Initial feasibility of a multi‐station high resolution three‐dimensional dark blood angiography protocol for the assessment of peripheral arterial disease

Abstract

To evaluate the feasibility of a multi-station three dimensional (3D) T1-weighted turbo spin echo (TSE) dark-blood Sampling Perfection with Application optimized Contrasts using different flip angle Evolution sequence (T1w-SPACE), to assess aorta, iliac, and superficial femoral (SFA) arteries (inflow vessels) by comparing it with a multi-station contrast enhanced MR angiography (CE-MRA) with identical resolution. A total of 6 volunteers and 14 peripheral arterial disease (PAD) patients were included in the study. Abdominal and thigh T1w-SPACE and lower leg time-resolved MRA (TR-MRA) with low dose contrast were followed by 3-station CE-MRA. Quantitative measurements of lumen area at 17 locations from T1w-SPACE and CE-MRA were obtained. Additionally, vessel wall areas at the same locations were obtained from the T1w-SPACE images. Quantitative comparison of lumen areas with T1w-SPACE and CE-MRA revealed strong correlation between the two techniques and strong inter-observer agreement for each of the two imaging methods (r > 0.9; P < 0.001). Localized vessel wall area measurements obtained in PAD patients were significantly greater compared with those obtained in normal volunteers (mean difference 43.75 +/- 12.46 mm(2); P < 0.001). Stenosis severity obtained from T1w-SPACE localized measurements showed significant arterial area stenosis in PAD patients. T1w-SPACE imaging of inflow vessels is feasible, and in addition to CE-MRA has the ability to assess atherosclerotic plaque and vascular remodeling.