title: Simultaneous magnetic resonance angiography and perfusion (MRAP) measurement: initial application in lower extremity skeletal muscle.
abstract: OBJECTIVE
  To obtain a simultaneous 3D magnetic resonance angiography and perfusion (MRAP) using a single acquisition and to demonstrate MRAP in the lower extremities. A time-resolved contrast-enhanced exam was used in MRAP to simultaneously acquire a contrast-enhanced MR angiography (MRA) and dynamic contrast-enhanced (DCE) perfusion, which currently requires separate acquisitions and thus two contrast doses. MRAP can be used to assess large and small vessels in vascular pathologies such as peripheral arterial disease.
  
  
  METHODS
  MRAP was performed on 10 volunteers following unilateral plantar flexion exercise (one leg exercised and one rested) on two separate days. Data were acquired after administration of a single dose of contrast agent using an optimized sampling strategy, parallel imaging, and partial-Fourier acquisition to obtain a high spatial resolution, 3D-MRAP frame every 4 seconds. Two radiologists assessed MRAs for image quality, a signal-to-noise ratio (SNR) analysis was performed, and pharmacokinetic modeling yielded perfusion (K(trans) ).
  
  
  RESULTS
  MRA images had high SNR and radiologist-assessed diagnostic quality. Mean K(trans) ± standard error were 0.136 ± 0.009, 0.146 ± 0.012, and 0.191 ± 0.012 min(-1) in the resting tibialis anterior, gastrocnemius, and soleus, respectively, which significantly increased with exercise to 0.291 ± 0.018, 0.270 ± 0.019, and 0.338 ± 0.022 min(-1) . Bland-Altman analysis showed good repeatability.
  
  
  CONCLUSIONS
  MRAP provides simultaneous high-resolution MRA and quantitative DCE exams to assess large and small vessels with a single contrast dose. Application in skeletal muscle shows quantitative, repeatable perfusion measurements, and the ability to measure physiological differences.
authors: Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA; Case Center for Imaging Research, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio, USA.
authors: Katherine L
authors: KL
authors: Wright
authors: Nicole
authors: N
authors: Seiberlich
authors: John A
authors: JA
authors: Jesberger
authors: Dean A
authors: DA
authors: Nakamoto
authors: Raymond F
authors: RF
authors: Muzic
authors: Mark A
authors: MA
authors: Griswold
authors: Vikas
authors: V
authors: Gulani
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D035002:Lower Extremity / Q000098:blood supply / Q000502:physiology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D064847:Multimodal Imaging / Q000379:methods*; D018482:Muscle, Skeletal / Q000098:blood supply / Q000502:physiology*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: MR angiography; dynamic contrast enhanced MRI; perfusion
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