Non-enhanced, ECG-gated MR angiography of the pedal vasculature: comparison with contrast-enhanced MR angiography and digital subtraction angiography in peripheral arterial occlusive disease

Schubert, Tilman; Takes, Martin; Aschwanden, Markus; Klarhoefer, Markus; Haas, Tanja; Jacob, Augustinus Ludwig; Liu, David; Gutzeit, Andreas; Kos, Sebastian

doi:10.1007/s00330-015-4068-6

Cited by 16 publications

(7 citation statements)

References 30 publications

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“…Others vascular diagnostic imaging modalities, such as CTA, 70 nonenhanced MRA, 71,72 IVUS, 73 and the most recent emerging noninvasive US transducer array-based photoacoustic (optoacoustic) tomography (PTA), 74,75 are invoked to characterize anatomical details and morphologic characteristic of arterial lesion in diabetics lower limbs PAD. Generally, CTA and MRA are used in selected patients before revascularization to solve some specific questions caused by disagreement between previous imaging modalities and an existing particular clinical setting.…”

Section: Diagnostic Accuracymentioning

confidence: 99%

Ultrasound in the Modern Management of the Diabetic Foot Syndrome: A Multipurpose Versatile Toolkit

Pieruzzi

Napoli

Goretti

et al. 2020

The International Journal of Lower Extremity Wounds

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Ultrasound (US) is a noninvasive and versatile technology that in recent years found acceptance in almost all the medical specialties, with diagnostic and interventional applications. In the diabetic foot syndrome (DFS), US found specific indications mainly in the screening, quantification, and follow-up of the vascular component of the pathology, but also in the study of the deformities and structural modifications induced by neuropathy and in the diagnosis and surgical management of infections, especially those that induce anatomical changes, like abscesses and fasciitis. This review will summarize all these application of US, giving special attention to the vascular aspects, and on the predominant role that US gained in recent times to guide the indication to revascularization, on the new standardized approach to the study of the arterial tree of the limb and the foot, the so-called duplex ultrasound arterial mapping, which significantly increased the utilization of US to plan the revascularizations in this complex pathology. Outside the vascular fields, the diagnosis of neuropathy and infection and the intraoperative use of US in the surgical management of abscesses and fasciitis will be discussed, leaving the last part to the new and interesting applications of US in the management of DFU, a field that is still in evolution, offering new possibilities to the health care professionals involved in the management of these chronic wounds. The variety of applications both in diagnostic and operative fields makes US a rather versatile technology—a toolkit—that should have a special place among those at reach of the specialists of DFS care.

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Section: Diagnostic Accuracymentioning

confidence: 99%

Ultrasound in the Modern Management of the Diabetic Foot Syndrome: A Multipurpose Versatile Toolkit

Pieruzzi

Napoli

Goretti

et al. 2020

The International Journal of Lower Extremity Wounds

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“…As a result, insufficient subtraction from systolic-diastolic phase may be lead to inferior image quality [15]. Schubert et al demonstrated that if technically successful, the diagnostic performance of cardiac-phase-dependent NCE-MRA is comparable to the CE-MRA even in distal pedal arteries [16]. In our study, most of the foot arterial segments, especially the two main foot arteries (the dorsalis pedis artery and lateral plantar artery), had good or excellent diagnostic image quality.…”

Section: Discussionmentioning

confidence: 99%

Non-contrast-enhanced MR angiography of the foot with flow spoiled-fresh blood imaging (FS-FBI): feasibility study and comparison of different scanning parameters

Zhang

She

et al. 2019

Chin J Acad Radiol

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Objectives To evaluate the feasibility of foot arteries using flow-spoiled-fresh blood imaging (FS-FBI) and to investigate how the FS-FBI scanning parameters affect the flow sensitivity and impact the depiction of pedal arteries. Methods The study included 46 young healthy volunteers examined by FS-FBI using 1.5T MRI scanner. Additional FS-FBI examination with different flip angles (FA) of the radiofrequency refocusing pulse and echo time (TE) was performed on 36 volunteers. Two radiologists separately analyzed and graded the venous contamination, image quality, displaying rate, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) values of foot arteries. Multi-sample Friedman test and paired two-sided Student's t test were used for statistical analysis (P < 0.05).Results Average image quality and venous contamination score of all arteries was good. The demonstration rate of distal anterior and posterior tibial artery, and lateral plantar artery was 100%. Dorsalis pedis artery, first dorsal metatarsal artery, medial plantar artery, and plantar arch were demonstrated at a rate above 90%. The demonstration rate of medial tarsal artery was 73.9%, whereas arcuate artery was detected with a rate of only 5.4%. Significant differences in image quality, SNR, and CNR of distal arterial area were observed between different FA and TE. Conclusion Non-contrast-enhanced MR angiography of foot using FS-FBI enables clear separation of veins from arteries, and yields reliable depiction of the foot arterial tree in healthy volunteers. Distal arterial branches of foot can be better depicted by appropriate adjustment of the flow-sensitivity parameters.Keywords Non-contrast-enhanced magnetic resonance angiography · Flow spoiled-fresh blood imaging · Foot arteries · Flip angle of the refocusing pulse · Echo time * Dairong Cao Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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“…In eight studies of the lower extremities (four of which were limited to the calf or foot) involving a total of 238 patients using either CEMRA (seven studies) or CTA (one study) as the reference standard exam, cardiac‐gated subtractive noncontrast MRA using a fast spin‐echo based readout provided a median sensitivity of ∼86%, and a median specificity of ∼86% for the detection of ≥50% stenosis (evidence level 1b) . However, three other studies involving a total of 75 patients have reported poor image quality and a high rate of nondiagnostic vessel segments …”

Section: Level Of Evidence For Noncontrast Mramentioning

confidence: 99%

Noncontrast MR angiography: An update

Edelman

Koktzoglou

2018

Magnetic Resonance Imaging

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Both computed tomography (CT) angiography (CTA) and contrast-enhanced MR angiography (CEMRA) have proven to be useful and accurate cross-sectional imaging modalities over a wide range of vascular territories and vascular disorders. A key advantage of MRA is that, unlike CTA, it can be performed without the administration of a contrast agent. In this review article we consider the motivations for using noncontrast MRA, potential contrast mechanisms, imaging techniques, advantages, and drawbacks with respect to CTA and CEMRA, and the level of evidence for using the various MRA techniques. In addition, we explore new developments that promise to expand the reliability and range of clinical applications for noncontrast MRA, along with functional MRA capabilities not available with CTA or CEMRA.

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Non-enhanced, ECG-gated MR angiography of the pedal vasculature: comparison with contrast-enhanced MR angiography and digital subtraction angiography in peripheral arterial occlusive disease

Abstract: • Comparison of non-enhanced MRA with contrast-enhanced MRA and DSA as gold standard. • High resolution MRA at 3 T for the depiction of small pedal vessels. • Evaluation of high resolution non-enhanced MRA in PAOD patients.

Cited by 16 publications

References 30 publications

Ultrasound in the Modern Management of the Diabetic Foot Syndrome: A Multipurpose Versatile Toolkit

Ultrasound in the Modern Management of the Diabetic Foot Syndrome: A Multipurpose Versatile Toolkit

Non-contrast-enhanced MR angiography of the foot with flow spoiled-fresh blood imaging (FS-FBI): feasibility study and comparison of different scanning parameters

Noncontrast MR angiography: An update

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