1. Home>
2. Specialties>
3. General Medicine>
4. Summary and Comment

CONTRAST ANGIOGRAPHY OR MAGNETIC RESONANCE ANGIOGRAPHY FOR PVD?

When can newer vascular imaging technologies replace less advanced techniques, which may be more invasive or use more contrast material? This blinded prospective study of 155 patients with peripheral vascular disease compared the diagnostic accuracy of contrast angiography (CA) with magnetic resonance angiography (MRA). The researchers evaluated the ability of both technologies to discriminate between occluded and patent distal vessels of the lower limb, and to identify near-normal segments that were suitable bypass-graft sites. The "gold standard" was intraoperative angiography, in which contrast was injected directly into the bypass graft to obtain maximal distal contrast delivery. The two technologies had similar sensitivities for distinguishing patent from completely occluded segments. But CA was less sensitive than MRA for detecting near-normal segments (77 percent vs. 82 percent), presumably because of poor contrast delivery at sites beyond severe stenoses. However, contrast angiography was more specific for detecting near-normal segments (92 percent vs. 84 percent). The authors concluded that both tests had similar accuracy. Comment: Because of lower costs and less patient discomfort, MRA seems to be the more attractive of these alternative tests. This study did not test MRA's ability to map the proximal vasculature of the lower extremities; thus, the ideal testing strategy is still somewhat uncertain.

— TH Lee

Published in Journal Watch General Medicine September 29, 1995

Citation(s):

Baum RA, et al. Multicenter trial to evaluate vascular magnetic resonance angiography of the lower extremity. JAMA 1995 Sep 20 274 875-880.

• Medline abstract (Free)