Ankle brachial index <0.9 underestimates the prevalence of peripheral artery occlusive disease assessed with whole-body magnetic resonance angiography in the elderly

Acta Radiol. 2008 Mar;49(2):143-9. doi: 10.1080/02841850701732957.

Abstract

Background: Whole-body magnetic resonance angiography (WBMRA) permits noninvasive vascular assessment, which can be utilized in epidemiological studies.

Purpose: To assess the relation between a low ankle brachial index (ABI) and high-grade stenoses in the pelvic and leg arteries in the elderly.

Material and methods: WBMRA was performed in a population sample of 306 subjects aged 70 years. The arteries below the aortic bifurcation were graded after the most severe stenosis according to one of three grades: 0-49% stenosis, 50-99% stenosis, or occlusion. ABI was calculated for each side.

Results: There were assessable WBMRA and ABI examinations in 268 (right side), 265 (left side), and 258 cases (both sides). At least one > or =50% stenosis was found in 19% (right side), 23% (left side), and 28% (on at least one side) of the cases. The corresponding prevalences for ABI <0.9 were 4.5%, 4.2%, and 6.6%. An ABI cut-off value of 0.9 resulted in a sensitivity, specificity, and positive and negative predictive value of 20%, 99%, 83%, and 84% on the right side, and 15%, 99%, 82%, and 80% on the left side, respectively, for the presence of a > or =50% stenosis in the pelvic or leg arteries.

Conclusion: An ABI <0.9 underestimates the prevalence of peripheral arterial occlusive disease in the general elderly population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Ankle / blood supply*
  • Arterial Occlusive Diseases / diagnosis*
  • Arterial Occlusive Diseases / epidemiology
  • Brachial Artery / physiopathology*
  • Cohort Studies
  • Contrast Media / administration & dosage
  • Female
  • Gadolinium DTPA
  • Humans
  • Image Enhancement / methods
  • Imaging, Three-Dimensional / methods
  • Leg / blood supply
  • Magnetic Resonance Angiography / methods*
  • Male
  • Pelvis / blood supply
  • Peripheral Vascular Diseases / diagnosis*
  • Peripheral Vascular Diseases / epidemiology
  • Predictive Value of Tests
  • Prevalence
  • Prospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Whole Body Imaging / methods*

Substances

  • Contrast Media
  • gadodiamide
  • Gadolinium DTPA