Contrast material-enhanced, moving-table MR angiography versus digital subtraction angiography for surveillance of peripheral arterial bypass grafts.

Purpose: To assess the accuracy of moving-table MR angiography (MRA) in the evaluation of peripheral bypass grafts.

Materials And Methods: There were 39 patients who had had peripheral bypass graft surgery and then subsequently underwent digital subtraction angiography (DSA) and contrast material-enhanced MRA, which was performed with moving-table software on a 1.0-T system before and during administration of 40 mL gadolinium. For evaluation, every bypass graft was divided into three parts and every leg into 14 segments. Disease severity was scored in four categories (0%-29%, 30%-69%, 70%-99%, 100%). Results were compared with those of the DSA. A total of 147 bypass graft segments and 938 vessel segments were classified.

Results: In 132 of the assessable 147 bypass segments, disease gradings with both methods were congruent; however, 13 stenoses were misinterpreted by MRA for one grade and two additional lesions by two grades, leading to an accuracy in precise stenoses detection of 89.9%. The sensitivity and specificity values in the detection of bypass graft stenoses >69% (grade 3 + 4 lesions) reached 90.0% and 98.3%, respectively. In 821 of 938 vessel segments the accuracy of MRA in stenoses detection reached 87.5%. The sensitivity and specificity values in the detection of grade 3 + 4 lesions were 95.6% and 94.0% for the native vessels, respectively.

Conclusion: Moving-table MRA was as accurate in assessing bypass grafts as it was for the native arteries and showed a great accuracy in stenosis detection compared with DSA. Therefore, MRA is a promising modality for bypass graft surveillance and might be a noninvasive alternative to DSA in this regard.