[Cardiovascular whole-body MR imaging in patients with symptomatic peripheral arterial occlusive disease].
OBJECTIVE
To examine patients with peripheral-arterial-occlusive-disease (PAOD) for systemic effects associated with atherosclerosis using a comprehensive state-of-the-art whole-body MR examination protocol. The protocol comprises the assessment of the complete arterial vasculature (except coronary arteries), the brain, and the heart.


METHODS
Multi-station whole-body 3D MR angiography was performed in sixty consecutive patients with clinical suspicion for PAOD at 1.5 T (Magnetom Avanto, Siemens, Erlangen, Germany). Functional and delayed enhancement cardiac images were acquired, as well as FLAIR images of the brain and TOF angiography of intracranial vessels. MR and DSA images were assessed by independent observers for atherosclerotic manifestations and other pathology. Sensitivity and specificity for the detection of vascular pathology was calculated for MR data using conventional DSA of the symptomatic region as standard-of-reference.


RESULTS
Sensitivity and specificity for the detection of significant vascular stenosis (> 70 % luminal narrowing) was 94 % and 96 % (PPV 87 %, NPV 98 %). Significant microangiopathic tissue alterations (n = 7) and/or cerebral infarction (n = 18) were diagnosed in 23/60 patients. Thirty-eight of 60 patients presented with systolic left ventricular wall motion abnormalities. In 24 patients subendocardial or transmural delayed enhancement was detected in corresponding regions, indicating prior myocardial infarction.


CONCLUSIONS
For patients with PAOD and suspected systemic atherosclerotic disease a comprehensive diagnosis of accompanying cardiovascular pathology and therefore staging of systemic atherosclerotic disease is feasible within one MR examination.
Fenchel
M
M
Abteilung für Radiologie, Eberhard-Karls-Universität Tübingen. michael.fenchel@med.uni-tuebingen.de
Jost
D
D
Kramer
U
U
Stauder
N
N
Bretschneider
C
C
Klumpp
B
B
Scheule
A
A
Nägele
T
T
Claussen
C D
CD
Miller
S
S
D000368:Aged; D015901:Angiography, Digital Subtraction; D050197:Atherosclerosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002985:Clinical Protocols; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity