Evaluation of Peripheral Arterial Disease with Nonenhanced Quiescent-Interval Single-Shot MR Angiography

Hodnett, Philip A.; Koktzoglou, Ioannis; Davarpanah, Amir H.; Scanlon, Timothy; Collins, Jeremy D.; Sheehan, John J.; Dunkle, Eugene; Gupta, Navyash; Carr, James C.; Edelman, Robert R.

doi:10.1148/radiol.11101336

Cited by 109 publications

(69 citation statements)

References 30 publications

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“…This method relies on subtraction of systolic from diastolic acquisitions for angiography. [32][33][34][35] Single-shot partial Fourier FSE sequences (i.e. single-shot FSE, half-Fourier rapid acquisition with relaxation enhancement or fast asymmetric FSE) have allowed shortened acquisition times to provide clinically feasible imaging of the peripheral arterial vascular system, especially the lower limb.…”

Section: 30mentioning

confidence: 99%

Peripheral limb vascular malformations: an update of appropriate imaging and treatment options of a challenging condition

Madani¹,

Farrant²,

Chhaya³

et al. 2015

BJR

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Peripheral vascular malformations encompass a wide spectrum of lesions that can present as an incidental finding or produce potentially life-or limb-threatening complications. They can have intra-articular and intraosseous extensions that will result in more diverse symptomology and present greater therapeutic challenges. Developments in classification, imaging and interventional techniques have helped to improve outcome. The onus is now placed on appropriate detailed preliminary imaging, diagnosis and classification to direct management and exclude other more common mimics. Radiologists are thus playing an increasingly important role in the multidisciplinary teams charged with the care of these patients. By fully understanding the imaging characteristics and image-guided procedures available, radiologists will be armed with the tools to meet these responsibilities. This review highlights the recent advances made in imaging and the options available in interventional therapy.Peripheral vascular malformations (PVMs) encompass a wide spectrum of lesions that can present as an incidental finding or produce potentially life-or limb-threatening complications. PVMs are relatively common within the extremities and usually confined to the subcutaneous tissues and muscles. They can have, however, intra-articular and intraosseous extensions that will result in more diverse symptomology and present greater therapeutic challenges. Any misdiagnosis can lead to inappropriate management and treatment.

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Section: 30mentioning

confidence: 99%

Peripheral limb vascular malformations: an update of appropriate imaging and treatment options of a challenging condition

Madani¹,

Farrant²,

Chhaya³

et al. 2015

BJR

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“…NC-MRA has emerged as a potential diagnostic technique for PAD [20][21][22][23][24][25], with QISS MRA specifically demonstrating good accuracy for hemodynamic stenosis in diabetic patients. Whilst DSA can be performed with carbon dioxide as a contrast agent to prevent nephrotoxicity, image quality is poorer [15,16] and DSA remains an invasive procedure with attendant risks.…”

Section: Discussionmentioning

confidence: 99%

“…Also, this confounded direct comparison between patient tolerance of NC-MRA and DSA, allowing only a small comparison using patients who had a diagnostic DSA without intervention (n=8). The duration of NC-MRA was approximately 15 min longer than in a previous study of QISS MRA accuracy in diabetic patients, most likely due to the inclusion of the pedal QISS-ASL MRA acquisition [23,26]. Further, patients were offered music to listen to during MRA, which was not offered during DSA.…”

Section: Cviamentioning

confidence: 99%

“…Recently, several non-contrast MRA (NC-MRA) techniques have been developed to image peripheral arteries [20][21][22][23][24][25][26]. These include fresh-blood imaging, quiescent-interval single-shot (QISS) imaging, and flow-sensitizing dephasing gradient-prepared steady-state free precession imaging [20,25,[27][28][29][30].…”

Section: Introductionmentioning

confidence: 99%

“…These include fresh-blood imaging, quiescent-interval single-shot (QISS) imaging, and flow-sensitizing dephasing gradient-prepared steady-state free precession imaging [20,25,[27][28][29][30]. QISS MRA has good accuracy and robustness for PAD assessment, specifically in diabetic patients, with an estimated sensitivity of 87.0-89.7% and specificity of 94.6-96.5% using gadolinium-enhanced MRA for comparison [23,26]. QISS-arterial spin-labelled (QISS-ASL) MRA has been proposed for pedal arterial imaging [31].…”

Section: Introductionmentioning

confidence: 99%

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Patient Perception of Lower Limb Non-Contrast Magnetic Resonance Angiography and Digital Subtraction Angiography in Diabetic Patients with Peripheral Arterial Disease

Lukies

Richmond

Hornsey

et al. 2017

Cardiovasc Imaging Asia

Self Cite

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Peripheral arterial disease (PAD) is common in diabetic patients, with an estimated prevalence of 20-29% in those over 50 years of age, and causes significant morbidity, with amputation or limb loss occurring in around 4% of patients [1]. The imaging diagnosis of PAD in diabetic patients is challenging because renal impairment is common and vessels tend to be cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective: Non-contrast magnetic resonance angiography (NC-MRA) is an attractive technique for imaging peripheral arterial disease (PAD) in diabetic patients where arterial calcification and renal impairment are common. Our purpose was to evaluate patient perception of lower limb NC-MRA and compare this perception to that of digital subtraction angiography (DSA). Materials and Methods:Thirty-one diabetic patients (18 male, 13 female, mean age=69 years) with symptomatic PAD (critical ischemia, n=10) referred for DSA were prospectively recruited, and 1.5T quiescent-interval single-shot NC-MRA was performed before DSA (intervention performed during DSA, n=23). Patients rated anxiety, pain, discomfort, willingness to repeat (Likert scale: 1 most favorable to 7 least favorable), and difficulty compared to expectations (-3 better to +3 worse).Results: Twenty-nine patients' results were analyzed (DSA under general anesthesia, n=1; incomplete NC-MRA due to morbid obesity, n=1). NC-MRA and DSA median scores were 1 vs. 3, 1 vs. 2, 2 vs. 2, and 1 vs. 1 for anxiety, pain, discomfort, and willingness to repeat, respectively. The median score for difficulty compared to expectations was 0 (as expected) for both examinations. The anxiety and pain scores for NC-MRA were significantly lower than those for DSA (p=0.006 and p=0.001, respectively). Reasons for the less favorable NC-MRA experience included machine noise (n=3), pain from coil pressure (n=3), and claustrophobia (n=1).Conclusion: NC-MRA was well tolerated overall, and better than DSA for anxiety and pain. Although DSA is commonly required for intervention in PAD, NC-MRA may inform disease management and potentially obviate DSA where conservative management, or open surgery, are indicated. Reduced acoustic noise, lighter receiver coils, and wider scan bores may improve procedural tolerance.

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Magnetic Resonance, Computed Tomographic, and Angiographic Imaging of Peripheral Artery Disease

Horikawa

Kaufman

2017

Peripheral Artery Disease

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Evaluation of Peripheral Arterial Disease with Nonenhanced Quiescent-Interval Single-Shot MR Angiography

Abstract: QISS nonenhanced MR angiography offers an alternative to currently used imaging tests for symptomatic chronic lower limb ischemia, for which the administration of iodinated or gadolinium-based contrast agents is contraindicated.

Cited by 109 publications

References 30 publications

Peripheral limb vascular malformations: an update of appropriate imaging and treatment options of a challenging condition

Peripheral limb vascular malformations: an update of appropriate imaging and treatment options of a challenging condition

Patient Perception of Lower Limb Non-Contrast Magnetic Resonance Angiography and Digital Subtraction Angiography in Diabetic Patients with Peripheral Arterial Disease

Magnetic Resonance, Computed Tomographic, and Angiographic Imaging of Peripheral Artery Disease

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