Decreased Venous Contamination on 3D Gadolinium-Enhanced Bolus Chase Peripheral MR Angiography Using Thigh Compression

Decreased Venous Contamination on 3D Gadolinium-Enhanced Bolus Chase Peripheral MR Angiography Using Thigh Compression

Hong Lei Zhang¹, Bernard Y. Ho¹, Minh Chao¹, K. Craig Kent¹, Harry L. Bush¹, Peter L. Faries¹, Alan I. Benvenisty² and Martin R. Prince¹

¹ Cornell MRI, Weill Medical College of Cornell University, 416 E 55th St., New York, NY 10022.
² Department of Surgery, Columbia University College of Physicians and Surgeons, 630 W168 St., New York, NY 10032.

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Fig. 1A. —67-year-old man with claudication. Time-resolved 2D-projection MR angiogram obtained with blood pressure cuff on right thigh shows contrast travel time of 16 sec (s) to left popliteal artery trifurcation without compression and travel time of 24 sec to right popliteal artery trifurcation with compression. Note at 22 sec, muscle enhancement is seen on left side but not on right side with thigh compression. At 60 sec, right calf shows much less soft-tissue enhancement than left calf.

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Fig. 1B. —67-year-old man with claudication. Three-dimensional bolus chase peripheral MR angiography shows high signal-to-noise ratio and no venous contamination with third-order branch visualization. Patient had symmetric travel time to ankle despite asymmetric occlusive disease.

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Fig. 2. —Arterial and soft-tissue enhancement curves averaged for all patients with compression applied by blood pressure cuff (n = 15) showing right leg with compression (dashed lines) and left leg without compression (solid lines). To correct for temporal differences, we shifted time axis to define 2 sec before contrast arrival at left popliteal artery trifurcation as 0. Note that blood pressure cuff compression delays arterial peak and substantially suppresses background-tissue enhancement for entire duration of imaging. ${blacktriangleup}$ = artery with compression, ${blacksquare}$ = artery without compression, • = tissue with compression, ${diamondsuit}$ = tissue without compression.

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Fig. 3A. — Calf stations of 3D bolus chase MR angiography in patients with fast rate of flow (contrast travel time to popliteal artery trifurcation, < 20 sec (s). Contrast travel time to trifurcation on time is shown on each image. On time-resolved 2D-projection MR angiograms obtained without thigh compression, all patients show some venous contamination.

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Fig. 3B. — Calf stations of 3D bolus chase MR angiography in patients with fast rate of flow (contrast travel time to popliteal artery trifurcation, < 20 sec (s). Contrast travel time to trifurcation on time is shown on each image. Time-resolved 2D-projection MR angiograms were obtained with thigh compression applied by tourniquets (B) and blood pressure cuffs (C). Note that least soft-tissue enhancement and venous contamination occurs with subsystolic thigh compression applied by blood pressure cuffs.

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Fig. 3C. — Calf stations of 3D bolus chase MR angiography in patients with fast rate of flow (contrast travel time to popliteal artery trifurcation, < 20 sec (s). Contrast travel time to trifurcation on time is shown on each image. Time-resolved 2D-projection MR angiograms were obtained with thigh compression applied by tourniquets (B) and blood pressure cuffs (C). Note that least soft-tissue enhancement and venous contamination occurs with subsystolic thigh compression applied by blood pressure cuffs.

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