[MR angiography of peripheral arterial disease of the distal legs: is time resolved MRA (TRICKS) necessary?].
OBJECTIVE
To demonstrate the added diagnostic value of time-resolved imaging of contrast kinetics (TRICKS) in the evaluation of lower limb arteries compared to standard 3 level MRA with stepping table method.


METHODS
Forty patients (30% diabetics) with lower extremity peripheral arterial disease (87.5% with chronic ischemia) underwent standard contrast MRA including TRICKS of the distal arteries. Five arterial segments were defined per leg, and 395 arterial segments were compared (one patient with amputation). Two reviewers evaluated the quality of arterial imaging, presence of venous return and degree of stenosis per segment. The degree of interobserver agreement for arterial stenosis measurement was calculated.


RESULTS
More arterial segments could be analyzed on the TRICKS sequence (good or excellent analysis in 63.03%-66.32% of arterial segments compared to 41.51%-47.08% on routine MRA). There was less venous contamination on TRICKS images (25.57% to 27.60% gain). The degree of interobserver agreement was superior with TRICKS compared to standard MRA (kappa 0.85 vs 0.69).


CONCLUSIONS
The TRICKS sequence can be added to standard MRA for pre-therapeutic evaluation of distal arteries in patients with peripheral arterial disease, especially with chronic ischemic with rest pain and/or trophic changes.
Archambault
E
E
Service de Radiologie et Imagerie Médicale, Hôpital de la Cavale Blanche, CHU Brest, boulevard Tanguy Prigent, 29609 Brest Cedex.
Gouny
P
P
Hébert
T
T
Salley
N
N
Nowak
E
E
Nonent
M
M
D000368:Aged; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D016491:Peripheral Vascular Diseases / Q000175:diagnosis*