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Lower Extremity: Low-Dose Contrast Agent Intraarterial MR Angiography in Patients—Initial Results¹

¹ From the Departments of Diagnostic Radiology (D.B., H.G.H., R.H., G.B.) and Angiology (M.A., K.A.J.), University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland; Biozentrum, University of Basel, Switzerland (A.C.S.); and Hochrheinklinik, Bad Saeckingen, Germany (W.O.D.). Received March 17, 2004; revision requested May 25; revision received June 17; accepted June 28. Address correspondence to D.B. (e-mail: dbilecen@uhbs.ch).

Institutional review board approval and patient consent were obtained. A low-dose injection protocol for intraarterial three-dimensional (3D) gadolinium-enhanced magnetic resonance (MR) angiography was derived from femoral flow phantom studies and prospectively evaluated in patients with peripheral arterial occlusive disease (PAOD). All MR angiograms were obtained at 1.5 T with a T1-weighted gradient-echo sequence. MR angiograms of a gadolinium dilution series (0.8–200.0 mmol/L) were acquired in a femoral phantom at different flow rates. Signal-to-noise ratios (SNRs) above the 75% threshold of the measured maximum were considered optimal. The lowest optimal concentration was injected intraarterially in nine patients to obtain 3D MR angiograms of the thigh and calf station. Contrast-to-noise ratios (CNRs) were calculated for four arterial segments. The low optimal concentration of 50 mmol/L (20-mL bolus volume), about 5% of the total permissible dose, showed SNRs larger than the 75% threshold in the phantom study. In patients, this concentration led to high-spatial-resolution angiograms with mean CNRs of 70.0 ± 14.5 (± standard deviation) for the superficial femoral artery and 47.5 ± 13.4 at the infrapopliteal level. Low-dose contrast agent intraarterial 3D MR angiography showed high arterial enhancement, enabling assessment of lower extremity arteries in patients with PAOD and multiple injections—a crucial precondition for MR-guided endovascular interventions.   

© RSNA, 2004

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