Dynamic Contrast-Enhanced MR Angiography from the Distal Aorta to the Ankle Joint with a Step-by-Step Technique

• Published in: American journal of roentgenology (1976) Vol. 175; no. 5; pp. 1291 - 1298
• Main Authors: Huber, A, Heuck, A, Baur, A, Helmberger, T, Waggershauser, T, Billing, A, Heiss, M, Petsch, R, Reiser, M
• Format: Journal Article
• Language: English
• Published: Leesburg, VA Am Roentgen Ray Soc 01.11.2000; American Roentgen Ray Society
• Subjects: Aged; Angiography, Digital Subtraction; Ankle Joint - blood supply; Ankle Joint - diagnostic imaging; Aortic Diseases - diagnosis; Aortic Diseases - diagnostic imaging; Arterial Occlusive Diseases - diagnosis; Arterial Occlusive Diseases - diagnostic imaging; Biological and medical sciences; Cardiovascular system; Contrast Media - administration & dosage; False Positive Reactions; Gadolinium DTPA - administration & dosage; Humans; Iliac Artery - diagnostic imaging; Iliac Artery - pathology; Image Enhancement - methods; Image Processing, Computer-Assisted - methods; Injections, Intravenous; Investigative techniques, diagnostic techniques (general aspects); Leg - blood supply; Leg - diagnostic imaging; Magnetic Resonance Angiography - methods; Medical sciences; Middle Aged; Peripheral Vascular Diseases - diagnosis; Peripheral Vascular Diseases - diagnostic imaging; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Sensitivity and Specificity; Stents; Subtraction Technique; Human; Radiodiagnosis; Stenosis; Cardiovascular disease; Descending aorta; Enhancement factor; Nuclear magnetic resonance imaging; Contrast effect; Arterial disease; Vascular disease; Ankle joint; Dynamics; Medical imagery; Step by step method; Technique; NMR angiography
• ISSN: 0361-803X; 1546-3141
• DOI: 10.2214/ajr.175.5.1751291

The aim of this study was to visualize the arteries from the distal aorta to the ankle joint and to determine the accuracy of MR angiography for detecting stenoses and occlusions. Twenty-four patients with peripheral arterial occlusive disease underwent digital subtraction angiography and were examined on a 1.5-T MR scanner. The transit time for contrast material was determined with a test bolus injection. A T1-weighted three-dimensional gradient-echo sequence with short TR and TE was used for a dynamic measurement at the level of the iliac arteries, the upper leg, and the lower leg arteries. For each level a single dose of gadolinium was injected into an antecubital vein with an MR power injector. Maximal-intensity-projection reconstructions were calculated after subtraction of the first measurement at each level. Two experienced MR radiologists who were unaware of the digital subtraction angiography results interactively evaluated both the MIP reconstructions and the single slices on a workstation, first independently and then in a consensus interpretation. With digital subtraction angiography, 80 hemodynamically significant stenoses and 39 occlusions were detected. For the stenoses and occlusions, a sensitivity of 100% was found for MR angiography. The specificity for the assessment of stenoses and occlusions was 98% and 94%, respectively, for the iliac arteries; 98% and 94%, respectively, for the upper leg arteries; and 94% and 95%, respectively, for the lower leg arteries. Most false-positive findings of occlusion were due to metal stents present in the iliac (n = 3) and upper leg (n = 4) arteries. The MR imaging technique that we used revealed the arteries from the distal aorta to the ankle and proved to be reliable at showing arterial stenoses and occlusions.