Optimization of contrast-enhanced peripheral MR angiography with mid-femoral venous compression (VENCO)

To compare a standard protocol for contrast-enhanced three-dimensional magnetic resonance angiography (3D CE-MRA) of the lower extremities to a high spatial resolution protocol with venous compression (VENCO) at the mid-femoral level.

12 patients with peripheral arterial occlusive disease (8-males; age range, 52 - 74 years; mean 67.1 years; 4 females; age range, 57 - 71 years; mean 62.1 years) were examined once with a standard MR angiography (MRA) protocol, and a second time with a high spatial resolution protocol in combination with mid-femoral venous compression (60 mm Hg) for the last two stations. All imaging was performed on a 1.5 T whole-body MR scanner (Magnetom Sonata, Siemens Medical Solutions, Erlangen, Germany) using a dedicated coil and paramagnetic contrast agent (gadodiamide, Omniscan, Amersham, Oslo, Norway). Signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) were calculated and image quality as well as venous overlay were assessed on a five-point scale for both examinations. Statistical significance was established at p < 0.05.

Mean SNR and CNR values of the two lower stations with VENCO were statistically significantly higher in comparison to the standard protocol (66 +/- 8 vs. 52 +/- 11 and 53 +/- 9 vs. 41 +/- 8, respectively; p < 0.01). The same was true for overall image quality with VENCO (4.0 +/- 0.2 vs. 3.4 +/- 0.8; p < 0.05) and presence of venous overlay (3.5 +/- 0.4 vs. 4.1 +/- 0.9; p < 0.05), respectively.

VENCO 3D CE-MRA is simple to put into practice and advances the performance of multi-station MRA strategies for assessment of the peripheral arterial vasculature.