Fast magnetic resonance angiography using turbo-FLASH sequences in advanced aortoiliac disease

A prospective study using contrast enhanced turbo-FLASH (Fast Low-Angle Shot) magnetic resonance (MR) angiography was performed to assess the arterial anatomy in patients who had advanced atherosclerotic aortoiliac disease. This new imaging sequence was employed in 17 patients and the results were compared with conventional abdominal aortography. MR angiography accurately detected all aortic occlusions (3/3), their sites and their extent. All nine iliac occlusions were correctly identified (sensitivity 100%, specificity of 90%). The sensitivity was 100% for stenosis of 50% or greater in the abdominal aorta, and the iliac and common femoral arteries. The degree of stenosis was overgraded in 20 of 51 lesions (39.2%). Mild stenosis was overgraded as moderate stenosis in 10 and as severe stenosis in three. Moderate stenosis was overgraded as severe stenosis in four. None of the mild or moderate stenoses resulted in areas of signal voids suggestive of occlusions. Three severe stenoses were seen as areas of signal voids (two iliac, one femoral). In the eight patients who had in total 10 aneurysmal dilatations of the aorta or the iliac arteries, MR angiography was superior in demonstrating the true extent of the aneurysms. We conclude that turbo-FLASH MR angiography has the potential to be a useful non-invasive imaging technique for patients with advanced aortoiliac disease.