title: Comprehensive MR angiography of the lower limbs: a hybrid dual-bolus approach including the pedal arteries.
abstract: The purpose of this study was to include the pedal vasculature into the coverage of peripheral multistation magnetic resonance angiography (3DceMRA). A total of 216 patients suffering from peripheral vascular disease were examined with a modified hybrid dual-bolus technique. The cruropedal arteries were acquired first with two sagittal slabs and time-resolved 3D sequences. Then the aortofemoral vessels were visualized using the bolus-chase technique and a second contrast injection. Interventional procedures were performed in 104 patients, and in 69 of those, the cruropedal vessels were also examined with digital subtraction angiography (iaDSA). Using 3DceMRA, the cruropedal arteries were displayed with both excellent and good quality in 95% (205/216 cases), and without any venous overlay in 94% (203/216 cases). The aortofemoral vessels were not jeopardized by the first contrast injection. With iaDSA as the standard of reference, observed sensitivity of 3DceMRA was found in ranges from 80% (29%, 99%) to 100% (86%, 100%) for assessing significant stenoses, and observed specificity ranged between 93% [80%, 98%] and 100% (82%, 100%). In conclusion, hybrid dual-bolus 3DceMRA significantly reduces the limitations of standard single-bolus 3DceMRA in anatomic coverage and temporal resolution of the cruropedal arteries, thus providing high-quality images of the entire peripheral vasculature.
authors.affiliation: Diagnostic and Interventional Radiology, Herz- und Gefässklinik GmbH, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany. schmitt.radiologie@herzchirurgie.de
authors.forename: R
authors.initials: R
authors.lastname: Schmitt
authors.forename: G
authors.initials: G
authors.lastname: Coblenz
authors.forename: O
authors.initials: O
authors.lastname: Cherevatyy
authors.forename: H
authors.initials: H
authors.lastname: Brunner
authors.forename: S
authors.initials: S
authors.lastname: Fröhner
authors.forename: E
authors.initials: E
authors.lastname: Wedell
authors.forename: G
authors.initials: G
authors.lastname: Karg
authors.forename: G
authors.initials: G
authors.lastname: Christopoulos
mesh_terms: D000368:Aged; D001158:Arteries / Q000473:pathology*; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005528:Foot / Q000098:blood supply* / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D035002:Lower Extremity / Q000098:blood supply / Q000473:pathology; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D009942:Organometallic Compounds / Q000008:administration & dosage; D016491:Peripheral Vascular Diseases / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine