Comparison of Moving Bed Contrast Enhanced MR Angiography Versus DigitalSubtraction Angiography in Peripheral Arterial Disease

Peripheral arterial disease (PAD) is described as partial or total occlusion of one or more peripheral arteries due to atherosclerosis. Although upper extremity arteries and carotid arterial systems are effected from atherosclerosis, in practice the term of PAD is used only for lower extremity atherosclerotic arterial diseases. Similar to cardiovascular diseases, risk factors are hypertension, dyslipidemia, smoking and diabetes mellitus. Aortic bifurcation is commonly involved. After the recent technical developments, magnetic resonance anjiography (MRA) has become the most preferable noninvasive imaging modality for determining the changes in the aorta and peripheral vascular structures. The aim of this study is to evaluate the accuracy of contrast enhanced moving bed Flash 3D MRA in the depiction of significant stenoses and occlusions, with intraarterial DSA serving as the reference standard. We have evaluated the efficacy of contrast enhanced moving bed Flash 3D MRA versus digital subtraction angiography (DSA) in 43 patients with peripheral arterial disease who underwent DSA after MRA within 30 days. DSA was accepted as gold standard and the sensitivity, specificity and accuracy of MRA were determined. Also the symptoms, atherosclerotic risk factors and laboratory parameters of patients were noted. Overall sensitivity and specificity values of contrast enhanced moving bed Flash 3D MRA for significant (>70%) stenosis were 91% and 97.3%; for total occlusion, sensitivity and specificity values were 90% and 99.3% respectively. For both of them, the accuracy was 96%. No significant difference is found between contrast enhanced moving bed 3D MRA and DSA for the diagnosis of peripheral arterial disease (p>0.05). In conclusion, contrast enhanced moving bed Flash 3D MRA is a reliable, fast, noninvasive imaging modality in the diagnosis of patients, in planning of interventional procedures and follow-up of the patients with peripheral arterial disease.