Boris Roehrl MD, Presenter: Nothing to Disclose

R. Peter Kunz, Abstract Co-Author: Nothing to Disclose

Katja Oberholzer MD, Abstract Co-Author: Nothing to Disclose

Sascha Herber MD, Abstract Co-Author: Nothing to Disclose

Christoph Dueber MD, Abstract Co-Author: Nothing to Disclose

Karl Friedrich Kreitner MD, Abstract Co-Author: Nothing to Disclose

to compare Vasovist-enhanced MRA of the pedal vasculature with selective intraarterial DSA.

18 patients with peripheral arterial occlusive disease and type I or II diabetes were prospectively examined at 1.5 T. For contrast enhancement, 0.03 mmol of Vasovist were applied. MR imaging consisted of dynamic imaging with acquisition of 6 consecutive data sets and of high-resolution steady state imaging. Selective DSA was performed within 24 hours and served as a standard of reference. Image analysis was done by two observers and comprised assessment of image quality as well as the detection of patent segments of the distal calf and pedal vessels.

There were no differences between MRA and DSA regarding overall image quality. MRA detected significantly more patent vessel segments than did DSA (p < 0.001, kappa = 0.46). Interobserver agreement of MRA was very good with respect to the detection of patent vessel segments and the assessment of hemodynamically relevant stenoses (kappa = 0.97 and kappa = 0.89, respectively). SNR and CNR measurements delineated high values during dynamic imaging after contrast arrival and during steady state imaging. Steady state imaging depicted significantly more patent metatarsal arteries than did dynamic imaging, and delineated inflammatory complications like osteomyelitis, soft tissue abscesses and fistulas related to the diabetic foot syndrome. There were no clinically significant trends in vital signs, laboratory test and ECGs.

Vasovist-enhanced MRA of the pedal vasculature proved to be superior than selective DSA. It demonstrated a long imaging time window, and thus allowed for better depiction of the pedal outflow. Furthermore, steady stae imaging delineated inflammatory complications associated with the diabetic foot syndrome.

Vasovist-enhanced MRA allows for sufficient imaging of the pedal vasculature, and for assessment of inflammatory complications of the diabetic food.

Roehrl, B, Kunz, R, Oberholzer, K, Herber, S, Dueber, C, Kreitner, K, MRA of the Pedal Arteries with Vasovist, a Blood Pool Contrast Agent, and Comparison with Selective Intraarterial DSA in Patients with Diabetes.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6017861.html