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• Clinical Article •
Application of three-dimensional dynamic contrast-enhanced magnetic resonance angiography in diagnosing lower extremity arterial disease in patients with diabetic foot
ZHANG Ji  ZHAO Xiao-er  WU Hui  XIA Jin-xiang  LIAN Hu 

DOI:10.3969/j.issn.1674-8034.2014.02.009.


[Abstract] Objective: To investigate the diagnostic value of three-dimensional dynamic contrast enhanced magnetic resonance angiography (3D CE-MRA) in lower extremity arterial disease (LEAD) of diabetic foot (DF).Materials and Methods: Fifteen diabetic cases suspected of LEAD underwent CE-MRA using 3D FLASH automatic subtraction sequence. Satisfactory lower extremity vasculars were obtained by post progressing techniques. All cases also underwent digital subtraction angiography (DSA) within one week. Stenosis grading of each segment of vascular is divided into three levels: grade A (normal/degree of stenosis < 50%), grade B (narrowed≥50%), C (block). The comprehensive diagnostic value of CE-MRA were analyzed taking DSA as the standard.Results: (1) In 15 cases, all target arteries were well demonstrated and the diagnosis was definite. (2) LEAD examined with CE-MRA were well consistent with that of DSA in DF cases (consistency check, Kappa value 0.944>0.75, P<0.05). Two medical imaging examination techniques have well consistency in diagnosing grade A and C of vascular stenosis (Kappa value 0.94, 0.84 respectively, both>0.75, both P<0.05). Two techniques have general consistency in diagnosing grade B of vascular stenosis (Kappa value 0.608, <0.75>0.4, P<0.05). (3) The positive of CE-MRA for lower extremity arterial stenosis was 96.0%, the false positive and false negative was 3.3%, 2.0% respectively;the sensitivity and specificity was 98.0%, 96.7% respectively. (4)The sensitivity of CE-MRA in diagnosing grade A, B, C of lower extremity artery stenosis of was 96.7%, 80%, 84.6% respectively, the specificity 98.0%, 92.9%, 97.1% respectively.Conclusions: 3D CE-MRA have well agreement with DSA in the positive and classification of stenosis degree for lower extremity arterial stenosis, especially grade A, C. It is unable to avoid false positives and false negatives, but CE-MRA might be performed as a routine examination method in diagnosing LEAD of DF patients, with high sensitivity, high specificity, noninvasive, no radiation, no renal toxicity and quick scaning.
[Keywords] Magnetic resonance angiography；Diabetic foot；Arterial occlusive disease；Lower extremity；Angiography, digital subtraction

ZHANG Ji Department of Magnetic Resonance Imaging, the Second People’s Hospital of Hefei City, Hefei 230011, China

ZHAO Xiao-er Department of Magnetic Resonance Imaging, the Second People’s Hospital of Hefei City, Hefei 230011, China

WU Hui Department of Magnetic Resonance Imaging, the Second People’s Hospital of Hefei City, Hefei 230011, China

XIA Jin-xiang Department of Magnetic Resonance Imaging, the Second People’s Hospital of Hefei City, Hefei 230011, China

LIAN Hu Department of Magnetic Resonance Imaging, the Second People’s Hospital of Hefei City, Hefei 230011, China

Conflicts of interest   None.

Received  2013-12-10
Accepted  2014-02-08
DOI: 10.3969/j.issn.1674-8034.2014.02.009
DOI:10.3969/j.issn.1674-8034.2014.02.009.

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