LAUSR

INTRODUCTION Lower extremity arterial disease (LEAD) is often associated with chronic renal failure, so the use of nephroprotective modalities is essential. OBJECTIV We compared the diagnostic performance of non-contrast quiescent-interval single-shot magnetic resonance angiography (QISS MRA) and digital subtraction angiography (DSA). METHODS QISS MRA and DSA images of LEAD patients were compared. A 19-segment model was used to grade the degree of stenosis (none, <50%, 50-70%, >70%) and image quality (5-point Likert scale; 1: non-diagnostic, 5: excellent image quality). The diagnostic accuracy and interpretability were calculated in terms of obstructive (>70%) stenosis; DSA was the reference standard. Intraclass correlation coefficient (ICC) was calculated for interobserver reproducibility of image quality and stenosis assessment. RESULTS 623 segments were evaluated in 34 patients (10 women, mean age: 67 ± 9 years). Image quality of QISS MRA was at least equivalent to DSA in all regions (all regions: 4 [4-5] vs. 4 [3-5]; aorto-iliac: 4 [4-4] vs. 4 [4-5]; femoro-popliteal: 4 [4-4] vs. 4 [4-5]; tibio-peroneal: 4 [4-5] vs. 3.5 [3-4]; all p≤0.01). The interpretability of QISS MRA was superior to DSA in all regions (99.0% vs. 96.1%, p<0.001). The proportion of non-diagnostic segments was six times higher for DSA than for QISS MRA (24 vs. 4). The diagnostic accuracy of QISS MRA was 91.3%, sensitivity 84.8%, specificity 93.0%, positive predictive value 76.3%, negative predictive value 95.8%. In stenosis grading, the ICC for all regions was 0.94 for QISS MRA and 0.88 for DSA. CONCLUSION QISS MRA proved to be a reliable alternative to DSA in the diagnosis of lower extremity arterial disease. Orv Hetil. 2022; 163(45): 1782-1788.