Peripheral arterial disease MRI
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Peripheral arterial disease Microchapters |
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Differentiating Peripheral arterial disease from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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AHA/ACC Guidelines on Management of Lower Extremity PAD |
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Guidelines for Structured Exercise Therapy for Lower Extremity PAD |
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Guidelines for Minimizing Tissue Loss in Lower Extremity PAD |
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Guidelines for Revascularization of Claudication in Lower Extremity PAD |
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Guidelines for Management of Acute Limb Ischemial in Lower Extremity PAD |
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Guidelines for Longitudinal Follow-up for Lower Extremity PAD |
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Peripheral arterial disease MRI On the Web |
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American Roentgen Ray Society Images of Peripheral arterial disease MRI |
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Directions to Hospitals Treating Peripheral arterial disease |
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Risk calculators and risk factors for Peripheral arterial disease MRI |
Editors-in-Chief: C. Michael Gibson, M.D., Beth Israel Deaconess Medical Center, Boston, MA; Robert G. Schwartz, M.D. [1], Piedmont Physical Medicine and Rehabilitation, P.A.; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
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Overview
When symptoms suggestive of peripheral artery disease are present, clinical evaluation along with non invasive testing are enough to establish the diagnosis. Invasive diagnostic studies are anatomic studies that are not used for diagnosis but rather for preoperative evaluation of the anatomy of the vessels. The invasive diagnostic studies, which are basically anatomic studies that rely on imaging, include the following: conventional angiography, CT angiography, MRA, duplex ultrasound[1].
MRI
The use of cardiovascular MRI in peripheral arterial disease is outlined.
- Magnetic resonance angiography is the most sensitive modality to make this diagnosis of PVD.
- Magnetic resonance angiography
- Benefits:
- Useful to asses PAD anatomy and presence of significant stenoses
- Useful to select patients who are candidates for endovascular or surgical revascularization
- Limitations:
- Tends to overestimate the degree of stenosis
- May be inaccurate in arteries treated with metal stents
- Can not be used in patients with contraindications to the magnetic resonance technique
- Benefits:
- Contrast angiography
2010 ACCF/ACR/AHA/NASCI/SCMR Expert Consensus Document on Cardiovascular Magnetic Resonance (DO NOT EDIT)[2]
Recommendations for Peripheral Artery Disease (DO NOT EDIT) [2]
| Class I |
| "CMR for PAD" |
| "1.Is recommended to diagnose anatomic location and degree of stenosis of PAD (Level of Evidence: A) " |
| "2.Should be performed with gadolinium enhancement (Level of Evidence: B) " |
| "3.Is useful in selecting patients with lower extremity PAD as candidates for endovascular intervention (Level of Evidence: A) " |
| Class IIb |
| "CMR of the extremities may be considered" |
| "1.To select patients with lower extremity PAD as candidates for surgical bypass and to select the sites of surgical anastomosis(Level of Evidence: B) " |
| "2.For post-revascularization (endovascular and surgical bypass) surveillance in patients with lower extremity PAD (Level of Evidence: B)
Additionally, MRA of the lower extremities is appropriate for patients with claudication. " |
References
- ↑ Wennberg PW, Rooke TW. Chapter 109. Diagnosis and Management of Diseases of the Peripheral Arteries and Veins. In: Fuster V, Walsh RA, Harrington RA, eds. Hurst's The Heart. 13th ed. New York: McGraw-Hill; 2011.
- ↑ 2.0 2.1 American College of Cardiology Foundation Task Force on Expert Consensus Documents. Hundley WG, Bluemke DA, Finn JP, Flamm SD, Fogel MA; et al. (2010). "ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents". Circulation. 121 (22): 2462–508. doi:10.1161/CIR.0b013e3181d44a8f. PMC 3034132. PMID 20479157.