Peripheral Vascular Occlusive Disease: Evaluation with Contrast-Enhanced Moving-Bed MR Angiography Versus Digital Subtraction Angiography in 106 Patients
Christian Loewe1,
Maria Schoder1,
Thomas Rand1,
Udo Hoffmann1,
Johannes Sailer1,
Thomas Kos2,
Johannes Lammer1 and
Siegfried Thurnher1
1 Department of Radiology, Section of Angiography and Interventional Radiology,
University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
2 Department of Angiology, University of Vienna, A-1090 Vienna, Austria.
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Fig. 1A. —78-year-old man with lower right leg claudication. Subtracted
coronal maximum intensity projection of MR angiography image of lower leg
arteries shows short occlusion (arrow) of right superficial femoral
artery in femoropopliteal region. Note multiple grade 2 stenoses in left
superficial femoral artery and occlusion of left anterior tibial artery
(arrowhead).
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Fig. 1B. —78-year-old man with lower right leg claudication.
Corresponding digital subtraction angiogram confirms MR angiographic findings
(arrow, arrowhead). During this examination, balloon dilation of
short occlusion of right superficial femoral artery was performed with good
success.
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Fig. 2A. —58-year-old man with lower leg claudication and previous
osteosynthesis of left femur. Subtracted coronal maximum intensity projection
of MR angiography image of peripheral arteries shows 5-cm-long occlusion of
external iliac artery on right leg and occlusion of superficial femoral
arteries on both legs. On right leg, popliteal artery reconstitutes for 5 cm
(P2-segment) and is occluded again below knee. Although long occlusions are
seen in inflow region, calf arteries are well opacified.
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Fig. 2B. —58-year-old man with lower leg claudication and previous
osteosynthesis of left femur. Corresponding digital subtraction angiogram
confirms MR angiographic findings.
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Fig. 3A. —57-year-old man with diabetes and nonhealing ulceration of
right great toe. MR angiogram of lower leg arteries shows patent vessels in
pelvis and thigh. In calf, exact visualization of right leg arteries is
partially hampered by venous overaly. Incomplete occlusion of right posterior
and anterior tibial arteries is correctly diagnosed. Right dorsal pedal artery
and plantar arteries are partially opacified (arrow). Note partial
occlusion of left peroneal artery (arrowhead).
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Fig. 3B. —57-year-old man with diabetes and nonhealing ulceration of
right great toe. Patient underwent digital subtraction angiography before
distal bypass graft surgery, and corresponding digital subtraction angiograms
confirm MR angiographic findings (arrow).
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Fig. 4A. —63-year-old woman with claudication of right lower leg.
Subtracted MR angiogram of lower leg arteries shows significant eccentric
stenosis of right common femoral artery. Multiple high-grade stenoses are seen
in both superficial femoral arteries. Note short occlusion on right side. In
P1 segment of right popliteal artery, 2-cm-long occlusion (arrow) is
seen. Posterior tibial artery is also occluded.
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Fig. 4B. —63-year-old woman with claudication of right lower leg.
Corresponding digital subtraction angiogram confirms stenoses and occlusions
in pelvic and upper leg regions. Nevertheless, popliteal artery
(arrow) is shown to be patent, indicating severe overestimation on MR
angiography. Overestimation may have been caused by popliteal compression
resulting from misplaced knee support.
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Fig. 5A. —67-year-old woman with distal lower leg claudication.
Subtracted coronal maximum intensity projections of MR angiography image of
lower leg arteries show distal peripheral vascular occlusive disease with long
occlusion of right posterior tibial artery and multiple short occlusions of
anterior tibial artery of right calf.
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Fig. 5B. —67-year-old woman with distal lower leg claudication.
Magnification of area outlined in A shows superficial femoral arteries
of both legs were patent (stenosis [arrow] of <30% of luminal
narrowing).
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Fig. 5C. —67-year-old woman with distal lower leg claudication. On
digital subtraction angiogram corresponding to A, significant stenosis
is seen in medial part of superficial femoral artery.
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Fig. 5D. —67-year-old woman with distal lower leg claudication.
Magnification of area outlined in C shows significant stenosis
(arrow).
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Copyright © 2002 by the American Roentgen Ray Society.
