Purpose:To develop a contrast-enhanced magnetic resonance (MR) technique to measure skeletal muscle perfusion in peripheral arterial disease (PAD).
Materials and Methods:A total of 11 patients (age ϭ 61 Ϯ 11 years) with mild to moderate symptomatic PAD (anklebrachial index [ABI] ϭ 0.75 Ϯ 0.08) and 22 normals were studied using an MR-compatible ergometer. PAD and normal max (Nl max ; N ϭ 11) exercised to exhaustion. Nl low (N ϭ 11) exercised to the same workload achieved by PAD. At peak exercise, 0.1 mm/kg of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) was infused at 3-4 cm 3 / second followed by a saline flush at the same rate. A dualcontrast gradient echo (GRE) sequence enabled simultaneous acquisition of muscle perfusion and arterial input function (AIF). The perfusion index (PI) was defined as the slope of the time-intensity curve (TIC) in muscle divided by the arterial TIC slope.
Results
Conclusion:Peak-exercise measurement of lower limb perfusion with dual-contrast, first-pass MR distinguishes PAD from normals. This method may be useful in the study of novel therapies for PAD.