Hybrid Peripheral 3D Contrast-Enhanced MR Angiography of Calf and Foot Vasculature
Ranista Tongdee1,2,
Vamsi R. Narra1,
Gary McNeal3,
Charles F. Hildebolt1,
Fadi El-Merhi1,4,
Glenn Foster1 and
Jeffrey J. Brown1
1 Department of Body MRI, Mallinckrodt Institute of Radiology and Washington
University in St. Louis, Washington University Medical Center, 510 S
Kingshighway Blvd., St. Louis, MO 63110-1076.
2 Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
3 Siemens Medical Solutions, Malvern, PA 19355.
4 University of Texas Health Science Center at San Antonio, San Antonio, TX
78229-3900.
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Fig. 1A —42-year-old healthy male volunteer. images illustrate position of
acquisition slabs in first session (A) and second session (B).
First session is sagittal acquisition hybrid peripheral (HyPer) 3D
contrast-enhanced MR angiography (CE-MRA) images of calf and pedal vessels.
There are two sagittal slabs, one placed over each lower leg. Acquisition time
was 16 sec for two sagittal slabs or 8 sec per slab, and resulting voxel size
is 1.4 x 1.0 x 1.0 mm3. In second session with bolus
chase 3D CE-MRA of abdomen, pelvis, and lower extremities, acquisitions were
performed in coronal plane with automatic moving table at abdomen and pelvis
level (station I), thigh level (station II), and calf and foot level (station
III). Resulting voxel size in station III is 1.6 x 1.1 x 1.5
mm3.
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Fig. 1B —42-year-old healthy male volunteer. images illustrate position of
acquisition slabs in first session (A) and second session (B).
First session is sagittal acquisition hybrid peripheral (HyPer) 3D
contrast-enhanced MR angiography (CE-MRA) images of calf and pedal vessels.
There are two sagittal slabs, one placed over each lower leg. Acquisition time
was 16 sec for two sagittal slabs or 8 sec per slab, and resulting voxel size
is 1.4 x 1.0 x 1.0 mm3. In second session with bolus
chase 3D CE-MRA of abdomen, pelvis, and lower extremities, acquisitions were
performed in coronal plane with automatic moving table at abdomen and pelvis
level (station I), thigh level (station II), and calf and foot level (station
III). Resulting voxel size in station III is 1.6 x 1.1 x 1.5
mm3.
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Fig. 2A —60-year-old man with bilateral leg pain. Anteroposterior (A)
and left anterior oblique (B) maximum-intensity-projection (MIP) images
obtained using bolus chase 3D contrast-enhanced MR angiography (CE-MRA) show
venous contamination in calf and foot station.
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Fig. 2B —60-year-old man with bilateral leg pain. Anteroposterior (A)
and left anterior oblique (B) maximum-intensity-projection (MIP) images
obtained using bolus chase 3D contrast-enhanced MR angiography (CE-MRA) show
venous contamination in calf and foot station.
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Fig. 2C —60-year-old man with bilateral leg pain. Comparable MIP images of
sagittal slab 3D CE-MRA of right leg (C) and left leg (D) show
no venous contamination and clear delineation of arterial vasculature in
feet.
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Fig. 2D —60-year-old man with bilateral leg pain. Comparable MIP images of
sagittal slab 3D CE-MRA of right leg (C) and left leg (D) show
no venous contamination and clear delineation of arterial vasculature in
feet.
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Fig. 2E —60-year-old man with bilateral leg pain. Left anterior oblique view
of left leg (E) and magnification image of left anterior oblique view
of left leg (F) show details even in small arterial branches.
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Fig. 2F —60-year-old man with bilateral leg pain. Left anterior oblique view
of left leg (E) and magnification image of left anterior oblique view
of left leg (F) show details even in small arterial branches.
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Fig. 3A —71-year-old man with history of blue toes. Conventional digital
subtraction angiography (A), sagittal slab 3D contrast-enhanced MR
angiography (CE-MRA) (B), and bolus chase 3D CE-MRA (C) images
of calf and foot vessels. In right leg, there is very good correlation in
depiction of arterial branches between conventional angiography and sagittal
slab 3D CE-MRA. There is no venous contamination in sagittal slab 3D CE-MRA,
whereas bolus chase MRA shows moderate degree of venous contamination. In left
leg, small vessels at level of proximal portion of peroneal artery are better
seen in bolus chase MRA than in sagittal slab MRA. This is likely secondary to
differential flow between both legs. Because acquisition time for sagittal
slab MRA is very rapid and timing delay is calculated for early enhancing
vessels, there is some risk that sagittal slab acquisition will be too early
to depict small vessels with slow flow when compared with bolus chase MRA.
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Fig. 3B —71-year-old man with history of blue toes. Conventional digital
subtraction angiography (A), sagittal slab 3D contrast-enhanced MR
angiography (CE-MRA) (B), and bolus chase 3D CE-MRA (C) images
of calf and foot vessels. In right leg, there is very good correlation in
depiction of arterial branches between conventional angiography and sagittal
slab 3D CE-MRA. There is no venous contamination in sagittal slab 3D CE-MRA,
whereas bolus chase MRA shows moderate degree of venous contamination. In left
leg, small vessels at level of proximal portion of peroneal artery are better
seen in bolus chase MRA than in sagittal slab MRA. This is likely secondary to
differential flow between both legs. Because acquisition time for sagittal
slab MRA is very rapid and timing delay is calculated for early enhancing
vessels, there is some risk that sagittal slab acquisition will be too early
to depict small vessels with slow flow when compared with bolus chase MRA.
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Fig. 3C —71-year-old man with history of blue toes. Conventional digital
subtraction angiography (A), sagittal slab 3D contrast-enhanced MR
angiography (CE-MRA) (B), and bolus chase 3D CE-MRA (C) images
of calf and foot vessels. In right leg, there is very good correlation in
depiction of arterial branches between conventional angiography and sagittal
slab 3D CE-MRA. There is no venous contamination in sagittal slab 3D CE-MRA,
whereas bolus chase MRA shows moderate degree of venous contamination. In left
leg, small vessels at level of proximal portion of peroneal artery are better
seen in bolus chase MRA than in sagittal slab MRA. This is likely secondary to
differential flow between both legs. Because acquisition time for sagittal
slab MRA is very rapid and timing delay is calculated for early enhancing
vessels, there is some risk that sagittal slab acquisition will be too early
to depict small vessels with slow flow when compared with bolus chase MRA.
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Copyright © 2006 by the American Roentgen Ray Society.
