Contrast-enhanced moving-table MR angiography: Prospective comparison to catheter arteriography for treatment planning in peripheral arterial occlusive disease

PURPOSE: Prospective comparison of contrast-enhanced moving-table magnetic resonance (MR) angiography to catheter arteriography in endovascular and su rgical treatment planning in patients with peripheral arterial occlusive di sease. MATERIALS AND METHODS: Thirteen patients scheduled for catheter arteriograp hy for lower extremity arterial occlusive disease underwent contrast-enhanc ed moving-table MR angiography immediately prior to arteriography. A treatm ent plan was determined by the vascular surgeon, based on MR angiography, w ho was blinded to the catheter arteriogram. The treatment plan determined b y the MR angiogram was compared to the final treatment plan, which was base d on the catheter arteriogram and intraluminal pressure measurements. RESULTS: Treatment plans based on MR angiography and catheter arteriography were identical in 10 of 13 patients (71%). For identifying lesions resulti ng in intervention, MR angiography had sensitivity of 100% and a positive p redictive value of 92%. MR angiography had a treatment specific predictive value of 88% for each lesion identified, and 95% for lesions identified in patients evaluated for claudication. If treatment plans were based on MR an giography only, 46% of patients would have avoided catheter arteriography. CONCLUSION: Contrast-enhanced moving-table MR angiography may be an effecti ve alternative to catheter arteriography in endovascular and surgical treat ment planning in selected patients with peripheral arterial occlusive disea se, but larger studies are necessary to confirm this.