HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Figures Only Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hany, T. F. Articles by Grist, T. M. Search for Related Content PubMed PubMed Citation Articles by Hany, T. F. Articles by Grist, T. M.

Aorta and Runoff Vessels: Single-Injection MR Angiography with Automated Table Movement Compared with Multiinjection Time-resolved MR Angiography—Initial Results¹

¹ From the Departments of Medical Physics (T.J.C., E.E.C., F.R.K., C.A.M.) and Radiology (T.F.H., F.R.K., T.M.G.), University of Wisconsin–Madison, E3/311 Clinical Science Center, 600 Highland Ave, Madison, WI 53792-3252; Department of Physics, Centro De Investigacion y de Estudios Avanzados, or CINVESTAV, Mexico City, Mexico (E.E.C.); and Department of Radiology, Northwestern University, Chicago, Ill (R.A.O.). Received December 11, 2000; revision requested January 18, 2001; revision received February 14; accepted March 3. Supported in part by the National Science Foundation, Swiss National Science Foundation, and Nycomed-Amersham. Address correspondence to T.J.C. (e-mail: carrollt@master.radiology.wisc.edu).

	ABSTRACT

TOP ABSTRACT INTRODUCTION Materials and Methods Results Discussion REFERENCES

 
The authors compared two techniques for performing runoff, contrast material–enhanced magnetic resonance (MR) angiography. Multiinjection time-resolved imaging of contrast kinetics (TRICKS) and single-injection bolus-chase MR angiographic examinations were performed in 10 volunteers and 10 patients. Image quality and venous overlay of the major blood vessels of the abdomen, thigh, and calf were evaluated. Significantly more (P < .05) vessels were depicted with diagnostic quality on multiinjection TRICKS than on single-injection bolus-chase MR angiographic images.

Index terms: Aorta, MR, 981.12942 • Arteries, extremities, 92.12942, 92.12943 • Magnetic resonance (MR), vascular studies, 981.12942, 981.12943

	INTRODUCTION

TOP ABSTRACT INTRODUCTION Materials and Methods Results Discussion REFERENCES

 
The major advantages of intraarterial digital subtraction angiography are high-spatial-resolution images and temporal information regarding delayed filling of the vasculature of interest. The invasiveness of the procedure, nephrotoxicity of iodinated contrast media, and radiation exposure, however, led to the development of noninvasive imaging techniques (1,2).

Time-of-flight magnetic resonance (MR) angiography has proved to be accurate in the depiction of vascular pathologic conditions in the peripheral vasculature, particularly in the lower extremities. However, long acquisition times and flow-related artifacts have hindered its widespread application (3,4). To overcome these drawbacks, contrast material–enhanced MR angiography, which combines use of a heavily T1-weighted gradient-echo sequence and the intravenous injection of a gadolinium-based agent, was introduced (5–8). This technique permits the acquisition of a full three-dimensional data set within a comfortable breath hold of 30 seconds (9). The synchronization of contrast agent arrival and data acquisition is crucial for this imaging technique. This is normally achieved by using a test bolus injection and fluoroscopic or automated triggering (10,11). A different approach combines the repeated sampling of the low-spatial-resolution k-space views with temporal interpolation to produce a series of time-resolved imaging of contrast kinetics (TRICKS) three-dimensional MR angiographic images. Three-dimensional TRICKS images reveal the dynamics of contrast material arrival and obviate a timing image (12).

In the evaluation of peripheral vascular disease, contrast-enhanced MR angiography has been used to display the entire vasculature in a single imaging session (13,14). Continuous or repeated contrast agent injections are used to display the abdominal aorta to the pedal arch. Recently, single-injection bolus-chase MR angiography, which combines automated table movement with fast repeated acquisitions at successive levels of the vasculature, similar to bolus-chase conventional angiography, has been introduced (13–15). To improve vessel depiction, separate acquisition and subtraction of a precontrast mask is required. A relatively fast injection is necessary for the depiction of renal arteries; therefore, venous contamination of the distal stations may occur owing to limited first-pass extraction of the bolus.

The purpose of this study was to compare a single-injection bolus-chase MR angiographic protocol with a multiinjection TRICKS MR angiographic protocol for the evaluation of the aorta and runoff vessels in volunteers and patients. The benefit of the TRICKS protocol in the peripheral vasculature was assessed by means of direct comparison of these two techniques.

	Materials and Methods

TOP ABSTRACT INTRODUCTION Materials and Methods Results Discussion REFERENCES

 
All examinations were performed with a standard 1.5-T MR imager (Signa Horizon; GE Medical Systems, Milwaukee, Wis). A dedicated peripheral vascular four-channel quadrature phased-array coil (Medical Advances, Milwaukee, Wis) was used for signal reception. Precise injection rates were ensured by means of an automated power injector (Spectris; Medrad, Indianola, Pa). For all examinations, 40 mL of gadodiamide (Omniscan; Nycomed-Amersham, Princeton, NJ) was used.

Ten volunteers without any positive medical history (five women, five men; mean age, 25.6 years ± 4.3 [SD]) and 10 consecutive patients with peripheral vascular disease referred for bolus-chase MR angiography (three women, seven men; mean age, 68.2 years ± 13.5) were included in the study population. The patients included six with grade IIA and four with grade IIB peripheral vascular disease on the basis of the Fontaine classification. For intraindividual comparison, the patients and volunteers underwent MR angiography with the TRICKS protocol in a separate session within 14 days of the bolus-chase MR angiographic examination. For volunteers and patients, written informed consent to participate in this institutional review board–approved study was obtained before imaging procedures.

For bolus-chase MR angiography, commercially available software (SMARTSTEP; GE Medical Systems) was used (15). The imaging protocol included the following imaging procedures. First, three three-plane localizer images of the calf, thigh, and abdomen were acquired. After three MR angiographic volumes were prescribed that covered the abdominal and lower extremity vasculature, a contiguous three-dimensional MR angiographic mask image was acquired with integrated automated table movement. The maximal superior extent of the examination was 140 cm from the ankle (3 x 48 cm minus 2 x 2-cm overlap). The imaging parameters for acquisition of the mask images were identical to those used for acquisition of the contrast-enhanced images: repetition time msec/echo time msec of 6.8/1.5, flip angle of 30°, fractional echo, field of view of 48 x 36 cm, 256 x 224 matrix, 28 sections, effective section thickness of 3.0–3.6 mm, zero interpolation to 1.5–1.8 mm, acquisition time of 28 seconds for each station. The abdominal image was obtained in a breath hold, with use of the body coil. After the mask acquisitions, contrast-enhanced imaging was started at the abdominal station, which was automatically initialized after automated bolus detection (SMARTPREP; GE Medical Systems) of the dual-phase (20 mL at 1.0 mL/sec followed by 20 mL at 0.5 mL/sec) single injection of 40 mL of gadodiamide (10,16). After the abdominal station acquisition and automated table movement, three-dimensional MR angiographic images of the thigh and calf were acquired sequentially. The average imaging time was 25 minutes, and the average postprocessing time was 10–20 minutes.

The TRICKS protocol combined a non–time-resolved single-volume acquisition of the abdomen with two time-resolved acquisitions of the lower extremities. After similar scout images were acquired, the TRICKS protocol included breath-hold three-dimensional MR angiography (7.5/1.5, fractional echo, flip angle of 30°, field of view of 48 x 36 cm, 512 x 192 matrix, 28 sections, effective section thickness of 3.0–3.6 mm, zero interpolation to 1.5–1.8 mm, acquisition time of 33 seconds) of the abdominal vasculature with use of the body coil. The contrast material timing for the abdomen was based on the arrival of a 2-mL test bolus of gadodiamide determined with a two-dimensional multiphase gradient-recalled echo acquisition. A precontrast mask image was acquired. For contrast-enhanced three-dimensional MR angiography, 10 mL of gadodiamide was injected at 2 mL/sec. For the two remaining stations (thigh and calf), TRICKS imaging was performed with the following parameters: 7.8/1.7, fractional echo, flip angle of 30°, field of view of 48 x 36 cm, 512 x 192 matrix, 24 sections, section thickness of 4–5 mm, zero interpolation to 2.0–2.5 mm. TRICKS images were obtained with a frame rate of 7–9 seconds and acquisition time of 2 minutes 14 seconds per station. For the thigh station, 13 mL of gadodiamide was injected at 0.5 mL/sec; for the calf stations, 15 mL of gadodiamide was injected at 0.5 mL/sec. For the TRICKS acquisitions, however, no timing was required since the injection was started after the mask data were acquired. The peak arterial time frame was automatically determined prior to reconstruction, which reduced the latent time between image acquisition and display to minutes (17). The average imaging time was 25 minutes.

Images obtained with the two imaging protocols were analyzed by one experienced vascular radiologist (T.M.G.), who was blinded to the technique and diagnosis. For image analysis, the individual vasculature was divided into the following segments: the dorsal pedal artery to the suprarenal aorta (suprarenal, infrarenal aorta, renal arteries, common iliac artery, external iliac artery, internal iliac artery, common femoral artery, deep femoral artery, popliteal artery, anterior tibial artery, posterior tibial artery, peroneal artery, and dorsal pedal artery). The following branch vessels were also included: lateral and medial circumflex femoral arteries, descending genicular artery, mediolateral arteries, and superoinferior genicular arteries. Since each segment in each lower extremity was analyzed separately, a total of 38 segments per patient were included. The renal arteries were evaluated separately. For further detailed analysis, the vasculature was subdivided into small arteries (lateral and medial circumflex femoral arteries, descending genicular artery, mediolateral arteries, and superoinferior genicular arteries) and large arteries (to represent the remaining vessel segments).

Analysis of diagnostic quality was based on a four-point scale: 1, not seen; 2, seen, cannot exclude a pathologic condition; 3, seen, can exclude a pathologic condition; and 4, well seen, can exclude a pathologic condition. Analysis of venous contamination was based on a three-point scale: 1, none; 2, present but does not interfere with diagnostic assessment; and 3, interferes with diagnostic assessment.

Clinical evaluation was based on the findings on each MR angiographic image. A second experienced vascular interventional radiologist (R.A.O.) evaluated the images while blinded to patient identity and imaging technique. The following treatment options were available: (a) medical management, (b) conventional angiography for additional diagnostic information, (c) endovascular treatment (percutaneous transluminal angioplasty with or without stent placement), (d) combined endovascular and surgical treatment, and (e) surgery only.

Statistical analysis of the diagnostic image quality scores was performed to assess any significant differences between bolus-chase and TRICKS MR angiographic images. The number of vessel segments (n = 38) with a grade that indicated diagnostic image quality (score of 3 or 4) were summed separately for each patient. The resulting sums were compared for each technique with a paired Wilcoxon signed rank test to determine any significant differences.

Further subanalyses were performed to compare the number of large arteries (24 segments) and the number of small vessels (14 segments) that were of diagnostic image quality. Finally, the number of stations (abdominal, thigh, or calf) that were corrupted by venous overlay for each patient was calculated for TRICKS and bolus-chase MR angiographic images. A paired Wilcoxon signed rank test was used to determine whether a significant difference in venous contamination existed between TRICKS and bolus-chase MR angiography. In all cases, statistical analysis was performed by using commercially available software (S-PLUS; Mathsoft, Cambridge, Mass).

	Results

TOP ABSTRACT INTRODUCTION Materials and Methods Results Discussion REFERENCES

 
In the following analysis, vessels that received a diagnostic quality grade of greater than 2 were defined as diagnostic. In both volunteers and patients, more vessels were graded as diagnostic on TRICKS than on bolus-chase MR angiographic images. In this study, however, conventional angiography was not performed in any of the subjects, so there was no standard of reference to validate discrepant findings.

Volunteers
Overall analysis showed that 264 of 380 (69.4%) segments were assessed as diagnostic on TRICKS MR angiographic images compared with 244 of 380 (64.2%) segments on bolus-chase MR angiographic images. Selective analysis of the large arterial segments of the abdomen, thigh, and calf (Table 1) showed that the number of diagnostic vessels was uniformly high (>85%) for both TRICKS and bolus-chase MR angiography, with the exception of the large arteries of the calf depicted on bolus-chase MR angiographic images. Small vessels in the thigh and calf stations were found to be of diagnostic quality in fewer than 30% of all the small vessels with both techniques.

View larger version (76K): [in this window] [in a new window] [Download PPT slide]   Figure 1. a, Coronal bolus-chase MR angiographic image obtained in a 28-year-old male volunteer shows severe venous contamination in the abdominal and calf stations (upper and lower arrows, respectively). b, Coronal TRICKS MR angiographic image shows only minimal venous contamination in the abdominal station and clear delineation of the arterial vasculature in the calf station.

View larger version (131K): [in this window] [in a new window] [Download PPT slide]   Figure 2. a, Coronal bolus-chase MR angiographic image in a 76-year-old male patient shows venous contamination in the calf station (arrows). b, Coronal TRICKS MR angiographic image obtained in the same patient as in a shows no venous contamination. c, Coronal bolus-chase MR angiographic image obtained in a 53-year-old male patient shows a clear arterial phase in the aorta and renal arteries by means of optimal triggering. Fast venous return is already present in the thigh station and later in the calf station (upper and lower arrows, respectively). d, Coronal TRICKS MR angiographic image obtained in the same patient as in c does not exhibit venous overlay.

In four of the 10 patients, the same treatment options were selected. In four other patients, additional diagnostic work-up was needed for bolus-chase MR angiography but not for TRICKS MR angiography. In the remaining two patients, both the bolus-chase and TRICKS images were sufficient for diagnosis, although treatment options differed in these patients (Table 4, patients 4 and 6).

	Discussion

TOP ABSTRACT INTRODUCTION Materials and Methods Results Discussion REFERENCES

 
Time-resolved acquisitions in the lower extremities, in combination with conventional breath-hold contrast-enhanced acquisitions in the abdominal vasculature, provide a minimally invasive method for imaging of the abdominal and peripheral vasculature without the need for the nephrotoxic contrast media or radiation exposure associated with conventional angiography. In this study, we assessed the benefit of performing MR angiography in the peripheral vasculature with the TRICKS protocol. Our data in volunteers and patients suggest that in contrast to image quality with bolus-chase MR angiography, that with TRICKS MR angiography is superior since venous contamination is reduced or even eliminated.

In the volunteers and patients, there were differences in the delineation of the major arteries in the abdomen, pelvis, and calf stations despite use of comparable in-plane resolution, section thickness, and acquisition time. With both techniques, however, the renal arteries could be assessed in fewer than half the patients. This can be explained in part by the relatively low in-plane resolution, the relatively small size of the vessels, and the reduced contrast agent volume used per station with both techniques compared with those used in a dedicated renal acquisition.

In situ vein bypass or small vessel angioplasty below the knee are performed increasingly in many medical centers. Venous contamination in the lower extremities may confound diagnosis, however, since the contrast agent returns after the first passage through the capillary bed and after the parenchymal phase. The factors that contribute to venous contamination are not fully understood, but several authors emphasized that slow contrast agent injections allow increased elimination in the capillary bed and delayed venous return. In bolus-chase MR angiography, relatively slow injection rates are used (13,14). To achieve sufficient spatial resolution and image contrast for the abdominal station, a tradeoff between injection speed and volume has to be made. After acquisition of the abdominal station and reduction of the injection speed, the thigh and calf stations are acquired consecutively. Since the acquisition times are considerably longer than the bolus passage times, the contrast agent has already arrived in the lower locations, especially in the calves, which can result in increased venous contamination. Further reduction of the injection rate could possibly reduce venous contamination in the calves but would reduce the image quality in the abdominal station, since the resulting signal from contrast material would not support acquisition of high-spatial-resolution images.

Reduction in acquisition time, however, would reduce the probability of venous enhancement since the bolus could be followed more accurately. Technically, this can be achieved by shortening repetition times or by decreasing voxel size. Mask subtraction improves image contrast but cannot reduce venous contamination since the mask acquisitions were performed before contrast agent injection (18). An additional source of venous contamination is inappropriate timing of the bolus arrival. The bolus-chase technique uses an automated means of detection of bolus arrival with triggering of the three-dimensional acquisition (16). Only slight movement of the patient or a different breathing pattern may lead to late triggering of the acquisition, which can be prevented by using a test-bolus technique.

The TRICKS technique uses the combination of an integrated mask and complex subtraction and the detection of the peak arterial frame for selective reconstruction (17). Since the integrated mask image subsequently removes contrast material already present in the veins from the previous injection, clean arterial frames can be achieved. In addition, with the application of the peak arterial time-frame technique, the signal intensity in the temporally acquired k-space regions is analyzed and those frames with increasing signal intensity are used for reconstruction of a clean arterial frame. Since this procedure is performed in k space and not in image space, reduction of postprocessing times to minutes is achieved. Initially, long data reconstruction time hampered the use of three-dimensional TRICKS in clinical settings. With our current computing systems and automated detection of the peak arterial frame before reconstruction, no significant time delay between data acquisition and display of TRICKS images occurs.

Venous contamination impaired diagnostic assessment in nine of 10 calf stations at bolus-chase MR angiography. Enhancement of the superficial and deep venous systems obscured the runoff arteries in part. Whenever one leading artery, such as the anterior tibial artery, can be identified and patency confirmed, delineation of the other two arteries seems less important, since no intervention would be performed in those cases. Without the knowledge of the status of the calf vasculature, there remains an uncertainty, which is reflected in our study in the great number of cases that would need further work-up. This can be achieved by using a two-dimensional time-of-flight acquisition that encompasses the pedal and calf vasculature prior to the bolus-chase acquisition or conventional angiography. Both solutions result in additional costs compared with the TRICKS acquisition.

Regarding interventional procedures below the ankle, only a few centers perform surgery or such procedures. If only one pedal artery is patent, the vascular surgeon has to decide between primary amputation and a bypass procedure (19). Since assessment of the entire pedal vasculature was not included, further work-up would be needed with both techniques.

Both imaging techniques use comparable in-plane resolution and section thickness, which is reflected by a low percentage in detection of small vessels, such as the lateral circumflex femoral artery or the genicular arteries. Increasing image resolution to detect those vessels is questionable since detection of those vessels has no effect on patient treatment.

Recent technical developments in imaging hardware and software allow acquisition of time-resolved high-spatial-resolution images of the abdominal arteries (20,21). A combination of time-resolved imaging in all vascular regions would further improve the diagnostic ability to detect vascular disease and guide therapy.

A major limitation of this study is the need for a standard of reference for the validation of diagnoses made with both TRICKS and bolus-chase MR angiography. This is particularly evident in the lack of agreement between bolus-chase and TRICKS MR angiography in the evaluation of the renal arteries. Both TRICKS and bolus-chase MR angiography failed to consistently obtain diagnostic images of the renal arteries. The large field of view essential for abdominal imaging imposes demanding limitations on spatial resolution in the superoinferior direction.

In conclusion, time-resolved acquisitions in the lower extremities, in combination with a conventional breath-hold contrast-enhanced technique for the abdominal aorta, provide information on the vascular status of patients with peripheral vascular disease in less than 30 minutes.

	ACKNOWLEDGMENTS

 
The authors thank Jason Fine, PhD, for his insightful discussion and assistance in the statistical analysis of this manuscript.

	FOOTNOTES

 
Abbreviation: TRICKS = time-resolved imaging of contrast kinetics

Author contributions: Guarantors of integrity of entire study, T.F.H., T.J.C., T.M.G., C.A.M.; study concepts and design, T.F.H., T.J.C., T.M.G., R.A.O.; literature research, E.E.C., T.F.H.; clinical studies, R.A.O., T.M.G.; data acquisition, T.F.H., T.J.C., E.E.C., F.R.K., C.A.M.; data analysis/interpretation, T.F.H., T.J.C., R.A.O.; statistical analysis, T.J.C.; manuscript preparation, T.F.H., T.J.C., F.R.K.; manuscript definition of intellectual content, T.F.H., T.J.C.; manuscript editing, T.J.C., T.F.H.; manuscript revision/review, T.F.H., T.J.C., R.A.O., F.R.K., E.E.C., T.M.G.; manuscript final version approval, T.F.H., T.J.C.

	REFERENCES

TOP ABSTRACT INTRODUCTION Materials and Methods Results Discussion REFERENCES

 

1. Katayama H, Yamaguchi K, Kozuka T, Takashima T, Seez P, Matsuura K. Adverse reactions to ionic and nonionic contrast media: a report from the Japanese Committee on the Safety of Contrast Media. Radiology 1990; 175:621-628.[Abstract/Free Full Text]
2. Waugh JR, Sacharias N. Arteriographic complications in the DSA era. Radiology 1992; 182:243-246.[Abstract/Free Full Text]
3. Schiebler ML, Listerud J, Holland G, Owen R, Baum R, Kressel HY. Magnetic resonance angiography of the pelvis and lower extremities: works in progress. Invest Radiol 1992; 27:90-96.
4. McCauley TR, Monib A, Dickey KW, et al. Peripheral vascular occlusive disease: accuracy and reliability of time-of-flight MR angiography. Radiology 1994; 192:351-357.[Abstract/Free Full Text]
5. Prince MR. Gadolinium-enhanced MR aortography. Radiology 1994; 191:155- 164.[Abstract/Free Full Text]
6. Prince MR. Body MR angiography with gadolinium contrast agents. Magn Reson Imaging Clin N Am 1996; 4:11-24.[Medline]
7. Ros PR, Gauger J, Stoupis C, et al. Diagnosis of renal artery stenosis: feasibility of combining MR angiography, MR renography, and gadopentetate-based measurements of glomerular filtration rate. AJR Am J Roentgenol 1995; 165:1447-1451.[Abstract/Free Full Text]
8. Snidow JJ, Harris VJ, Trerotola SO, et al. Interpretations and treatment decisions based on MR angiography versus conventional arteriography in symptomatic lower extremity ischemia. J Vasc Interv Radiol 1995; 6:595-603.[Medline]
9. Leung DA, McKinnon GC, Davis CP, Pfammatter T, Krestin GP, Debatin JF. Breath-hold, contrast-enhanced, three-dimensional MR angiography. Radiology 1996; 200:569-571.[Abstract/Free Full Text]
10. Ho VB, Foo TK. Optimization of gadolinium-enhanced magnetic resonance angiography using an automated bolus-detection algorithm (MR SmartPrep). Invest Radiol 1998; 33:515-523.[CrossRef][Medline]
11. Earls JP, Rofsky NM, DeCorato DR, Krinsky GA, Weinreb JC. Hepatic arterial-phase dynamic gadolinium-enhanced MR imaging: optimization with a test examination and a power injector. Radiology 1997; 202:268-273.[Abstract/Free Full Text]
12. Korosec FR, Frayne R, Grist TM, Mistretta CA. Time-resolved contrast-enhanced 3D MR angiography. Magn Reson Med 1996; 36:345-351.[Medline]
13. Meaney JF, Ridgway JP, Chakraverty S, et al. Stepping-table gadolinium-enhanced digital subtraction MR angiography of the aorta and lower extremity arteries: preliminary experience. Radiology 1999; 211:59-67.[Abstract/Free Full Text]
14. Ho KY, Leiner T, de Haan MW, Kessels AG, Kitslaar PJ, van Engelshoven JM. Peripheral vascular tree stenoses: evaluation with moving-bed infusion-tracking MR angiography. Radiology 1998; 206:683-692.[Abstract/Free Full Text]
15. Ho VB, Choyke PL, Foo TK, et al. Automated bolus chase peripheral MR angiography: initial practical experiences and future directions of this work-in-progress. J Magn Reson Imaging 1999; 10:376-388.[CrossRef][Medline]
16. Prince MR, Chenevert TL, Foo TK, Londy FJ, Ward JS, Maki JH. Contrast-enhanced abdominal MR angiography: optimization of imaging delay time by automating the detection of contrast material arrival in the aorta. Radiology 1997; 203:109-114.[Abstract/Free Full Text]
17. Carroll TJ, Korosec FR, Swan JS, Grist TM, Frayne R, Mistretta CA. Method for rapidly determining and reconstructing the peak arterial frame from a time-resolved CE-MRA exam. Magn Reson Med 2000; 44:817-820.[CrossRef][Medline]
18. Leung DA, Pelkonen P, Hany TF, Zimmermann G, Pfammatter T, Debatin JF. Value of image subtraction in 3D gadolinium-enhanced MR angiography of the renal arteries. J Magn Reson Imaging 1998; 8:598-602.[Medline]
19. Paetz B, Maeder N, Meybier H, Allenberg JR. Pedal reconstructions for limb salvage. Eur J Vasc Surg 1991; 5:621-625.[CrossRef][Medline]
20. Vigen KK, Peters DC, Grist TM, Block WF, Mistretta CA. Undersampled projection-reconstruction imaging for time-resolved contrast-enhanced imaging. Magn Reson Med 2000; 43:170-176.[CrossRef][Medline]
21. Schoenberg SO, Bock M, Knopp MV, et al. Renal arteries: optimization of three-dimensional gadolinium-enhanced MR angiography with bolus-timing-independent fast multiphase acquisition in a single breath hold. Radiology 1999; 211:667-679.[Abstract/Free Full Text]

This article has been cited by other articles:

				F. M. Vogt, M. O. Zenge, M. E. Ladd, C. U. Herborn, K. Brauck, W. Luboldt, J. Barkhausen, and H. H. Quick Peripheral Vascular Disease: Comparison of Continuous MR Angiography and Conventional MR Angiography--Pilot Study Radiology, April 1, 2007; 243(1): 229 - 238. [Abstract] [Full Text] [PDF]

				G. Andreisek, T. Pfammatter, K. Goepfert, D. Nanz, P. Hervo, R. Koppensteiner, and D. Weishaupt Peripheral Arteries in Diabetic Patients: Standard Bolus-Chase and Time-resolved MR Angiography Radiology, December 19, 2006; (2006) 2422051111. [Abstract] [Full Text]

				F. S. Pereles, J. D. Collins, J. C. Carr, C. Francois, M. D. Morasch, R. M. McCarthy, E. A. Krupinski, G. M. Butler, and J. P. Finn Accuracy of Stepping-Table Lower Extremity MR Angiography with Dual-Level Bolus Timing and Separate Calf Acquisition: Hybrid Peripheral MR Angiography Radiology, July 1, 2006; 240(1): 283 - 290. [Abstract] [Full Text] [PDF]

				R. Tongdee, V. R. Narra, G. McNeal, C. F. Hildebolt, F. El-Merhi, G. Foster, and J. J. Brown Hybrid peripheral 3D contrast-enhanced MR angiography of calf and foot vasculature. Am. J. Roentgenol., June 1, 2006; 186(6): 1746 - 1753. [Abstract] [Full Text] [PDF]

				M. Lapeyre, H. Kobeiter, P. Desgranges, A. Rahmouni, J.-P. Becquemin, and A. Luciani Assessment of Critical Limb Ischemia in Patients with Diabetes: Comparison of MR Angiography and Digital Subtraction Angiography Am. J. Roentgenol., December 1, 2005; 185(6): 1641 - 1650. [Abstract] [Full Text] [PDF]

				J. H. Rapp, S. D. Wolff, S. F. Quinn, J. A. Soto, S. G. Meranze, S. Muluk, J. Blebea, S. P. Johnson, N. M. Rofsky, A. Duerinckx, et al. Aortoiliac Occlusive Disease in Patients with Known or Suspected Peripheral Vascular Disease: Safety and Efficacy of Gadofosveset-enhanced MR Angiography--Multicenter Comparative Phase III Study Radiology, July 1, 2005; 236(1): 71 - 78. [Abstract] [Full Text] [PDF]

				O. A. Meissner, J. Rieger, C. Weber, U. Siebert, B. Steckmeier, M. F. Reiser, and S. O. Schoenberg Critical Limb Ischemia: Hybrid MR Angiography Compared with DSA Radiology, April 1, 2005; 235(1): 308 - 318. [Abstract] [Full Text] [PDF]

				F. M. Vogt, W. Ajaj, P. Hunold, C. U. Herborn, H. H. Quick, J. F. Debatin, and S. G. Ruehm Venous Compression at High-Spatial-Resolution Three-dimensional MR Angiography of Peripheral Arteries Radiology, December 1, 2004; 233(3): 913 - 920. [Abstract] [Full Text] [PDF]

				C. A. Binkert, P. D. Baker, B. D. Petersen, J. Szumowski, and J. A. Kaufman Peripheral Vascular Disease: Blinded Study of Dedicated Calf MR Angiography versus Standard Bolus-Chase MR Angiography and Film Hard-Copy Angiography Radiology, September 1, 2004; 232(3): 860 - 866. [Abstract] [Full Text] [PDF]

				R. Bezooijen, H. C. M. van den Bosch, A. V. Tielbeek, G. R. P. Thelissen, K. Visser, M. G. M. Hunink, L. E. M. Duijm, J. Wondergem, J. Buth, and P. W. M. Cuypers Peripheral Arterial Disease: Sensitivity-encoded Multiposition MR Angiography Compared with Intraarterial Angiography and Conventional Multiposition MR Angiography Radiology, April 1, 2004; 231(1): 263 - 271. [Abstract] [Full Text] [PDF]

				C. U. Herborn, W. Ajaj, M. Goyen, S. Massing, S. G. Ruehm, and J. F. Debatin Peripheral Vasculature: Whole-Body MR Angiography with Midfemoral Venous Compression--Initial Experience Radiology, March 1, 2004; 230(3): 872 - 878. [Abstract] [Full Text] [PDF]

				P. Perreault, M. A. Edelman, R. A. Baum, E. K. Yucel, R. M. Weisskoff, K. Shamsi, and E. R. Mohler III MR Angiography with Gadofosveset Trisodium for Peripheral Vascular Disease: Phase II Trial Radiology, December 1, 2003; 229(3): 811 - 820. [Abstract] [Full Text] [PDF]

				J. K. Willmann, S. Wildermuth, T. Pfammatter, J. E. Roos, B. Seifert, P. R. Hilfiker, B. Marincek, and D. Weishaupt Aortoiliac and Renal Arteries: Prospective Intraindividual Comparison of Contrast-enhanced Three-dimensional MR Angiography and Multi-Detector Row CT Angiography Radiology, March 1, 2003; 226(3): 798 - 811. [Abstract] [Full Text] [PDF]

				J. S. Swan, T. J. Carroll, T. W. Kennell, D. M. Heisey, F. R. Korosec, R. Frayne, C. A. Mistretta, and T. M. Grist Time-resolved Three-dimensional Contrast-enhanced MR Angiography of the Peripheral Vessels Radiology, October 1, 2002; 225(1): 43 - 52. [Abstract] [Full Text] [PDF]

This Article Abstract Figures Only Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hany, T. F. Articles by Grist, T. M. Search for Related Content PubMed PubMed Citation Articles by Hany, T. F. Articles by Grist, T. M.