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Patient‐specific timing for bolus‐chase peripheral MR angiography
Author(s) -
Maki Jeffrey H.,
Wilson Gregory J.,
Cartright Scott D.,
Bastawrous Sarah
Publication year - 2016
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24968
Subject(s) - peripheral , medicine , angiography , bolus (digestion) , radiology , magnetic resonance angiography , nuclear medicine , magnetic resonance imaging
Purpose To develop a timing algorithm for three‐station moving‐table MR angiography of the peripheral arteries (pMRA) based on individual patient hemodynamics that optimizes arterial opacification and minimizes venous enhancement. Methods Two separate patient cohorts were identified for this retrospective study. The first consisted of 71 patients for development of a patient specific timing algorithm to calculate multiple contrast agent bolus transit times at 1.5 Tesla using a spoiled gradient echo sequence. This timing data was applied to a separate group of 59 patients in which one of four predetermined pMRA protocols was performed based on a time‐resolved MRA of the calves. Image quality was evaluated by two blinded readers grading venous enhancement and arterial opacification. Results Transit time from abdominal aorta to foot (Ao‐F) ranged from 5–46 s, with a mean of 17.8 ± 8.2 s. Arteriovenous window (AVW) transit time ranged from −5 to 65 s, with a mean of 18.3 ± 16.0 s. Ischemic patients had longer injection site‐to‐arterial transit times (25.6 versus 20.7 s; P < 0.01). Of the 59 patients who underwent diagnostic pMRA, 81 and 83% (two readers, respectively) showed no or minimal venous enhancement, and all of the exams were diagnostic. Venous enhancement grades were significantly greater ( P < 0.04) for ischemic versus nonischemic patients. Conclusion Performing pMRA using a timing algorithm based on each patient's unique hemodynamics can minimize lower station venous enhancement. J. MAGN. RESON. IMAGING 2016;43:249–260.