Non-invasive ECG-triggered 2D TOF MR angiography of the pelvic and leg arteries in an open 1.0-tesla high-field MRI system in comparison to conventional DSA

Suttmeyer, Britta; Teichgräber, Ulf; Thomas, Alexandre; Albrecht, L.; Jonczyk, Martin; Verba, M.; Güttler, Felix; Schnackenburg, Bernhard; Hamm, Bernd; Bucourt, Maximilian de

doi:10.1515/bmt-2013-0113

Cited by 14 publications

(11 citation statements)

References 21 publications

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“…We cannot exclude that there was a possible slight over-estimation of the MRA derived vessel diameters as recently reported since our study context did not comprise the validation of vessel diameter measurements, e.g. macroscopic by pathology or visually by gold standard digital subtraction angiography [ 15 , 28 ]. In addition, we cannot exclude that also the degree of stenosis especially on the lower leg vessels was over-estimated by MRA in our study as reported before [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 98%

“…Magnetic resonance angiography (MRA) is an alternative method to evaluate leg artery morphology non-radiation-based and is more sensitive and specific to detect stenosis compared to duplex sonography and computed tomography angiography [ 13 ]. Until now only few studies have used MRA for investigations of leg arteries in patients [ 14 , 15 ], but not in the general population to establish important reference values for arterial morphology, to assess the subclinical status of PAD and obtain information on artery variants as vascular surgery conditions in the general community.…”

Section: Introductionmentioning

confidence: 99%

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Reference values of vessel diameters, stenosis prevalence, and arterial variations of the lower limb arteries in a male population sample using contrast-enhanced MR angiography

et al. 2018

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IntroductionMorphological characterization of leg arteries is of significant importance to detect vascular remodeling triggered by atherosclerotic changes. We determined reference values of vessel diameters and assessed prevalence of stenosis and arterial variations of the lower limb arteries in a healthy male population sample.MethodsGadolinium-enhanced magnetic resonance angiography at 1.5 Tesla was performed in 756 male participants (median age = 52 years, range = 21–82 years) of the population-based Study of Health in Pomerania. Vessel diameters were measured in 9 predefined segments of the pelvic and leg arteries and 95th percentiles were used for upper reference values of means of left and right side arteries.ResultsReference values of vascular diameters decreased from proximal to distal arteries: common iliac = 1.18cm; internal iliac = 0.75cm; external iliac = 1.03cm; proximal femoral = 1.02cm; distal femoral = 0.77cm; popliteal = 0.69cm; anterior tibial = 0.42cm; posterior tibial = 0.38cm; fibular = 0.40cm. Body-surface area indexed reference values increased with age in all segments. A number of 53 subjects (7.0%) had at least one stenosis, mainly in the lower leg arteries anterior tibial (n = 28, 3.7%), posterior tibial (n = 18, 2.4%) and fibular (n = 20, 2.6%). The risk of stenosis increased considerably with age (odds ratio = 1.08; p<0.001). The most common arterial variant was type I-A in both legs (n = 620, 82%).ConclusionWe present reference values for different pelvic and leg artery segment diameters in men that decrease from proximal to distal and increase with age. Stenoses were most prevalent in lower leg arteries and type I-A was the most common variant in the lower leg.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Reference values of vessel diameters, stenosis prevalence, and arterial variations of the lower limb arteries in a male population sample using contrast-enhanced MR angiography

et al. 2018

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“…The disadvantage of TOF-MRV is that the FOV is small for each obtained image and that it is time consuming for obtaining a full image of the lower extremity [ 8 ]. MRI with gadolinium-based contrast media is a quicker method for imaging the lower extremities [ 19 , 20 , 21 , 22 ]. Although MRI does not involve radiation exposure, the noniodinated contrast agents that are used have harmful effects.…”

Section: Discussionmentioning

confidence: 99%

Novel Diagnostic Options without Contrast Media or Radiation: Triggered Angiography Non-Contrast-Enhanced Sequence Magnetic Resonance Imaging in Treating Different Leg Venous Diseases

et al. 2020

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Objectives: Venous diseases in the lower extremities long lacked an objective diagnostic tool prior to the advent of the triggered angiography non-contrast-enhanced (TRANCE) technique. Methods: An observational study with retrospective data analysis. Materials: Between April 2017 and June 2019, 66 patients were evaluated for venous diseases through TRANCE-magnetic resonance imaging (MRI) and were grouped according to whether they had occlusive venous (OV) disease, a static venous ulcer (SU), or symptomatic varicose veins (VV). The clinical appliance of TRANCE-MRI was analysed by groups. Results: In total, 63 patients completed the study. TRANCE-MRI could identify venous thrombosis, including that of the abdominal and pelvic vessels, and it enabled the timely treatment of underlying diseases in patients with OV disease. TRANCE-MRI was statistically compared with the duplex scan, the gold standard to exclude deep vein thrombosis (DVT) in the legs, with regard to their abilities to detect venous thrombosis by using Cohen’s kappa coefficient at a compatible value of 0.711. It could provide the occlusion degree of the peripheral artery for treating an SU. Finally, TRANCE-MRI can be used to outline all collateral veins and occult thrombi before treating symptomatic or recurrent VV to ensure a perfect surgical plan and to avoid complications. Conclusions: TRANCE-MRI is an innovative tool in the treatment of versatile venous pathology in the lower extremities and is widely used for vascular diseases in our institution.

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“…Signal loss in a patent vessel from the saturation of in-plane flow is one of the most common pitfalls in two-dimensional (2D) TOF MR. The other disadvantage of TOF-MRV is that the FOV is small for each image obtained and that it requires considerable time to obtain a whole image of the lower extremity [ 17 , 18 , 19 ]. MRI with gadolinium-based contrast media is a relatively rapid method for imaging the lower extremities [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Stasis Leg Ulcers: Venous System Revises by Triggered Angiography Non-Contrast-Enhanced Sequence Magnetic Resonance Imaging

et al. 2020

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Objectives: The distribution of venous pathology in stasis leg ulcers is unclear. The main reason for this uncertainty is the lack of objective diagnostic tools. To fill this gap, we assessed the effectiveness of triggered angiography non-contrast-enhanced (TRANCE)-magnetic resonance imaging (MRI) in determining the venous status of patients with stasis leg ulcers. Methods: This prospective observational study included the data of 23 patients with stasis leg ulcers who underwent TRANCE-MRI between April 2017 and May 2020; the data were retrospectively analyzed. TRANCE MRI utilizes differences in vascular signal intensity during the cardiac cycle for subsequent image subtraction, providing not only a venogram but also an arteriogram without the use of contrast agents or radiation. Results: TRANCE MRI revealed that the stasis leg ulcers of nine of the 23 patients could be attributed to valvular insufficiency and venous occlusion (including deep venous thrombosis [DVT], May–Thurner syndrome, and other external compression). Moreover, TRANCE MRI demonstrated no venous pathology in five patients (21.7%). We analyzed TRANCE MRI hemodynamic parameters, namely stroke volume, forward flow volume, backward flow volume, regurgitant fraction, absolute volume, mean flux, stroke distance, and mean velocity, in the external iliac vein, femoral vein, popliteal vein, and great saphenous vein (GSV) in three of the patients with valvular insufficiency and three of those with venous occlusion. We found that the mean velocity and stroke volume in the GSV was higher than that in the popliteal vein in all patients with venous valvular insufficiency. Conclusions: Stasis leg ulcers may have no underlying venous disease and could be confirmed by TRANCE-MRI. TRANCE MRI has good Interrater reliability between Duplex study in greater saphenous venous insufficiency. It also potentially surpasses existing diagnostic modalities in terms of distinguishable hemodynamic figures. Accordingly, TRANCE-MRI is a safe and useful tool for examining stasis leg ulcers and is extensively applied currently.

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Non-invasive ECG-triggered 2D TOF MR angiography of the pelvic and leg arteries in an open 1.0-tesla high-field MRI system in comparison to conventional DSA

Abstract: The TOF-MRA protocol presented here can be performed in an open 1.0-T MRI system in 60-90 min. Visualization is degraded when the target artery leaves the plane orthogonal to the imaging plane (1) or signal yield is poor due to small caliber (2).

Cited by 14 publications

References 21 publications

Reference values of vessel diameters, stenosis prevalence, and arterial variations of the lower limb arteries in a male population sample using contrast-enhanced MR angiography

Reference values of vessel diameters, stenosis prevalence, and arterial variations of the lower limb arteries in a male population sample using contrast-enhanced MR angiography

Novel Diagnostic Options without Contrast Media or Radiation: Triggered Angiography Non-Contrast-Enhanced Sequence Magnetic Resonance Imaging in Treating Different Leg Venous Diseases

Stasis Leg Ulcers: Venous System Revises by Triggered Angiography Non-Contrast-Enhanced Sequence Magnetic Resonance Imaging

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