Ankle-brachial index (ABI) and quiescent-interval single shot (QISS) MRA in peripheral arterial disease (PAD): comparison of diagnostic accuracy and need for additional imaging procedures

Background PAD is a major cause of morbidity and accurate diagnosis is essential for optimal patient management. ABI measurement is the initial diagnostic test of choice however, accuracy is sometimes limited, e.g. in diabetic patients and with vessel calcification. Additional imaging with CTA, MRA, or DSA is often required prior to revascularization. QISS MRA is a rapid, operator-independent non-contrast MRA technique which has been reported to evaluate PAD with accuracy comparable to that of CE-MRA (1). We compared ABI and QISS MRA with respect to the following: (a) what is the accuracy for hemodynamically significant stenoses; (b) was the detected abnormality located in the symptomatic limb; (c) after imaging with QISS MRA is there an expectation for additional imaging evaluation prior to intervention?