title: Cuff-compression of the proximal calf to reduce venous contamination in contrast-enhanced stepping-table magnetic Resonance angiography.
abstract: OBJECTIVE
  To minimize venous overlay at the calf station in contrast-enhanced three-dimensional (3D) stepping-table magnetic resonance angiography (MRA) using a continuous cuff-compression technique during MR data acquisition.
  
  
  METHODS
  Within 14 months, 32 patients suffering from symptomatic peripheral arterial occlusive disease (PAOD) with a bilateral ankle-brachial index (ABI) of 0.8 or below were consecutively enrolled in this study. Unilateral cuff-compression of the proximal calf was applied in the study group (n = 14). The control group (n = 18) underwent no compression. All patients underwent three-step 3D contrast-enhanced magnetic resonance angiography (3D CE-MRA) according to the institute's protocol. Venous contamination scores (vcs) at the calf station were blindly ranked by a 1 to 3 rating score (3 = major venous contamination). The vcs values of the control group were regarded as standard. Statistical significance between both groups was evaluated with a paired t test.
  
  
  RESULTS
  Symmetric venous contamination was observed within the control group with a mean vcs of 2.2+/-0.6 on the left side and 2.2+/-0.7 on the right side with deltavcsleft-right of 0.1+/-0.2 (P>0.1). In the study group, asymmetric venous contamination was determined with vcsmean = 2.3+/-0.6 for the uncompressed side and vcsmean =1.4+/-0.5 for the compressed side and a deltavcsuncomp-comp of 0.9+/-0.5 (P<0.00005). The control group and the uncompressed side of the study group showed no significant difference in venous contamination (P > 0.1).
  
  
  CONCLUSIONS
  Subdiastolic cuff-compression of the proximal calf is an easily applicable and inexpensive technique by which to reduce venous contamination of the calf station in stepping-table MR angiography and to improve evaluation of the infrapopliteal arteries.
authors.affiliation: Department of Diagnostic Radiology, University of Basel, Switzerland. dbilecen@uhbs.ch
authors.forename: D
authors.initials: D
authors.lastname: Bilecen
authors.forename: K A
authors.initials: KA
authors.lastname: Jäger
authors.forename: M
authors.initials: M
authors.lastname: Aschwanden
authors.forename: H G
authors.initials: HG
authors.lastname: Heidecker
authors.forename: A C
authors.initials: AC
authors.lastname: Schulte
authors.forename: G
authors.initials: G
authors.lastname: Bongartz
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007866:Leg / Q000098:blood supply*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D014680:Veins / Q000502:physiology