Correlation of quiescent-interval single-shot (QISS) magnetic resonance angiography (MRA), computed tomography angiography (CTA) and digital subtraction angiography (DSA) for peripheral arterial disease (PAD) assessment

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 limbthreatening ischemia (CLTI) or claudication. Given the limitations of CTA in evaluating heavily calcified vessels, we aimed to determine whether quiescent-interval single-shot (QISS) MRA provides better diagnostic agreement with digital subtraction angiography (DSA). PATIENTS AND METHODS: In this retrospective study, 25 patients who underwent lower limb QISS MRA between April 2022 and April 2024 were included. Thirteen patients also underwent CTA, and 19 underwent DSA. RESULTS: . DSA (κ = 0.57). In below-the-knee arteries, QISS MRA showed substantial agreement with DSA (κ = 0.61) and high sensitivity (86.2%). CONCLUSIONS: In this small, exploratory cohort QISS MRA showed promising performance for segment-based assessment of peripheral arterial disease (PAD), particularly in below-the-knee arteries in patients with medial arterial calcification, and outperformed CTA for the detection of ≥ 50% stenosis relative to DSA. Larger studies are needed to further establish its clinical utility.