ABSTRACT
PURPOSE: To develop a strategy for the complete work-up of vessel lumen and vessel wall for planning and follow-up of radiological interventions of lower extremity arteries. METHODS: A total of 36 patients (21 pre-, 8 post- and 7 pre- and postinterventional) were studied. MRA studies were performed using an ECG-triggered phase contrast technique for the demonstration of intraluminal flow and an axial high resolution time-of-flight technique to assess the vascular wall. All MRA studies were analysed by intraindividual DSA comparison for the assessment of flow and wall structures. RESULTS: Combined MRA techniques provided a good correlation with DSA for the assessment of vascular flow. The kappa test revealed a value of greater than 0.61 for most on the vessel segments proving a good correlation of both methods. Orthogonal high-resolution TOF-MRA provided additional information for the assessment postinterventional wall haematomas and hard plaques. CONCLUSION: Combination of PCA to study flow and axial TOF to study wall pathology improves the usefulness of peripheral MRA.
Subject(s)
Aorta, Abdominal/pathology , Arterial Occlusive Diseases/diagnosis , Arterial Occlusive Diseases/therapy , Electrocardiography , Femoral Artery/pathology , Iliac Artery/pathology , Magnetic Resonance Angiography , Adult , Aged , Aged, 80 and over , Aorta, Abdominal/physiopathology , Arterial Occlusive Diseases/physiopathology , Blood Flow Velocity , Catheterization , Female , Femoral Artery/physiopathology , Follow-Up Studies , Humans , Iliac Artery/physiopathology , Male , Middle Aged , Popliteal Artery/pathology , Reproducibility of Results , Sensitivity and Specificity , StentsABSTRACT
PURPOSE: To investigate whether phase-contrast MRA is a clinically suited approach to examine arteries of the pelvis and lower extremities. METHODS: The study was divided into two parts, a volunteer study and patient study. Three MRA techniques-2D TOF with venous saturation, 3D magnitude contrast and 2D phase contrast with ECG triggering-were intraindividually compared in 15 volunteers and evaluated by three blinded readers. Subsequently, a total of 230 vessel segments of 45 MRA studies using ECG-triggered phase contrast were compared with intraarterial DSA. All vessel segments were scored by three blinded readers using a five-point scale with DSA serving as the gold standard. RESULTS: ECG-triggered phase contrast provided better image quality than the other MRA techniques as assessed by the Friedman test. Clinical studies demonstrated a significant correlation of DSA and MRA as assessed by the Spearman correlation and kappa statistics for individual readers. CONCLUSION: MRA of the pelvis and lower extremities may be performed with 2D ECG-triggered phase-contrast MRA within a reasonable time frame (< 30 min). MRA slabs provide orientation similar to that with DSA projections and good to very good correlation of vessel pathology as shown by kappa statistics.