Stepping-table gadolinium-enhanced digital subtraction MR angiography of the aorta and lower extremity arteries: Preliminary experience

PURPOSE: To compare stepping-table digital subtraction gadolinium-enhanced magnetic resonance (MR) angiography of the distal aorta and lower extremity arteries with conventional catheter digital subtraction x-ray angiography in patients with arterio-occlusive disease. MATERIALS AND METHODS: Twenty patients underwent both conventional catheter angiography and fast three-dimensional gadolinium-enhanced MR angiography of the aorta and outflow vessels at 1.5 T; the images were acquired in thre e consecutive imaging locations during a single infusion of a gadolinium ch elate. RESULTS: Compared with catheter angiography, according to the findings of t wo blinded independent reviewers, MR angiography had sensitivities of 81% a nd 89% and specificities of 91% and 95%, respectively, for demonstration of insignificant (less than or equal to 50%) stenosis versus significant (51% -100%) stenosis. For demonstration of occlusion, the sensitivity and specif icity were 94% and 97%, respectively, by consensus. There was good interobs erver correlation between the two readers overall (kappa = 0.65 for reporti ng the degree of narrowing in all lesions; 0.86, for reporting of insignifi cant versus significant stenoses; and 0.928, for reporting of occluded vers us patent segments). CONCLUSION: Stepping-table digital subtraction contrast material-enhanced M R angiography has high accuracy compared with catheter angiography in patie nts with arterio-occlusive disease of the aorta and outflow vessels, these preliminary, study results suggest that this technique may ultimately provi de a safe, noninvasive, and cost-effective alternative to catheter angiogra phy.