Gadofosveset-enhanced MR angiography of the pedal arteries in patients with diabetes mellitus and comparison with selective intraarterial DSA

Abstract

To compare gadofosveset-enhanced magnetic resonance angiography (MRA) of the pedal vasculature with selective intraarterial DSA. Eighteen patients with PAOD and type II diabetes were prospectively examined at 1.5 T. For contrast enhancement, 0.03 mmol/kg body weight gadofosveset was used. MR imaging consisted of dynamic and of high-resolution steady-state imaging. Selective digital subtraction angiography (DSA) was performed within 5 days and served as standard of reference. Image analysis was done by two observers. There were no differences between MRA and DSA regarding overall image quality. First-pass MRA detected significantly more patent vessel segments than did DSA (P<0.001, kappa=0.46). Interobserver agreement of MRA was very good with respect to the detection of patent vessel segments and the assessment of hemodynamically relevant stenoses (kappa=0.97 and 0.89, respectively). Steady-state imaging depicted significantly more patent metatarsal arteries than did dynamic imaging, and delineated inflammatory complications including osteomyelitis, soft-tissue abscesses, and fistulas related to the diabetic foot. Gadofosveset-enhanced MRA of the pedal vasculature proved to be superior to DSA. It offered a long imaging time window, and allowed for better depiction of the pedal outflow. Steady-state imaging delineated inflammatory complications associated with the diabetic foot.

Unenhanced MR Angiography of the Foot: Initial Experience of Using Flow-Sensitive Dephasing–prepared Steady-State Free Precession in Patients with Diabetes

“…All the five foot arteries had a high percentage of diagnostic segments and excellent image quality in both healthy volunteers and diabetic patients, especially the two main foot arteries, the dorsal artery and lateral plantar artery. The average number of diagnostic segments of the two arteries on NCE-MRA was over 95%, which is similar to the results reported using time-resolved or dedicated single station CE-MRA of the foot in the previous studies [7, 12, 33]. Meanwhile, although the flow of the pedal arteries may be impaired in the context of diabetes, the NCE-MRA technique yielded similar percentage of diagnostic arterial segments in both healthy volunteers and diabetic patients (303/320=95% v.s.…”

Non-Contrast-Enhanced MR Angiography (NCE-MRA) of the Hand Using Flow-Sensitive Dephasing (FSD)-Prepared Steady-State Free Precession (SSFP) in Patients with Rheumatoid Arthritis

“…The SNR of CE-MRA is mainly depended on the contrast agent infusion volume. As the distal artery has poor blood flow velocity and thus has low contrast agent infusion volume, CE-MRA gets poor image quality [17].…”

High temporal and spatial resolution 3D time‐resolved contrast‐enhanced magnetic resonance angiography of the hands and feet

“…Such an agent might allow images with increased SNR at lower contrast dose due to the higher T1 relaxivity. Such studies have been done previously but not at the levels of acceleration used here (15, 23).…”

“…(8–15) for the hands and from Refs. (16–24) for the feet. Another approach studied previously but not included in the tables is one using high frame rate 2D acquisition (25, 26).…”