OBJECTIVES: Standard lower extremity contrast-enhanced magnetic resonance angiography (LE-CEMRA) with single injection bolus-chase methods on the basis of a single pelvis timing run can be accurate for depicting most vascular occlusive lesions but may fall short of catheter-based angiography when imaging tibial and pedal vessels. Magnetic resonance angiography techniques with a second contrast timing bolus and separate acquisitions for the calves and the pelvis greatly improve reliability and reduce venous contamination to levels that may render conventional angiography obsolete. METHODS: From July to December 2001, 60 consecutive patients underwent LE-CEMRA of the calves with separate stepping-table acquisitions of the pelvis and thighs. Forty-five (75%) had complete or partial angiographic correlation during an endoluminal intervention or operative completion study. Lower extremity vessels were divided into anatomic segments (aortoiliac, femoropopliteal, tibial-pedal) for review. Three blinded observers assessed magnetic resonance source partitions, maximum-intensity projections, and volume-rendered images. Disease per segment was graded from insignificant (<20%) to occluded (100%) in 10% increments. Segments were also scored for venous contamination (scale, 0 to 3) and diagnostic quality (scale, 1 to 5). Digital subtraction angiograms were assessed similarly but separately. RESULTS: The combination dual-timing/dual-injection technique had an overall sensitivity, specificity, and accuracy of 99%, 97%, and 98%. Venous contamination and artifact were virtually eliminated with combined technique LE-CEMRA. Diagnostic quality of calf and foot vessels was significantly superior to conventional bolus-chase magnetic resonance techniques (P <.01). CONCLUSION: Hybrid dual-acquisition LE-CEMRA allows complete timing specification that consistently produces high-quality, artifact-free images of the calf and pedal vessels. These techniques may be accurate enough to replace conventional digital subtraction angiogram for evaluation of lower extremity vascular occlusive disease.
OBJECTIVES: Standard lower extremity contrast-enhanced magnetic resonance angiography (LE-CEMRA) with single injection bolus-chase methods on the basis of a single pelvis timing run can be accurate for depicting most vascular occlusive lesions but may fall short of catheter-based angiography when imaging tibial and pedal vessels. Magnetic resonance angiography techniques with a second contrast timing bolus and separate acquisitions for the calves and the pelvis greatly improve reliability and reduce venous contamination to levels that may render conventional angiography obsolete. METHODS: From July to December 2001, 60 consecutive patients underwent LE-CEMRA of the calves with separate stepping-table acquisitions of the pelvis and thighs. Forty-five (75%) had complete or partial angiographic correlation during an endoluminal intervention or operative completion study. Lower extremity vessels were divided into anatomic segments (aortoiliac, femoropopliteal, tibial-pedal) for review. Three blinded observers assessed magnetic resonance source partitions, maximum-intensity projections, and volume-rendered images. Disease per segment was graded from insignificant (<20%) to occluded (100%) in 10% increments. Segments were also scored for venous contamination (scale, 0 to 3) and diagnostic quality (scale, 1 to 5). Digital subtraction angiograms were assessed similarly but separately. RESULTS: The combination dual-timing/dual-injection technique had an overall sensitivity, specificity, and accuracy of 99%, 97%, and 98%. Venous contamination and artifact were virtually eliminated with combined technique LE-CEMRA. Diagnostic quality of calf and foot vessels was significantly superior to conventional bolus-chase magnetic resonance techniques (P <.01). CONCLUSION: Hybrid dual-acquisition LE-CEMRA allows complete timing specification that consistently produces high-quality, artifact-free images of the calf and pedal vessels. These techniques may be accurate enough to replace conventional digital subtraction angiogram for evaluation of lower extremity vascular occlusive disease.
Authors: R Schmitt; G Coblenz; O Cherevatyy; H Brunner; S Fröhner; E Wedell; G Karg; G Christopoulos Journal: Eur Radiol Date: 2005-07-22 Impact factor: 5.315
Authors: Ruth P Lim; Zhaoyang Fan; Manjil Chatterji; Amanjit Baadh; Iliyana P Atanasova; Pippa Storey; Danny C Kim; Sooah Kim; Philip A Hodnett; Afhsan Ahmad; David R Stoffel; James S Babb; Mark A Adelman; Jian Xu; Debiao Li; Vivian S Lee Journal: Radiology Date: 2013-01-07 Impact factor: 11.105
Authors: Gurpreet Singh Sandhu; Rod P Rezaee; John Jesberger; Katherine Wright; Mark A Griswold; Vikas Gulani Journal: AJR Am J Roentgenol Date: 2012-03 Impact factor: 3.959