Management of congenital angiodysplasia of the lower limb: magnetic resonance imaging and angiography versus conventional angiography.

The purpose of the study was to compare magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) with conventional angiography in distinguishing congenital angiodysplasia amenable to radical cure from that in which only palliation is feasible and to design a rational pre-operative work-up in those patients undergoing an interventional procedure. Axial T-1, T-2 weighted spin-echo and contrast-enhanced 3D SPGR sequences were performed in 13 patients with angiodysplasia, followed by time-of-flight MRA. The results were compared with conventional arteriography and venography. Dysplasia was arteriovenous with microshunts in nine cases and purely venous in the remaining four. MRI was the best method for assessing the extent of malformation and involvement of anatomical structures. MR arteriography and MR venography were inferior to conventional techniques. It is concluded that MRI is valuable in distinguishing patients amenable to radical cure from those in whom only palliation is feasible. Pre-operatively, conventional arteriography and venography remain mandatory.