Abstract
Background: We used gadolinium-enhanced three-dimensional magnetic resonance angiography (MRA) as a screening tool for patients with clinical lower extremity arterial occlusive disease. When critical lesions were identified by MRA, digital subtraction angiography (DSA) was performed to determine the choice of therapy: percutaneous transluminal angioplasty, bypass surgery, amputation, or no treatment. Although MRA images are similar to those of DSA, we felt them wee some differences existed. This study compares the two. Methods: Between July 2004 and November 2005, 12 patients had their lower extremities evaluated by both MRA and DSA. Lesions identified by 3D-MRA were classified into 5 types: signal defect, stenosis, diminished signal, slit lesion, or complex lesion. These areas were categorized as occlusion, severe stenosis, mild stenosis, or no lesion on DSA. Results: MRA identified 105 lesions. Twenty-eight areas with a signal defect on MRA were associated with 23 areas of occlusion (82.1%), 4 areas of severe stenosis (14.3%), 1 area of mild stenosis (3.6%), and no areas of no lesion (0%) on DSA; 11 areas of stenosis were associated with no occlusion (0%), 4 areas of severe stenosis (36.4%), 5 areas of mild stenosis (45.5%), and 2 areas of no lesion (18.2%); 34 areas of diminished signal were associated with 1 area of occlusion (2.9%), 12 areas of severe stenosis (35.3%), 9 areas of mild stenosis (26.5%), and 12 areas of no lesion (35.3%); 24 slit lesions were associated with no areas of occlusion (0%), 2 areas of severe stenosis (8.3%), 15 areas of mild stenosis (62.5%), and 7 areas of no lesion (29.2%); 8 complex lesions were associated with no areas of occlusion (0%), 7 areas of severe stenosis (87.5%), no areas of mild stenosis (0%), and 1 area of no lesion (12.5%). Conclusion: Although MRA images are similar to DSA images, tey are not identical. Criteria and indications for each should be developed and used to complement each other.
