Infragenual cuff-compression reduces venous contamination in contrast-enhanced MR angiography of the calf.
OBJECTIVE
To reduce venous contamination at the calf level in three-dimensional contrast-enhanced MR angiography (CE-MRA) by applying continuous infragenual cuff-compression.


METHODS
Ten patients with clinically relevant peripheral arterial occlusive disease (PAOD) underwent dynamic three-dimensional CE-MRA of the calf. Six consecutive measurements were acquired with the first measurement serving as mask. Cuff-compression of 50 mmHg was attached below the knee. To allow intra-individual comparison, compression was applied unilaterally. The cuff was inflated three minutes before scanning and was continued throughout the MRA session. Venous contamination and arterial visualization scores were ranked using a five-point rating scale. Contrast-to-noise ratios (CNRs) of superficial enhancing calf-veins on the uncompressed and compressed calf sides were evaluated. An asymmetry index (AI) defined by CNR(mean) (uncompressed)/CNR(mean) (compressed) was introduced to describe the ratio in venous contrast agent supply between both sides quantitatively.


RESULTS
Three-dimensional CE-MRA of the calves demonstrated significantly lower superficial venous contamination scores (P < 0.004) and clearly improved arterial visualization (P < 0.009) on the compressed side. Additionally, AI values were larger than 1 (P < 0.02), indicating a higher contrast agent supply in the superficial veins on the uncompressed side.


CONCLUSIONS
Infragenual cuff-compression minimizes venous overlay in three-dimensional CE-MRA at calf level by reduction of contrast agent supply in the superficial veins.
Department of Diagnostic Radiology, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland. dbilecen@uhbs.ch
Deniz
D
Bilecen
Anja-Carina
AC
Schulte
Georg
G
Bongartz
Hanns-Georg
HG
Heidecker
Markus
M
Aschwanden
Kurt A
KA
Jäger
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery
D003287:Contrast Media