Guido Matthias Kukuk MD, Presenter: Nothing to Disclose

Dariusch Reza Hadizadeh Kharrazi MD, Abstract Co-Author: Nothing to Disclose

Arne Koscielny MD, Abstract Co-Author: Nothing to Disclose

Frauke Verrel MD, Abstract Co-Author: Nothing to Disclose

Hans H. Schild MD, Abstract Co-Author: Nothing to Disclose

Winfried Albert Willinek MD, Abstract Co-Author: Nothing to Disclose

To prospectively assess the veins of the lower extremities as an adjunct to peripheral MRA with a blood pool contrast agent (BPCA) in patients with suspected or known peripheral artery disease (PAD).

139 patients (89 male, 50 female; mean age: 63.2±14.4 [range: 26-87 years]) with PAD were examined after single injection of the BPCA Gadofosveset Trisodium (Vasovist, Bayer Schering Healthcare, Germany) on a 1.5 T whole body MRI. First pass (FP) and steady state (SS) MRA was acquired for the evaluation of PAD with effective voxel sizes of 0.88 x 0.88 x 1.5/0.99 mm³ (upper legs) and 0.88 x 0.88 x 1.1/0.52 x 0.52 x 0.49 mm³ (lower legs), respectively. Steady state images were assessed by 2 readers in consensus in order to identify incidental venous disease (deep vein thrombosis (DVT), varicosis, fistulae, etc.) and to determine suitable veins for bypass graft surgery. Duplex ultrasound performed by an independent third reader served as the standard of reference (SOR).

In 49/139 (35%) MRA with BPCA revealed additional imaging findings in the venous system. Incidental DVT was found in 3/139 (2%) patients, varicosis was present in 42/139 (30%) and arterio-venous fistula was diagnosed in 1/139 (0.7%). 43 of 139 patients (31%) were scheduled for coronary bypass surgery (6/43) or distal origin bypass surgery (DOBS; 37/43). MRA with BPCA allowed for mapping of veins suitable for bypass surgery in all 43/43 patients eligible for bypass surgery. All imaging findings were confirmed by duplex US and intraoperative results.

Peripheral MRA with a blood pool contrast agent allows for diagnosis of incidental, but relevant venous disease in patients with PAD. Assessment of the entire peripheral vasculature after one single contrast injection may become a promising clinical indication for blood pool contrast agents to determine concomitant arterial and venous disease.

MRA with a blood pool contrast agent in patients with peripheral artery disease allows for diagnosis of incidental but relevant venous disease.

Kukuk, G, Hadizadeh Kharrazi, D, Koscielny, A, Verrel, F, Schild, H, Willinek, W, Incidental Deep Vein Thrombosis and Venous Imaging Findings in a Cohort of 139 Patients with Peripheral Artery Disease (PAD) Referred for Peripheral MRA with a Blood Pool Contrast Agent.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6022258.html