were 98.3% (59 of 60), 98% (113.7 of 116), and 98.1% (172.7 of 176) for DSA and 100% (60 of 60), 100% (116 of 116), and 100% (176 of 176) for MR angiography. Steady-state MR angiography was especially useful for the distal peroneal artery and the proximal anterior tibial artery.
MR angiography performed with blood pool agents has an accuracy comparable with that of selective DSA in the lower leg but with less risk involved. Steady-state imaging performed with blood pool agents facilitates evaluation of MR angiography of infrapopliteal arteries.
前瞻性比较下肢应用血池对比剂稳态高分辨率磁共振（MR）血管成像与选择性数字减影血管造影（DSA）的诊断准确性，以选择性 DSA 作为参考标准，用于有症状外周动脉疾病患者。
获得当地伦理委员会批准和书面知情同意。在一项非随机试验中，在 20 名患者（平均年龄，69.4 岁 +/- 11.3 [标准差]）的 22 条小腿中进行了 3.0T 下应用血池对比剂的选择性 DSA 和 MR 血管成像，共评估 352 个动脉节段，包括 16 名男性（平均年龄，67.8 岁 +/- 12.4）和 4 名女性（平均年龄，75.6 岁 +/- 3.6 岁）。DSA 和 MR 血管成像在彼此 24 小时内进行，并由三位经验丰富的盲法放射科医生使用高分辨率稳态 MR 血管造影直接比较。DSA 和 MR 血管成像的共识阅读作为参考标准。
所有患者均成功完成 MR 血管成像，无严重不良事件。两种方式均显示 7 个显著狭窄段和 40 个闭塞段。在 3 例中，DSA 显示胫骨动脉闭塞或显著狭窄，但 MR 血管成像显示正常或显著狭窄。相应的平均节段灵敏度、特异性和准确性分别为 DSA 为 98.3%（60/60）、98%（113.7/116）和 98.1%（172.7/176），MR 血管成像为 100%（60/60）、100%（116/116）和 100%（176/176）。稳态 MR 血管成像特别适用于腓动脉远端和胫前动脉近端。
下肢应用血池对比剂的 MR 血管成像具有与选择性 DSA 相当的准确性，但风险较低。应用血池对比剂的稳态成像有助于评估下肢的血管成像。
