Diagnostic pitfalls in postinterventional intraarterial magnetic resonance angiography after recanalization of femoropopliteal arterial occlusions.

Huegli RW; Aschwanden M; Kos SRasmus MJaeger KJacob AL Bilecen D

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Diagnostic pitfalls in postinterventional intraarterial magnetic resonance angiography after recanalization of femoropopliteal arterial occlusions.

机译：Diagnostic pitfalls in postinterventional intraarterial magnetic resonance angiography after recanalization of femoropopliteal arterial occlusions.

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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.

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《Acta Radiologica》 |2008年第10期|1129-1136|共8页
作者
Huegli RW; Aschwanden M; Kos SRasmus MJaeger KJacob AL Bilecen D;
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Department of Radiology, University Hospital of Basel, Basel, Switzerland. rhuegli@uhbs.ch;

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正文语种英语
中图分类放射医学;
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Aged; Aged; 80 and over; Angiography; Digital Subtraction; Angioplasty; Balloon; Arterial Occlusive Diseases; Constriction; Pathologic; Contrast Media; Diagnosis; Differential; Female; Femoral Artery; Follow-Up Studies; Gadolinium DTPA; Humans; Image Enhancement; Image Processing; Computer-Assisted; Magnetic Resonance Angiography; Male; Middle Aged; Observer Variation; Peripheral Vascular Diseases; Popliteal Artery; Predictive Value of Tests; Prospective Studies; Reproducibility of Results; Severity of Illness Index; Treatment Outcome; *老年人; 老年人; 80以上; 血管造影术; 数字减影; 血管成形术; 气囊; 动脉闭塞性疾病; 缩窄; 病理性; 造影剂; 诊断; 鉴别; 股动脉; 随访研究; 钆DTPA; 图像增强; 图像处理; 计算机辅助; 磁共振血管造影术; 观察者偏差; 外周血管疾病; GUO动脉; 试验预期值; 前瞻性研究; 可重复性; 结果; 疾病严重程度指数; 治疗结果;

Diagnostic pitfalls in postinterventional intraarterial magnetic resonance angiography after recanalization of femoropopliteal arterial occlusions.

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