Evaluation of the aortoiliac and renal arteries: comparison of breath-hold, contrast-enhanced, three-dimensional MR angiography with conventional catheter angiography.

Abstract

To determine the diagnostic accuracy of breath-hold, contrast material-enhanced, three-dimensional (3D) magnetic resonance (MR) angiography in the assessment of the aortoiliac inflow tract and renal arteries with conventional catheter angiography as the standard of reference. In 39 patients with symptomatic peripheral vascular disease, both catheter and contrast-enhanced, 3D MR angiography were performed. In a prospective blinded analysis, each vascular segment (23 segments per arterial tree) was evaluated for the presence of obstructive stenosis, graded as mild (<50%), severe (50%-99%), or occlusion (100%), as well as for aneurysmal disease. Obstructive (n = 2) and aneurysmatic aortic (n = 6) lesions and 10 of 11 accessory renal arteries were identified and graded correctly with MR angiography. For detection of hemodynamically significant stenotic lesions (>50%) or occlusions with MR angiography, sensitivity and specificity, respectively, were 93% and 98% for the renal arteries, 96% and 100% for the common iliac arteries, 93% and 93% for the external iliac arteries, and 96% and 94% for the internal iliac arteries. The diagnostic performance of contrast-enhanced 3D MR angiography is comparable with that of catheter angiography and thus may contribute to assessment of the aorta, the renal arteries, and the pelvic arterial system in patients with peripheral vascular disease before they undergo therapy.