Evaluation of calf arteries in arteriosclerotic occlusive disease by NCE MRA: comparison with CE MRA and DSA

LIU Jiayi; ZHANG Nan; LUO Nan; CHEN Zhong; WEN Zhaoying; FAN Zhanming

Abstract：Objective To investigate the application value of non-enhanced magnetic resonance angiography (MRA) in the evaluation of the patency, involvement degree, and range of calf arterial lesions in arteriosclerotic occlusive diseases of lower extremities.Methods ABI was measured in 45 patients with claudication.21 patients with ABI lower than 0.9 received non-enhanced MRA, enhanced MRA, and digital subtraction angiography (DSA) examinations.Using DSA as the standard, 27 lower extremities with a focus on 135 segments including the popliteal artery, tibial-fibular trunk, anterior tibial artery, posterior tibial artery, and fibular artery were analyzed.Results Among total 135 segements, 99 patency arterial segments was shown in non-enhanced MRA, 96 patency segments in enhanced MRA and 101patency segments in DSA.A comparison among non-enhanced MRA, enhanced MRA, and DSA showed that the consistency of observation of vascular patency was excellent (Kappa>0.85, P<0.001).The determination of arteries with stenosis ≥50% did not display a statistically significant difference (P>0.05).A total of 15 vascular segments with stenosis ≥50% were present in all three examinations.Measurement of lesion length using non-enhanced MRA, enhanced MRA, and DSA was significantly difference (P<0.01).Conclusion Non-enhanced MRA was similar to enhanced MRA and DSA for observing vascular patency and recognizing vascular stenosis;in addition, it was more accurate than enhanced MRA for displaying the range of vascular involvement.Therefore, non-enhanced MRA was a reliable method for diagnosing vascular diseases in the lower extremities.However, it had a tendency to over-evaluate the degree of vascular stenosis.When patients had renal insufficiency, non-enhanced MRA could replace DSA and enhanced MRA;therefore, it represents a reliable method for pre-operative vascular evaluation of this group of patients.