Meta-Analysis Supports MRA in Peripheral Arterial Disease
Contrast-enhanced MR angiography has high accuracy for ID'ing, ruling out steno-occlusions
TUESDAY, Sept. 7 (HealthDay News) -- Contrast-enhanced magnetic resonance angiography (MRA) appears highly accurate in assessing steno-occlusions in adults with symptoms of peripheral arterial disease (PAD), according to research published in the Sept. 7 issue of the Annals of Internal Medicine.
Jan Menke, M.D., of University Hospital, and Jörg Larsen, M.D., of Evangelisches Krankenhaus -- both in Goettingen, Germany, included 32 prospective studies with 1,022 patients with PAD symptoms in a meta-analysis. About one-quarter of patients had critical limb ischemia and pain at rest or loss of tissue.
The researchers found that, for MRA, the pooled sensitivity was 94.7 percent and specificity was 95.6 percent for diagnosing segmental steno-occlusions. Pooled positive and negative likelihood ratios were 21.56 and 0.056, respectively. The technique also correctly classified 95.3 percent of arterial segments, overstaged 3.1 percent, and understaged 1.6 percent.
"Our meta-analysis of 32 prospective studies further increases the evidence that contrast-enhanced MRA has a high accuracy for both identifying and excluding clinically relevant arterial steno-occlusions in adults with PAD symptoms. MRA thus remains an important diagnostic alternative to radiation-based computed tomographic angiography and digital subtraction angiography," the authors conclude.