Document Detail


Diagnostic pitfalls in postinterventional intraarterial magnetic resonance angiography after recanalization of femoropopliteal arterial occlusions.
MedLine Citation:
PMID:  19031180     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Magnetic resonance (MR)-guided vascular interventions are of increasing interest, and, with the use of contrast-enhanced techniques, intraarterial contrast-enhanced MR angiography (ia-ce-MRA) competes with intraarterial digital subtraction angiography (ia-DSA) for the diagnostic evaluation of the infrainguinal vessel tree. PURPOSE: To assess the diagnostic value of ia-ce-MRA and high-resolution T1-weighted (hr-T1w) imaging compared to the gold-standard ia-DSA for residual stenosis and local dissections after femoropopliteal recanalization in patients with peripheral arterial occlusive disease (PAOD). MATERIAL AND METHODS: Eight patients with PAOD and short vessel occlusion of their femoropopliteal arteries underwent recanalization and balloon positioning under DSA. Patients were transferred to a short-bore MR scanner. Percutaneous transluminal angioplasty (PTA) was accomplished under MR fluoroscopy. Pre- and postinterventional ia-ce three-dimensional (3D) gradient-echo MRA with gadopentate dimeglumine was performed using the intraarterial introducer sheath. Maximum intensity projections (MIP) and multiplanar reconstructions (MPR) were calculated from the data set. High-resolution T1w images of the angioplasty region before and after dilatation were acquired. Control ia-DSA images were obtained. RESULTS: The postinterventional angioplasty results for stenosis grading were comparable in ia-MRA and ia-DSA. Only two of five local dissections in ia-DSA were visualized with the ia-ce-MRA runs including MIPs and MPRs. To clearly depict dissection, hr-T1w images were needed. CONCLUSION: Grading of stenotic lesions with ia-ce-MRA after PTA is comparable to ia-DSA. Intraarterial ce-MRA with calculated MIPs and MPRs is only partially sufficient to visualize local dissections after PTA. High-resolution T1w images are required for precise diagnosis of dissections in magnetic resonance tomography.
Authors:
R W Huegli; M Aschwanden; S Kos; M Rasmus; K Jaeger; A L Jacob; D Bilecen
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta radiologica (Stockholm, Sweden : 1987)     Volume:  49     ISSN:  1600-0455     ISO Abbreviation:  Acta Radiol     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-25     Completed Date:  2008-12-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706123     Medline TA:  Acta Radiol     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  1129-36     Citation Subset:  IM    
Affiliation:
Department of Radiology, University Hospital of Basel, Basel, Switzerland. rhuegli@uhbs.ch
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angiography, Digital Subtraction / methods
Angioplasty, Balloon / adverse effects,  methods*
Arterial Occlusive Diseases / diagnosis*,  therapy
Constriction, Pathologic / diagnosis,  etiology,  therapy
Contrast Media / diagnostic use
Diagnosis, Differential
Female
Femoral Artery / pathology*
Follow-Up Studies
Gadolinium DTPA / diagnostic use
Humans
Image Enhancement / methods
Image Processing, Computer-Assisted / methods
Magnetic Resonance Angiography / methods*
Male
Middle Aged
Observer Variation
Peripheral Vascular Diseases / diagnosis*,  etiology,  therapy
Popliteal Artery / pathology*
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Severity of Illness Index
Treatment Outcome
Chemical
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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