Non-enhanced 3D MR angiography of the lower extremity using ECG-gated TSE imaging with non-selective refocusing...

To evaluate non-enhanced 3D MR angiography using turbo spin echo (TSE) imaging with non-selective refocusing pulses (NATIVE SPACE MRA) for the visualization of the arteries of the lower extremity.

Three-station imaging (iliac arteries, femoral arteries, arteries of the lower leg) was performed in 8 healthy volunteers and 3 patients with peripheral artery disease (PAD) using a 1.5 T MR scanner. In 8 healthy volunteers, 4 different acquisition schemes were performed with the following imaging parameters: S 1: acquisition with every heartbeat (RR = 1), spoiler gradient of 25 % (SG = 25 %); S 2: RR = 1, SG = 0 %; S 3: RR = 2, SG = 25 %; S 4: RR = 2, SG = 0 %. The subjective image quality on a 4-point-scale (4 = excellent to 1 = not diagnostic) and relative SNR were assessed. In 3 patients with peripheral artery disease (PAD), SPACE MRA was performed for assessment of stenosis.

The mean subjective image quality was significantly lower for the iliac arteries compared to the femoral arteries and arteries of the lower leg (p < 0.0001). The subjective image quality for acquisition scheme S 1 was significantly lower than the image quality for S 3 and S 4 for the iliac arteries (p < 0.01), while the subjective image quality for acquisition scheme S 2 was significantly lower than S 3 and S 4 for the femoral arteries and the arteries of the lower leg (p < 0.01). The relative SNR was significantly higher for acquisition schemes S 3 and S 4 as compared to S 1 and S 2 (p < 0.0001) for all regions. SPACE MRA disclosed 7 significant stenoses in 3 PAD patients.

ECG-gated SPACE MRA is a promising imaging technique for non-enhanced assessment of the arteries of the lower extremity.