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Contrast-enhanced peripheral MRA: technique and contrast agents

Yousef W Nielsen1, Henrik S Thomsen

  • 1Deparment of Radiology, Copenhagen University Hospital Bispebjerg, Bispebjerg, Denmark. ywnielsen@gmail.com

Acta Radiologica (Stockholm, Sweden : 1987)
|July 31, 2012
PubMed

Insights

Contrast-enhanced magnetic resonance angiography (CE-MRA) offers a safe, non-invasive method for diagnosing peripheral arterial disease. Optimized MRI techniques and stable contrast agents ensure high diagnostic accuracy comparable to traditional angiography.

Area of Science:

  • Radiology
  • Medical Imaging
  • Cardiovascular Imaging

Background:

  • Contrast-enhanced magnetic resonance angiography (CE-MRA) is increasingly utilized for diagnosing peripheral arterial disease.
  • CE-MRA provides a non-invasive alternative to conventional angiography, avoiding ionizing radiation.

Purpose of the Study:

  • This review focuses on current concepts in peripheral CE-MRA.
  • Emphasis is placed on optimizing MRI techniques and understanding contrast agent properties.

Main Methods:

  • Peripheral CE-MRA involves imaging arteries from the aortic bifurcation to the feet using the bolus-chase method.
  • Key technical factors include magnetic field strength, coil configuration, parallel imaging, and contrast bolus timing.
  • Optimization strategies include venous compression, hybrid protocols, and time-resolved imaging.

Main Results:

  • Gadolinium-based contrast agents are used, with extracellular agents for first-pass MRA and blood-pool agents for both first-pass and steady-state MRA.
  • Careful technique and stable agents mitigate risks, such as nephrogenic systemic fibrosis in patients with renal insufficiency.

Conclusions:

  • Optimized peripheral CE-MRA with stable contrast agents is a safe and accurate diagnostic tool.
  • Its diagnostic accuracy approaches that of conventional catheter X-ray angiography.

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