title: Mapping of autogenous saphenous veins as an imaging adjunct to peripheral MR angiography in patients with peripheral arterial occlusive disease and peripheral bypass grafting: prospective comparison with ultrasound and intraoperative findings.
abstract: BACKGROUND
  Mapping of the great saphenous vein is very important for planning of peripheral and coronary bypass surgery. This study investigated mapping of the great saphenous vein as an adjunct to peripheral MR angiography using a blood pool contrast agent in patients who were referred for evaluation of peripheral arterial occlusive disease and bypass surgery.
  
  
  METHODS
  38 patients with peripheral arterial occlusive disease (21 men; mean age: 71 years, range, 44-88 years) underwent peripheral MR angiography using the blood pool contrast agent Gadofosveset trisodium. Apart from primary arterial assessment images were evaluated in order to determine great saphenous vein diameters at three levels: below the saphenofemoral junction, mid thigh and 10 cm above the knee joint (usability: diameter range: >3 and <10 mm at one level and >3.5 and <10 mm at a neighboring level). Duplex ultrasound was performed by an independent examiner providing diameter measurements at the same levels. Additionally, vessel usability was determined intraoperatively by the vascular surgeon during subsequent bypass surgery.
  
  
  RESULTS
  Mean venous diameters for MR angiography/duplex ultrasound were 5.4±2.6/5.5±2.8 mm (level 1), 4.7±2.7/4.6±2.9 mm (level 2) and 4.4±2.2/4.5±2.3 mm (level 3), respectively, without significant differences between the modalities (P = 0.207/0.806/0.518). Subsequent surgery was performed in 27/38 patients. A suitable saphenous vein was diagnosed in 25 and non-usability was diagnosed in 2 of the 27 patients based on MR angiography/duplex ultrasound, respectively. Usability was confirmed by intraoperative assessment in all of the 24 patients that received a venous bypass graft in subsequent bypass surgery. In 1 case, in which the great saphenous vein was assessed as useable by both MR angiography and duplex ultrasound, it was not used during subsequent bypass surgery due to the patients clinical condition and comorbidities.
  
  
  CONCLUSIONS
  Simultaneous mapping of the great saphenous vein as an imaging adjunct to peripheral MR angiography with a blood pool contrast agent is an alternative to additive duplex ultrasound in patients undergoing subsequent peripheral bypass grafting.
authors.affiliation: University of Bonn, Dept. of Radiology, Germany.
authors.forename: Ann-Marie Bintu Munda
authors.initials: AM
authors.lastname: Jah-Kabba
authors.affiliation: University of Bonn, Dept. of Radiology, Germany.
authors.forename: Guido Matthias
authors.initials: GM
authors.lastname: Kukuk
authors.affiliation: University of Bonn, Dept. of Radiology, Germany.
authors.forename: Dariusch Reza
authors.initials: DR
authors.lastname: Hadizadeh
authors.affiliation: University of Bonn, Dept. of Radiology, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Träber
authors.affiliation: University of Bonn, Dept. of Surgery, Germany.
authors.forename: Arne
authors.initials: A
authors.lastname: Koscielny
authors.affiliation: University of Bonn, Dept. of Surgery, Germany.
authors.forename: Mustapha Sundifu
authors.initials: MS
authors.lastname: Kabba
authors.affiliation: University of Bonn, Dept. of Surgery, Germany.
authors.forename: Frauke
authors.initials: F
authors.lastname: Verrel
authors.affiliation: University of Bonn, Dept. of Radiology, Germany.
authors.forename: Hans Heinz
authors.initials: HH
authors.lastname: Schild
authors.affiliation: University of Bonn, Dept. of Radiology, Germany.
authors.forename: Winfried Albert
authors.initials: WA
authors.lastname: Willinek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging* / Q000601:surgery; D011446:Prospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography; D058017:Vascular Grafting / Q000379:methods*
chemical_list: C427127:superparamagnetic blood pool agent; D052203:Ferrosoferric Oxide