Contrast-enhanced MR angiography in patients with aortic occlusion (Leriche syndrome)

The diagnostic utility of contrast-enhanced three-dimensional magnetic resonance angiography (3D MRA) was retrospectively evaluated in 24 patients with Leriche syndrome. 3D MRA was performed either of the abdomen alone (n = 6), the abdomen and chest (n = 2), the abdomen and lower extremities (n = 12), or of all stations (n = 4). MRA image sets were evaluated regarding the location of the aortic occlusion, the presence of concomitant occlusive disease affecting the renal and visceral arteries, the type and extent of collateralization, and the level of the most proximal graftable arterial segments. Intravenous digital subtraction angiography was available for correlation in two patients, while surgical correlation was possible in 14 patients. MRA permitted classification of the level of aortic occlusion as juxtarenal (n = 8), infrarenal, and cranial to the origin of the inferior mesenteric artery (IMA; n = 11), and infrarenal but caudad to the IMA (n = 5). Extraanatomical grafts were displayed to similar advantage as collateral parietal and visceral pathways. Contrast-enhanced 3D MRA thus appears to be well suited for assessment of patients with suspected Leriche syndrome.