Distal lower extremity arteries: evaluation with two-dimensional MR digital subtraction angiography

Area of Science:

• Medical Imaging
• Vascular Imaging
• Radiology

Background:

• Assessing lower extremity arterial patency is crucial for diagnosing peripheral artery disease.
• Two-dimensional time-of-flight (TOF) MR angiography is a common technique, but its efficacy in distal vessels is debated.

Purpose of the Study:

• To compare the diagnostic performance of MR digital subtraction angiography (DSA) against 2D TOF MR angiography.
• To determine which technique is superior for visualizing patent arteries in the distal lower extremity.

Main Methods:

• 37 lower extremities in 23 patients underwent both 2D TOF MR angiography and 2D MR DSA.
• Images were analyzed in a blinded, randomized fashion, assessing arterial segments and digital arteries.
• Qualitative image quality and patency visualization were compared between the two techniques.

Main Results:

• MR DSA demonstrated significantly superior visualization of patent arterial segments and digital arteries compared to 2D TOF MR angiography (P < .001).
• MR DSA images were also qualitatively superior to 2D TOF images (P < .001).

Conclusions:

• Two-dimensional MR digital subtraction angiography is the preferred method over 2D TOF MR angiography for evaluating distal lower extremity arterial patency.
• MR DSA provides enhanced visualization critical for clinical decision-making in vascular assessment.