Unmasking pedal arteries in patients with critical ischemia using time-resolved contrast-enhanced 3D MRA

Abstract

In our prospective study, t3D MRA has been proven to be superior to DSA and US scan in pedal vasculature imaging in critical limb ischemia. This is a valuable, noninvasive method for detecting potential pedal bypass target arteries.

TRICKS Magnetic Resonance Angiography at 3-Tesla for Assessing Whole Lower Extremity Vascular Tree in Patients with High-Grade Critical Limb Ischemia: DSA and TASC II Guidelines Correlations

“…In addition, the present study also reveals excellent diagnostic capability of T-MTA in assessing significant stenosis for different portions of the lower limbs with an overall high sensitivity (99.5%), specificity (93.6%), PPV (95.4%), NPV (99.6%), and accuracy (97.7%). Concurrent with prior reports that suboptimal filling of distal vessels in DSA could lead to nonopacification of patent pedal arteries [9–12], six of our cases with target pedal arteries not visualized on DSA were depicted on T-MRA, enabling the subsequent successful surgical bypass grafting. This study confirms that the 3D three-station T-MRA at 3-tesla is a robust and an accurate method for assessing the entire vascular tree of patients with CLI, even though 75% of our patients had Fontaine stage IV lesions.…”

“…The feasibility of T-MRA at 1.5-tesla for assessing patients with PAOD has been previously advocated in several studies [8–11]. In addition, some researchers have described promising studies of T-MRA focusing in the assessment of infrapopliteal or pedal vessels [12, 13]. InterSociety Consensus for the Management of Peripheral Arterial Disease (TASC II) provided the most important guidelines for the vascular surgeons in the treatment decision of PAOD [1].…”

Critical limb ischemia: an update for interventional radiologists

“…Moreover, in 23% of the cases, 3D MR angiography detected flow that angiography did not (14). Similarly, in a separate study on pedal vascular imaging, 3D MR angiography was shown to offer a better representation of the CLI anatomy in the calf and pedal regions than DSA, and even afforded sub-millimeter voxel views (15). Furthermore, the recent introduction of blood pool MR angiography contrast agents have provided a more robust assessment of smaller vessels when compared to the more quickly cleared magnetic resonance imaging (MRI) contrast agents such as gadopentetate dimeglumine (Magnovist, Bayer, Leverkusen, Germany).…”

Traumatic Lateral Plantar Artery Pseudoaneurysm and the Use of Time-Resolved MR Angiography

“…This pulse sequence has the ability to acquire images through a volume of tissue throughout the passage of a single contrast bolus [13]. This ensures the acquisition of images which demonstrate the peak level of arterial Oblique coronal fast spin echo MR image of the ankle demonstrates a triangular 1.0×0.5 cm low signal intensity foreign body (arrow) medial to the base of the lesion, later confirmed to represent a retained glass fragment enhancement, while maintaining high sensitivity and specificity for arterial occlusive disease that is comparable to DSA [12,15,16]. In addition, information obtained from the bolus transit time can indirectly reflect flow rate.…”