Imaging of vascular pathology in hyperhomocysteinemic patients with digital subtraction angiography and magnetic resonance techniques.

Mild hyperhomocysteinaemia (mHH) is an independent risk factor for premature arteriosclerosis. We investigated the accuracy in the detection of early arteriosclerotic lesions in such patients. The left and right wall of the abdominal aorta, the aortic bifurcation and both common iliac arteries were evaluated with gated T1-weighted magnetic resonance imaging (gT1 MRI) and gated two-dimensional (2D) time-of-flight magnetic resonance angiography (g2D-TOF MRA) and were compared with intra-arterial digital subtraction angiography (iaDSA) in 11 patients with arteriosclerosis and mHH. Six patients showed arteriosclerosis in one or more of the total number of 55 studied arterial segments with iaDSA. Thirty-two of 37 normal and 12 of 18 stenotic segments with gT1 MRI, and 29 normal and 6 stenotic segments with g2D-TOF MRA, were correctly classified. Sensitivity of gT1 MRI and g2D-TOF MRA versus iaDSA was 67 and 33 %, the specificity was 86 and 78 % and the accuracy was 80 and 64 %, respectively. We conclude that arteriosclerosis in patients with mHH is a regular finding, and gT1 MRI in such patients is an acceptable technique.