Correlation of QISS MRA, CTA and DSA for PAD Assessement in a Small Cohort of Slovenian patients

Abstract

Background: Cross-sectional imaging methods such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are widely used for the assessment of peripheral arteries in patients with chronic limb-threatening ischemia (CLTI) or claudication. Given the limitations of CTA in evaluating heavily calcified vessels, we aimed to determine whether quiescent-interval slice-selective (QISS) MRA provides better diagnostic agreement with digital subtraction angiography (DSA).

Patients and Methods: In this retrospective study, 25 patients who underwent lower limb MRA between April 2022 and April 2024 were included. Thirteen patients also underwent CTA, and 19 underwent DSA. The mean patient age was 67 ± 12 years (range: 32–86), and 20 were male. CLTI was present in 12 patients (48%), and medial arterial calcification was noted in 7 patients (28%).

Results: A total of 444 segments were evaluated by MRA, 229 by CTA, and 149 by DSA. Cohen’s kappa analysis revealed moderate agreement between MRA and CTA, MRA and DSA, and also between CTA and DSA. When the analysis was limited to below-the-knee arteries, there was moderate agreement between MRA and CTA, and substantial agreement between MRA and DSA. Agreement between CTA and DSA was fair but not statistically significant.

Conclusion: QISS MRA is a promising tool for evaluating peripheral arteries, irrespective of the severity of arterial wall calcification, particularly in below-the-knee arteries.