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(Radiology. 1999;212:371-377.)
© RSNA, 1999

Vascular and Interventional Radiology

Iliofemoral Arterial Occlusive Disease: Contrast-enhanced MR Angiography for Preinterventional Evaluation and Follow-up after Stent Placement1

Johann Link, MD, Johann C. Steffens, MD, Joachim Brossmann, MD, Joachim Graessner, PhD, Stephanie Hackethal, MD and Martin Heller, MD

1 From the Department of Radiology, Christian-Albrechts-University of Kiel, Germany (J.L., J.C.S., J.B., S.H., M.H.); and Siemens Medical Systems, Hamburg, Germany (J.G.). Received December 1, 1997; revision requested February 23, 1998; final revision received November 16; accepted February 22, 1999. Address reprint requests to J.L., Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Regensburg 93042, Germany (e-mail: johann.link@klinik.uni-regensburg.de).

PURPOSE: To evaluate the efficacy of contrast material–enhanced magnetic resonance (MR) angiography for the diagnosis of peripheral arterial occlusion and follow-up after stent placement.

MATERIALS AND METHODS: Sixty-seven patients (21 women, 46 men; mean age, 64.6 years) were examined. Digital subtraction angiography and contrast-enhanced MR angiography were performed in 28 patients for preinterventional evaluation of iliofemoral arterial occlusion and in 39 patients for follow-up after stent placement in the iliac or femoral arteries, which had been performed several months before.

RESULTS: All 24 occlusions were correctly diagnosed with contrast-enhanced MR angiography. Of the 59 stenoses, 36 were greater than 50% and 23 were 50% or less. Sensitivity and specificity for the detection of stenoses greater than 50% were 100% and 83%, respectively. Patency of the different stents was determined correctly with contrast-enhanced MR angiography. Some stents caused signal intensity dropout, which made MR evaluation of stents difficult. Generally, these signal intensity artifacts were most severe in stainless steel stents and mild in some nitinol stents.

CONCLUSION: Contrast-enhanced MR angiography is comparable to digital subtraction angiography for the detection of stenosis greater than 50% and occlusion in the iliofemoral arteries. Stent patency can be determined, but contrast-enhanced MR angiography is not suitable for stent evaluation owing to signal intensity dropout; however, it provides information about the vascular anatomic areas proximal and distal to the stent.

Index terms: Arteries, grafts and prostheses, 922.1268, 984.1268, 986.1268 • Arteries, stenosis or obstruction, 922.721, 984.721, 986.721 • Magnetic resonance (MR), comparative studies • Magnetic resonance (MR), vascular studies, 922.12942, 922.12943, 984.12942, 984.12943, 986.12942, 986.12943 • Stents and prostheses, 922.1268, 984.1268, 986.1268




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