Determination of unknown high-grade atherosclerotic lesions by whole-body cardiovascular imaging: assessment of patients with symptomatic atherosclerotic disease of peripheral arteries.
OBJECTIVE
The long-term prospects for patients with peripheral-arterial-occlusive disease (PAOD) must be considered in the context of coexistent generalized atherosclerosis. We sought to determine the added clinical information of noninvasive magnetic resonance imaging (MRI) for detecting asymptomatic atherosclerotic disease in patients already at high risk.


METHODS
Eighty-four patients (64 men, mean age 66.2 + or - 10.0 years, range 34-84 years) with suspected or known PAOD were examined using a comprehensive cardiovascular MRI protocol. Two experienced observers reviewed all MRIs for the presence of "relevant findings," which were defined as pathology requiring immediate therapy or mid-term follow-up.


RESULTS
Assessment of cardiac structures and function in 84 study patients yielded new pathology in 40 (48%) patients, whereas cerebral imaging revealed new findings in 45 (54%) patients. Previously unsuspected vascular findings were evident in 46 (55%) patients. Using the information from the MRIs, in 54 (64%) of patients mid-term follow-up was required, whereas in 7 (8%) patients a change of therapy or immediate treatment was necessary.


CONCLUSIONS
Whole-body cardiovascular MRI is able to detect symptomatic and unsuspected findings in patients with PAOD. This technique was able to detect several vascular abnormalities that necessitated immediate medical attention and intervention in patients already identified as high-risk patients and, therefore, may show an increasing impact to determine individual therapeutic and follow-up concepts.
Fenchel
Michael
M
Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany. michael.fenchel@med.uni-tuebingen.de
Scheule
Albertus M
AM
Kramer
Ulrich
U
Bretschneider
Christiane
C
Klumpp
Bernhard
B
Seeger
Achim
A
Rittig
Kilian
K
Claussen
Claus D
CD
Miller
Stephan
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D051598:Whole Body Imaging / Q000379:methods*