Non Contrast MRA and Ankle Peak Systolic Velocity for Assessment of Lower Limb Arterial Disease in Diabetic Patients

Abstract INTRODUCTION Noninvasive techniques such as duplex ultrasound (DU) and non-contrast-enhanced magnetic resonance angiography (CE-MRA) are valid alternatives in the preoperative evaluation of lower limb ischemia diabetic patients. AIM OF THE Study Our aim is to assess the diagnostic accuracy of NCE-MRA and DU in diabetic patients with peripheral arterial disease (PAD) and either if we can depend on NCE-MRA in patients with renal impairment. THE CONTEXT 53 diabetic patients with unilateral or bilateral chronic lower limb ischemic disease - who have come to the department of radiology at Kafr El Sheik University Hospital for Doppler US. Out of the 53 patients 4 had intermittent claudication when walking more than 200 m (Rutherford II), 9 had sever claudication when walking more than 200 m (Rutherford stage III), 10 had rest pain (Rutherford stage IV), 11 had trophic changes (Rutherford stage V), ulcers and 19 has gangrene and major tissue loss (Rutherford stage VI) RESULT The study involved 53 patients, 28 men (52.8 %) and 25women (47.2 %). They were between 33 and 75.0 years with mean 59.56 years and standard deviation ±10.3. There was 26 patients chronic smokers 49.1%, 16 had renal failure 30.2 %, 30 had hypertension 56.6%. There was a good reliability and agreement between NCMRA & Doppler techniques with significant Kappa agreement in all measurements K = 0.91 P value was significant <0.001. Conclusion Both Non contrast enhanced angiography and duplex US have good predictive value of chronic lower limb ischemia but the combination between them has better diagnostic accuracy and we can depend on them in the patient with chronic renal disease.