Whole-body contrast-enhanced magnetic resonance angiography: new advances at 3.0 T

During the past decade, technical improvements and numerous advances in scanner hardware and software have significantly improved image quality, speed, and reliability of 3-dimensional (3-D) contrast-enhanced magnetic resonance angiography (CE-MRA). The accuracy of CE-MRA is now comparable with that of computed tomography angiography or even conventional catheter angiography. Peripheral vascular disease (PVD) accounts for 50,000 to 60,000 cases of percutaneous transluminal angioplasty and for about 100,000 cases of amputation annually in the United States. Proper treatment of the arterial disease requires a comprehensive assessment of the underlying vascular morphology because it is crucial to localize and gauge the severity of arterial lesions for further therapeutic decision making.Contrast-enhanced magnetic resonance angiography has been widely implemented in noninvasive evaluation of PVD with high diagnostic accuracy. The lack of ionizing radiation and the use of contrast agent with relatively small potential nephrotoxicity in population of PVD with high prevalence of renal impairment are the appealing features for broad acceptance of CE-MRA in initial diagnosis and repeated follow-up studies of patients with PVD. The minimum anatomical coverage for evaluation of PVD comprises the aortic bifurcation to the ankles; however, because of the systemic nature of atherosclerosis hypertension, renal or cerebrovascular disease frequently coexist. Thus, many clinicians regard evaluation of the whole-body arterial vasculature as desirable.