[MR angiography of pelvic arteries]

During the last years, magnetic resonance angiography (MRA) has become a widely used modality for intracerebral and carotid artery imaging. Due to technical limitations, the clinical impact of MRA in the iliofemoral arteries has been rather poor. New developments in MRA like ECG-triggered sequences and the occurrence of contrast-enhanced MRA has overcome most of these limitations. Therefore, a major advance in clinical use of these diagnostic tools can be predicted. This paper discussed the advantages of ECG-gated 2D-Phase contrast, ECG-gated 2D-Time-of-Flight and contrast enhanced FLASH 3D angiography sequences from a clinical point of view. 2D-PC-MRA is a robust technique, which provides an overview of the iliofemoral artery system in less than 5 minutes. Limitations are the true 2D impression of the sequence and the partial venous overlay. 2D-TOF-MRA on the other hand is time consuming, however it enables 3D reconstruction and effective venous suppression can be applied. Contrast enhanced MRA as the third sequence discussed provides high resolution images in less than 30 sec. However contrast bolus timing might be a problem. In conclusion the authors suggest a combination of 2D-PC-MRA and additional 2D-TOF sequences at questionable vascular areas as the modality of choice, due to the fact, that MRA of the iliofemoral arteries ist mostly only one step of a complete lower limb examination. Contrast MRA might become the method of choice in the future however problems with multiple contrast injections and upper limits of contrast dose have to be solved.