Magnetic resonance arteriography of the pelvis and lower extremities

Reconstructive vascular surgery is the last resort for limb salvage in patients with vascular insufficiency. Planning the sites of arterial bypass grafts depends on an exact knowledge of the angiographic anatomy. Currently, conventional contrast angiography is the primary preoperative study for surgical planning. Recently, magnetic resonance (MR) arteriography has been shown to be an accurate technique for the evaluation of slow arterial flow in the lower extremities. The purpose of this review will be to show how MR arteriography can be used as both an adjunct to and in some cases instead of conventional angiography for the preoperative assessment of lower-extremity vascular reconstruction. The derivation of common artifacts, the many pitfalls of interpretation, and the evaluation of peripheral arterial occlusion and percentage stenosis will be discussed. MR arteriography of the lower extremities is an important advance for the noninvasive evaluation of disease of the peripheral vasculature.