INTERPRETATIONS AND TREATMENT DECISIONS BASED ON MR-ANGIOGRAPHY VERSUS CONVENTIONAL ARTERIOGRAPHY IN SYMPTOMATIC LOWER-EXTREMITY ISCHEMIA

PURPOSE: To determine the frequency with which treatment plans based o n findings at magnetic resonance angiography (MRA) match those based o n findings at conventional x-ray arteriography (XRA) in the evaluation of symptomatic lower extremity ischemia. PATIENTS AND METHODS: Two-di mensional time-of-flight (TOF) MRA was performed in 42 patients underg oing XRA for evaluation of symptomatic lower extremity ischemia, The b lind interpretations and treatment plans based on MRA findings were co mpared with those based on XRA findings, with use of XRA as the standa rd of reference, RESULTS: For identification of hemodynamically signif icant stenosis or occlusion, the sensitivity and specificity of MRA wa s 100% and 23% for iliac segments, 100% and 82% for common femoral seg ments, 89% and 67% for superficial femoral segments, 100% and 88% for popliteal segments, and 92% and 91% for tibioperoneal segments, respec tively, The treatment plan based on MRA findings matched that based on XRA findings in 41% of patients. CONCLUSION: For evaluation of sympto matic lower extremity ischemia, two-dimensional TOF MRA cannot be cons idered a reliable substitute for XRA in patients who lack contraindica tions to XRA.