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Fig. 4A —76-year-old diabetic women with focal gangrene of left calf.
Coronal 3D bolus chase MR angiograms of thigh (A) and calf (B)
compared with volumetric interpolated breath-hold examination (VIBE) MR
angiogram of left calf and ankle (C) and selective digital subtraction
angiograms (DSA) of thigh (D), calf (E), and ankle (F).
Focal stenoses are seen in distal popliteal artery and tibioperoneal trunk
(long arrows, A and C). Peroneal artery is patent into
foot (short arrow, C). Proximal anterior tibial artery is
diffusely diseased, reconstitutes above level of ankle, and becomes patent in
foot. Note good correlation regarding short occlusion of distal left
superficial femoral artery (arrowhead, A and D)
depicted on both bolus-chase MR angiography (A) and selective DSA
(D) and good correlation regarding popliteal artery stenoses depicted
on both VIBE MR angiogram (arrows, C) and selective DSA
(arrows, E). Left dorsalis pedis artery is depicted on VIBE MR
angiograms (short arrow, C) and on selective DSA (short
arrow, F; G = left [gauche]) but not on third-step bolus chase MR
angiography (arrow, B). Note that because of calf pain, a
slight change in patient's position between unenhanced and contrast-enhanced
bolus chase MR angiography led to motion artifacts being clearly visible in
soft tissues, diminishing accuracy of arterial vessel analysis (B).
