High-resolution 3D arteriography of chronic total peripheral occlusions using a T1-W turbo spin-echo sequence with...

Area of Science:

• Medical Imaging
• Cardiovascular Interventions
• Magnetic Resonance Imaging

Background:

• Percutaneous revascularization of peripheral artery chronic total occlusions (CTOs) is challenging due to limited X-ray visualization.
• Operators often navigate complex vasculature
• blindly,
• increasing risks of procedural failure or vessel perforation.

Purpose of the Study:

• To develop and evaluate a novel 3D high-resolution MRI sequence for detailed imaging of peripheral artery CTOs.
• To assess the potential of this MRI approach as a pre- and postprocedural tool and as a real-time 3D roadmap during interventions.

Main Methods:

• Implementation of a 3D T(1)-weighted turbo spin-echo (TSE) MRI sequence with inner-volume (IV) imaging.
• Acquisition of high-resolution volumes of interest (VOIs) within 5-10 minutes.
• In vivo and ex vivo experiments on swine carotid CTO models and human peripheral arteries.

Main Results:

• Successful high-resolution 3D imaging of peripheral artery CTOs was achieved.
• The MRI sequence delineated vascular architecture, including contrast differences between patent and occluded segments.
• Lesion morphology heterogeneity was visualized, providing detailed anatomical information.

Conclusions:

• The developed 3D MRI sequence enables detailed visualization of peripheral artery CTOs, overcoming limitations of X-ray guidance.
• This technique offers a promising tool for pre- and postprocedural assessment and real-time guidance in complex interventions.
• The approach has demonstrated feasibility in both experimental models and human subjects.