Comparative value of helical CT-angiography, 2D TOF MR-angiography and 3D Gadolinium enhanced MRA in aorto-iliac occlusive disease

Purpose. To compare helical CT-angiography (CTA) and two techniques of MR a ngiography (MRA) to conventional angiography in aorto-iliac occlusive disea se. Materials and Methods. The abdominal aorta and iliac arteries in 22 patient s (4 for preoperative assessment of abdominal aortic aneurysm and 18 for pe ripheral vascular disease) were imaged using four techniques: digital subtr action angiography ("gold standard"), 2D TOF MR angiography, 3D Gd-enhanced MR angiography and helical CT angiography. Source (CTA and 2D TOF MRA) and MIPed images (after subtraction measures before and after gadolinium injec tion for 3D Gd-MRA) were reviewed. Results. Sensitivity, specificity and accuracy for the detection of signifi cant (>50%) stenosis and occlusion of aorto-iliac arteries were respectivel y: 38%, 89%, 77% for 2D TOF MRA; 75%, 71%, 72% for 3D Gd-MRA and 95%, 90%, 92% for CTA. Excluding the internal iliac arteries, results were 54%, 96%, 88% for 2D TOF MRA; 96%, 80%, 83% for 3D Gd-MRA and 92%, 93%, 95% for CTA. Conclusion. 3D Gd-MRA, a technique with potential for further improvement, is superior to 2D TOF MRA for detecting significant stenosis and occlusion of aorto-iliac arteries. Results at Gd-MRA are nearly similar to those at C TA (after excluding internal iliac arteries). Results at Gd-MRA are not aff ected by calcified plaque.