Introduction: Magnetic Resonance Angiography (MRA) potentials in all vascular districts have been largely applied also to peripheral vessels, where however there is no agreement as to the best type of sequence. We investigated the sensitivity, specificity and diagnostic accuracy of 2D TOF travel-sat MRA in the study of iliac-femoral artery stenoses. The gold standard was digital subtraction angiography (DSA).
Material and methods: Twenty patients (14 men and 6 women, mean age: 65 years with suspected atheromasic disease were examined. Diagnostic MRA and DSA were carried out within 48 hours of each other. A super-conductive 1 T magnet (Siemens Impact) and a body coil were used. 2D TOF travel-sat sequences were carried out with the following parameters: FA 40 degrees, TR 31 ms, ST 10 mm, overlap 1 mm, MA 128 x 512. The images acquired on the axial plane were postprocessed with MIP on the z axis from -15 degrees to 15 degrees. Two different radiologists evaluated MRA and DSA images and graded the stenoses on a multiple choice card: 1) negative, 2) 1-40%, 3) 41-70%, 4) 71-99%, 5) occlusion.
Results: MRA diagnosed 90 positives and 110 negatives: 60 were true positives, 92 true negatives, 30 false positives and 18 false negatives. MRA overestimated 8 cases and underestimated 4 cases. DSA findings were negative in 122 cases and positive in 78 cases: 4 grade 2, 10 grade 3, 28 grade 4 and 36 grade 5. Relative to DSA, MRA sensitivity, specificity and diagnostic accuracy were 72%, 75% and 74%, respectively; MRA diagnostic accuracy, sensitivity and specificity in hemodynamically severe stenoses (> 71%) were 80%, 78% and 71.8%, respectively.
Conclusion: Our study confirms the usefulness of 2D TOF travel-sat MRA in the study of iliac-femoral stenoses.