Accuracy of Computed Tomographic Angiography in Diagnosis of Peripheral Artery Diseases Compared to Magnetic Resonance Angiography

Abstract

Computerized Tomography Angiography (CTA) and Magnetic Resonance Angiography (MRA) have both now evolved into noninvasive techniques for imaging the lower limb vasculature. The purpose of the current study was to evaluate the diagnostic value of MRA at 1.5 T versus CTA for evaluation of lower extremity peripheral arterial disease (PAD). In this study, cases were maintained at King Fahad Hospital during the period from 2014-2017. Materials and methods: 100 consecutive patients (52 were males, 48 were females) were enrolled. Their ages ranged between 34–83 years old, average age was 62.3 years with clinically suspected lower extremity PAD underwent MRA and CTA under the standard protocol of examinations. The diagnosis was compared in both modalities by two radiologists with 8 and 10 years of experience. In the evaluation of those diagnostic tests; the study of agreement for their results was obtained. The selected arteries to be evaluated were: common iliac artery, external iliac, internal iliac, femoral, femoral profound, popliteal, anterior tibial, posterior tibial, peroneal artery and distal abdominal aorta. The results showed the consistency in the findings between the CTA and MRA in the selected arteries were as follows: Common Iliac Artery was found to be normal in 96 /100 patients, 2 arteries were affected with aneurysm. External iliac artery was normal in 95 cases and 2 with aneurysm. Internal iliac artery was normal in 94 cases and 4 with aneurysm. Femoral artery was normal in 98 cases and 5 were

V affected by aneurysm. Femoral profound artery was normal in 90 cases and 2 with aneurysm. Popliteal artery was normal in 86 cases, and aneurysm was found in 3 cases. Anterior tibial artery was normal in 84 cases, aneurysm in 3 cases. Posterior tibial artery was normal in 82 cases and aneurysm in 4 cases. Peroneal tibial artery was normal in 79 patients, 3 were affected with aneurysm. Most of the cases diagnosed as stenosis in CTA was found to be totally occluded in MRA .The distal abdominal aorta was found to be normal in all patients100%. There are no significant differences in the results found in the CTA and MRA in the diagnosis of the selected arteries. All the occluded cases were well diagnosed by MRA. Interpretation of MRA and CTA for PAD has an excellent agreement, with significant correlation between the two modalities at p=0.000 in the diagnosis of the normal arteries, aneurysm stenosis and occlusion in the selected peripheral arteries. The results support the increasing use of both MRA and CTA in the diagnostic imaging of patients with PAD.