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

Huegli, R. W. and Aschwanden, M. and Kos, S. and Rasmus, M. and Jaeger, K. and Jacob, A. L. and Bilecen, D.. (2008) Diagnostic pitfalls in postinterventional intraarterial magnetic resonance angiography after recanalization of femoropopliteal arterial occlusions. Acta radiologica, Vol. 49. pp. 1129-1136.

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Official URL: http://edoc.unibas.ch/dok/A6007121

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Abstract

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.
Faculties and Departments:03 Faculty of Medicine > Bereich Querschnittsfächer (Klinik) > Radiologie USB
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Querschnittsfächer (Klinik) > Radiologie USB
03 Faculty of Medicine > Bereich Querschnittsfächer (Klinik) > Ehemalige Einheiten Querschnittsfächer (Klinik) > Medizinische Radiologie (Steinbrich)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Querschnittsfächer (Klinik) > Ehemalige Einheiten Querschnittsfächer (Klinik) > Medizinische Radiologie (Steinbrich)
03 Faculty of Medicine > Bereich Querschnittsfächer (Klinik) > Ehemalige Einheiten Querschnittsfächer (Klinik) > Interventionelle Radiologie (Jacob)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Querschnittsfächer (Klinik) > Ehemalige Einheiten Querschnittsfächer (Klinik) > Interventionelle Radiologie (Jacob)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Angiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Angiologie
UniBasel Contributors:Jacob, Augustinus Ludwig and Jäger, Kurt A. and Bilecen, Deniz and Hügli, Rolf and Kos, Sebastian
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Blackwell
ISSN:0284-1851
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:07 Dec 2012 13:03
Deposited On:07 Dec 2012 13:00

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