MR angiography of the hand with subsystolic cuff-compression optimization of injection parameters

The purpose of our study was to assess the impact of various injection rates on contrast-enhanced high-resolution 3D MR angiography of the hand.

Ten healthy individuals (mean age, 24.4 years; range, 20-27 years) underwent 3D contrast-enhanced MR angiography of both hands. Starting 3 minutes before data acquisition, subsystolic upper arm cuff compression was applied unilaterally. A 1.5-T whole-body scanner with 3D gradient-echo sequence was used. Seven data sets (20 seconds) were obtained consecutively. I.v. contrast material of 0.1 mg/kg of body weight of gadobutrol was injected at rates of 0.5, 1.0, and 1.5 mL/s. For both hands, quantitative data evaluation was performed with contrast-to-noise ratio (CNR) in the radial, ulnar, palmar, and digital arteries and veins. Qualitative assessment of the arterial visualization score and venous contamination score was rated by two experienced radiologists using a 4-point scale.

The lowest venous contamination score (CNR and reviewers' assessment) was observed with an injection rate of 0.5 mL/s (p < 0.05). For the arterial signal, the reviewers' assessment was that an injection rate of 0.5 mL/s was best (p = 0.08). Compression yielded a significantly lower venous contamination score for the compressed side than for the noncompressed side for flow rates of 0.5 mL/s and 1.0 mL/s (p < 0.05).

Image quality of hand MR angiography was better with cuff compression. A flow rate of 0.5 mL/s yielded a good CNR and a significantly lower venous contamination score than the other flow rates.