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 surgical treatment planning in patients with peripheral arterial occlusive disease. MATERIALS AND METHODS: Thirteen patients scheduled for catheter arteriography for lower extremity arterial occlusive disease underwent contrast-enhanced moving-table MR angiography immediately prior to arteriography. A treatment plan was determined by the vascular surgeon, based on MR angiography, who was blinded to the catheter arteriogram. The treatment plan determined by the MR angiogram was compared to the final treatment plan, which was based 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 resulting in intervention, MR angiography had sensitivity of 100% and a positive predictive 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 angiography only, 46% of patients would have avoided catheter arteriography. CONCLUSION: Contrast-enhanced moving-table MR angiography may be an effective alternative to catheter arteriography in endovascular and surgical treatment planning in selected patients with peripheral arterial occlusive disease, but larger studies are necessary to confirm this.