DYNAMIC CONTRAST-ENHANCED MRI IN PATIENTS WITH PERIPHERAL ARTERY DISEASE

Sinkevich N.S.¹, Stukalova O.V.¹, Butorova E.A.¹, Maslennikov M.A.², Talitskiy K.A.¹, Bulkina O.S.¹, , Karpov Yu.A.¹, Ternovoy S.K.¹,3

1 – Russian Cardiology Research Center. Moscow, Russia.

2 – N.I. Pirogov First City Clinical Hospital. Moscow, Russia.

3 – I.M. Sechenov First Moscow State Medical University.

Moscow, Russia.

Purpose. Explore the possibilities of a dynamic contrast magnetic resonance imaging for skeletal muscle perfusion evaluation in patients with chronic lower limb ischemia compared with control group.

Materials and methods. A total of 56 subjects were studied, from which 35 patients with peripheral arterial disease (PAD) and a mean ankle-brachial index (ABI) 0.6±0.17 and a control group of 21 (13 age-matched patients with ischemic heart disease (IHD) with normal ABI and 8 healthy volunteers). All examined participants performed supine plantar flexion exercise in a 1.5T MRI scanner for 5 minutes or until limiting symptoms with intravenous gadolinium-based contrast media administration (GdDPA). Peak tissue perfusion (TP),  time-to-peak TP and time-to-peak arterial input flow (AIF) were measured.

Results. Peak rest TP of 21 controls was significantly higher than in PAD patients (p=0.0045), as well as peak exercise TP (p=0.0003). Intergroup analysis showed no post-exercise TP increase in healthy volunteers (p=0.06), at the opposite there was a significantly post-exercise peak TP increase in PAD patients (p=0.0012) and IHD controls (p=0.0001). Post-exercise time-to-peak AIF in PAD patients didn’t differ from the rest one, whereas in controls it was significantly lower (p=0.013). No contrast-related complications were matched.

Conclusions. Contrast-enhanced MRI is safe and effective method for skeletal muscle perfusion evaluation which strongly distinguishes PAD patients from those with normal limb flow. This method may be useful in a PAD treatment evaluation, sport medicine and experimental research.

Keywords: Contrast-enhanced MRI, peripheral artery disease, tissue perfusion, arterial input flow, ankle-brachial index.

Corresponding author:  Sinkevich N.S., Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

For citation: Sinkevich N.S., Stukalova O.V., Butorova E.A., Maslennikov M.A., Talitskiy K.A., Bulkina O.S., , Karpov Yu.A., Ternovoy S.K.  Dynamic contrast-enhanced MRI with peripheral artery disease. REJR. 2016; 6 (1): 65-72. doi: 10.18411/a-2016-007