Iliac artery evaluation with two-dimensional time-of-flight MR angiography: update.

PURPOSE: To determine the accuracy of two-dimensional (2D) time-of-flight (TOF) magnetic resonance (MR) angiography, performed with state-of-the-art equipment, in the evaluation of the iliac arteries. MATERIALS AND METHODS: The iliac arteries of 50 patients undergoing conventional arteriography for evaluation of lower-extremity ischemia or abdominal aortic aneurysm were also imaged with axial 2D TOF MR angiography. Blinded interpretations of conventional arteriograms and MR angiograms were compared. MR angiography was performed with a 1.5-T system with 2-mm contiguous axial sections, 60 degrees flip angle, 28-msec repetition time, and 7.4-msec echo time. RESULTS: Blinded interpretations of 2D TOF MR angiograms matched those of conventional arteriograms in 26 of 50 patients (52%). For the diagnosis of obstructive iliac artery lesions, sensitivity and specificity with MR angiography were 85% and 59%, respectively. Two of three saccular iliac artery aneurysms escaped detection with MR angiography. CONCLUSION: Iliac artery evaluation with axial 2D TOF MR angiography is not sufficiently accurate to warrant its use as a replacement for conventional arteriography in patients who lack contraindications to the latter.