Critical Limb Ischemia: Hybrid MR Angiography Compared with DSA

PURPOSE: To compare a hybrid magnetic resonance (MR) angiography protocol with selective digital subtraction angiography (DSA) in patients with critical limb ischemia. MATERIALS AND METHODS: The study was approved by the institutional review board, and written consent was obtained from all patients. Pretreatment DSA and hybrid MR angiography were performed in 19 consecutive patients (15 men, four women; mean age, 69.8 years; range, 44–86 years). Hybrid MR angiography included submillimeter dual-phase three-dimensional gadolinium-enhanced MR angiography in lower calf and foot, and four-station bolus-chase MR angiography in pelvis, thigh, and upper calf. Three readers identified the target lesion and inflow and outflow segments and determined treatment (bypass graft placement, percutaneous transluminal angioplasty, conservative management, amputation). Results of interobserver and intermethod comparisons were expressed as percentage of agreement and 95% confidence interval (CI). RESULTS: On hybrid MR angiog...