Rationale and Objectives
Noncontrast magnetic resonance angiography (NC-MRA) of pedal artery remains challenging
because of the global and regional disease load, tissue integrity, and altered microcirculation.
This study aims to investigate the feasibility of the NC-MRA of pedal arteries with
flow-sensitive dephasing–prepared steady-state free precession (FSD-SSFP) and to explore
the effect of disease load of type II diabetes on the vessel depiction.
Materials and Methods
FSD-SSFP was performed on a 1.5-T magnetic resonance system before the contrast-enhanced
MRA (CE-MRA) as a reference standard in 39 consecutive diabetic subjects (29 men and
16 women, aged 57.9 ± 11.4 years). Two experienced radiologists evaluated the overall
artery visibility (VA) and the contamination from soft tissue (SC) and veins (VC)
with a four-point scale. Chronic complications and measures including random blood
glucose (RBG), lipid panel, body mass index, risk of diabetic foot ulcers (RDF), and
glycated hemoglobin (HbA1c) by the imaging were recorded as disease load indicators.
Spearman rank correlation and ordinal regression were performed to investigate the
effect of disease load on the depiction of pedal arteries.
Results
The measurement of RBG and RDF were significantly correlated with the VC in CE-MRA
and with the overall visibility of pedal arteries in NC-MRA (P < .025 and P < .001, respectively). Blood pressure was the only parameter that was significantly
associated with SC in NC-MRA with FSD-SSFP (P < .025). For CE-MRA the effect of RDF on the overall VA manifested a significant
linear trend (P < .001), and the level of RBG was substantially associated with the VC (P < .025) without significantly impacting VA and SC. Hypertension only correlated with
SC in NC-MRA. VA was found independent of the presence of diabetic nephropathy, coronary
artery disease, abnormal lipid panel, HbA1c (75.0%), or optimized m1 value that ranged from 70 to 160 mT⋅ms2/m (mean, 125 ± 18 mT⋅ms2/m) in this study.
Conclusions
FSD-SSFP proved to be a useful modality of NC-MRA for pedal artery imaging in diabetic
patients. The vessel depiction is subject to the local and systemic disease load of
type II diabetes. Technical optimization of the flow-sensitive dephasing gradient
moment and properly choosing candidate would help augment the potential of this technique
in patient care of peripheral artery disease.
Key Words
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Article info
Publication history
Published online: January 16, 2015
Accepted:
November 29,
2014
Received:
June 27,
2014
Footnotes
Funding Sources: This work is partially sponsored by National Natural Science Foundation of China (NSFC81120108012 and NSFC81071147) and Shenzhen Basic Scientific Research Program (JCYJ20120615124706404).
Identification
Copyright
© 2015 AUR. Published by Elsevier Inc. All rights reserved.
