COMPARISON OF 2-DIMENSIONAL MR DIGITAL SUBTRACTION ANGIOGRAPHY OF THELOWER-EXTREMITY WITH X-RAY ANGIOGRAPHY

PURPOSE: To perform a preliminary evaluation of the diagnostic accurac y of contrast-enhanced, two-dimensional (2D) magnetic resonance (MR) d igital subtraction angiography (DSA) of the lower extremity by compari son with x-ray angiography (XRA). MATERIALS AND METHODS: Forty lower e xtremities in 22 patients were imaged at multiple levels with both XRA and 2D MR DSA. Images were retrospectively analyzed by three radiolog ists in a randomized blinded manner. Seventeen vascular segments were graded as an insignificant lesion, a significant lesion, or as an occl usion, With the use of segments well depicted with XRA as the gold sta ndard, the sensitivity, specificity, and accuracy of 2D MR DSA, as com pared with XRA, were evaluated. The McNemar-Stuart-Maxwell test was pe rformed to determine the significance of any differences found. RESULT S: Three hundred eighty-three arterial segments were evaluated with bo th techniques. Three hundred one segments were well depicted with XRA, There was no significant difference between 2D MR DSA and XRA for ass essing the degree of occlusive disease in these 301 segments (.25 < P <.5), The sensitivity, specificity, and diagnostic accuracy of 2D MR D SA were found to be 90%, 98%, and 93%, respectively. CONCLUSION: Two-d imensional MR DSA is an accurate method for assessing arterial lesions in the lower extremity.