Perfusion measurements of the calf in patients with peripheral arterial occlusive disease before and after percutaneous transluminal angioplasty using MR arterial spin labeling.
OBJECTIVE
To evaluate muscle perfusion in patients with peripheral arterial occlusive disease (PAOD) before and after percutaneous transluminal angioplasty (PTA) of the limb by means of MR arterial spin labeling (ASL) perfusion measurements during reactive hyperemia.


METHODS
Ten patients with symptomatic PAOD affecting the iliac or femoral vessels were investigated before and after PTA. A pseudo-continuous arterial spin labeling (PCASL) MR technique was applied. Perfusion was measured in soleus and tibialis anterior muscle during reactive hyperemia. Key parameters such as mean perfusion value (Phyp ), time-to-peak (TTP) and duration of hyperemia (Thyp ) describing the perfusion signal curve were examined.


RESULTS
Between baseline and post-PTA, Phyp increased in both muscle groups. At the same time, TTP and Thyp decreased in both muscle groups. At the same time the clinically assessed ankle brachial index (ABI) increased from 0.56 ± 0.10 to 0.83 ± 0.15. The impaired pain-free walking distance improved in all patients.


CONCLUSIONS
PCASL MRI can detect changes of the key perfusion parameters Phyp , TTP, and Thyp after successful PTA of the calf muscles during reactive hyperemia and seems to be a promising tool for monitoring of interventional treatments.
Division of Diagnostic Radiology Department of Diagnostic and Interventional Radiology, University of Tübingen, Tübingen, Germany; Section on Experimental Radiology Department of Diagnostic and Interventional Radiology, University of Tübingen, Tübingen, Germany.
Gerd
G
Grözinger
Rolf
R
Pohmann
Fritz
F
Schick
Ulrich
U
Grosse
Roland
R
Syha
Klaus
K
Brechtel
Kilian
K
Rittig
Petros
P
Martirosian
D000368:Aged; D017130:Angioplasty / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D001783:Blood Flow Velocity; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000503:physiopathology / Q000601:surgery; D007866:Leg / Q000098:blood supply / Q000503:physiopathology / Q000601:surgery; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013113:Spin Labels; D016896:Treatment Outcome
D013113:Spin Labels
MRI; arterial spin labeling; calf; percutaneous transluminal angioplasty; perfusion