Review: contrast-enhanced MRA is more sensitive and specific than CT angiography or ultrasonography for detection of lower-limb PAD.

M e t h o d s Data sources: MEDLINE, EMBASE/ Excerpta Medica, BIOSIS Previews, Science Citation Index, NTIS Database, LILACS, SIGLE, Dissertation Abstracts Online, Inside Conferences, Pascal (to April 2005); Cochrane Database of Systematic Reviews (issue 3, 2005); journals on imaging and vascular disease; and bibliographies of relevant studies. Study selection and assessment: Cohort or case–control studies in any language that assessed the diagnostic accuracy of MRA, CTA, or DUS in ≥ 20 patients ≥ 18 years of age with symptoms of lower-limb PAD, using a reference standard of intraarterial contrast angiography or findings at surgery or follow-up. 14 studies evaluated contrastenhanced MRA, 7 studies evaluated CTA, and 28 studies evaluated DUS. Only studies that presented results by arterial segment were reported. Quality assessment of individual studies was based on the QUADAS checklist. The interpretor of the index test results was blinded to reference test results in 84% of MRA studies and 71% of CTA and DUS studies; the interpretor of the reference test results was blinded to the results in 84% of MRA studies, 71% of CTA studies, and 82% of DUS studies. Outcomes: Sensitivity and specificity.