PHASE-CONTRAST MRI ASSESSMENT OF PEDAL BLOOD-FLOW

This study attempts to evaluate the reliability of cine phase contrast (PC) flow measurements in the assessment of normal pedal blood flow a nd quantitation of revascularisation-induced flow changes in patients with end-stage peripheral vascular occlusive disease (PVOD). Oblique a xial cine-PC acquisitions were obtained on a 1.5 T MRI system at the l evel of the talotibial joints in 8 normal subjects on four separate oc casions. Subsequently 8 patients with end-stage PVOD were examined bef ore and after surgical revascularisation (bilateral, n = 2; unilateral , n = 6). Measured flow in the trifurcation vessels was highly variabl e among normal subjects. Total pedal flow range from 32 to 183 ml/min (mean 91 ml/min) and was significantly different between the subjects evaluated (P < 0.0001). Measurements in the same subject over time wer e considerably less variable (P < 0.005). Normal arterial flow pattern s were consistently triphasic; those in patients with PVOD were either mono-biphasic. Pedal flow measured by cine-PC in patients was reduced compared with normal subjects (mean 38.3 ml/min). Flow was slower in symptomatic limbs (26.7 ml/min) compared with asymptomatic ones (48.9 ml/min). Flow increases in revascularised limbs (mean 315%) were signi ficantly different from those observed in non-affected limbs (P < 0.00 5). The ability to quantitate pedal blood flow and subsequent revascul arisation-induced flow increases appears promising for the identificat ion of optimal treatment options and monitoring of treatment results.