Aortoiliac and lower extremity arteries: Comparison of three-dimensional dynamic contrast-enhanced subtraction MR angiography and conventional angiography

PURPOSE: To determine the clinical feasibility of three-dimensional dynamic contrast agent-enhanced subtraction magnetic resonance (MR) angiography in patients with symptoms of lower extremity ischemia. MATERIALS AND METHODS: Twenty-three patients suspected of having lower extr emity ischemia underwent three-dimensional dynamic contrast-enhanced subtra ction MR angiography of the aortoiliac arteries and arteries of the lower e xtremity. As the reference standard, conventional angiography was also perf ormed. For data analysis, the arterial system was divided into 10 segments. Each segment was classified as normal, mildly stenosed, moderately stenose d, severely stenosed, or occluded. RESULTS: At conventional angiography, 83 stenosed segments (14 mildly steno sed, 16 moderately stenosed, 14 severely stenosed, and 39 occluded) were id entified in a total of 423 segments. For the segments with more than mild s tenosis, MR angiography was 97.1% sensitive and 99.2% specific. CONCLUSION: Three-dimensional dynamic contrast-enhanced subtraction MR angi ography has high sensitivity and specificity. This technique is a noninvasi ve alternative to conventional angiography for screening patients suspected of having lower extremity ischemia.