Assessment of aorto-iliac disease with magnetic resonance angiography using arterial phase 3-D gradient-echo and interstitial phase 2-D fat-suppressed spoiled gradient-echo sequences.

Purpose To evaluate magnetic resonance angiography (MRA) of the pelvis for the examination of the aorto-iliac system using arterial phase 3-D gradient echo and interstitial phase 2-D fat-suppressed spoiled gradient-echo (SGE), with comparison to surgery and angiography. Materials and Methods Ninety MR angiograms performed on 79 consecutive patients were analyzed, retrospectively, for the presence of narrowing, aneurysm, and dissection. Comparisons were made with angiography and surgery in 50 examinations, and a weighted kappa statistic test was applied to assess agreement. MR examinations were performed at 1.5T 3-D fast imaging in steady state precession (FISP) acquired immediately, and fat-suppressed SGE in the interstitial phase following gadolinium administration. Results MRA had overall sensitivities of 100% at aortic segments, 100% at common iliac, 93.8% at external, and 95.7% at internal iliac, and specificities of 100% at aortic segments, 89.7% at common iliac, 95.2% at external iliac, and 88.7% at internal iliac in detection of vascular disease. The agreement of MRA with the angiography and surgery yielded a weighted kappa statistic of 0.97 at the aortic, 0.94 at the common, 0.85 at the external, and 0.82 at the internal iliac segments. Conclusion This study demonstrates an excellent performance of MRA in the evaluation of aorto-iliac arterial system and almost perfect agreement with angiography and surgery at all vascular levels. J. Magn. Reson. Imaging 2003;17:43–53. © 2002 Wiley-Liss, Inc.