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Intraarterial Versus IV Gadolinium Injections for MR Angiography: Quantitative and Qualitative Assessment of the Infrainguinal Arteries

Anja-Carina Schulte1, Georg Bongartz2, Rolf Huegli2, Markus Aschwanden3, Kurt A. Jaeger3, Wladimir Ostheim-Dzerowycz4, Augustinus L. Jacob2 and Deniz Bilecen2

1 Biocenter, University of Basel, Basel, Switzerland.
2 Institute of Diagnostic Radiology, University Hospital of Basel, Petersgraben 4, Basel, Switzerland 4031.
3 Department of Angiology, University Hospital of Basel, Basel, Switzerland.
4 Hochrheinklinik, Bad Saeckingen, Germany.



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  		Fig. 1A —Anteroposterior maximum intensity projection images of left thigh and calf station obtained with fast spoiled 3D contrast-enhanced gradient-echo sequence in 69-year-old man after left antegrade percutaneous transluminal angioplasty of superficial femoral artery. Intraarterial angiogram. Gadolinium was administered intraarterially at a dose of 1 mmol/station.

 


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  		Fig. 1B —Anteroposterior maximum intensity projection images of left thigh and calf station obtained with fast spoiled 3D contrast-enhanced gradient-echo sequence in 69-year-old man after left antegrade percutaneous transluminal angioplasty of superficial femoral artery. Conventional IV angiogram obtained with identical acquisition parameters as A. Dose of 15 mmol of gadolinium was administered IV. At thigh level, optimal image quality was achieved with both injection modes, whereas at calf level of IV angiogram, disturbing venous overlay is observed.

 


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  		Fig. 2A —Comparison of anteroposterior maximum intensity projection images of right infrainguinal arteries obtained with fast spoiled 3D contrast-enhanced gradient-echo sequence in 75-year-old man after right antegrade percutaneous transluminal angioplasty of superficial femoral artery. Image obtained with intraarterial injection of low dose of gadolinium.

 


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  		Fig. 2B —Comparison of anteroposterior maximum intensity projection images of right infrainguinal arteries obtained with fast spoiled 3D contrast-enhanced gradient-echo sequence in 75-year-old man after right antegrade percutaneous transluminal angioplasty of superficial femoral artery. Image obtained with conventional IV injection of standard dose of gadolinium.

Note purely arterial filling of all arteries of interest in intraarterial angiogram. Although in IV angiogram, all arteries are fully evaluable at thigh level showing precise bolus timing, assessment of infrapopliteal arteries is complicated due to considerable venous contamination and background tissue enhancement.

 


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  		Fig. 3 —Comparison of contrast-to-noise ratio (CNR) values between intraarterial MR angiography (gray bars) and IV MR angiography (black bars). CNR ± SD of four arterial segments from thigh and calf station are averaged over all 11 patients.

 

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