NONINVASIVE VASCULAR IMAGING OF PERIPHERAL VESSELS

The purpose of this review is to describe recent advances in non-invas ive vascular imaging techniques and to discuss their current clinical applications for imaging of peripheral vessels. Principles for applyin g ultrasound, CT angiography (CTA), and magnetic resonance angiography (MRA) for non-invasive imaging of peripheral arteries and veins are p resented. Clinical applications are reviewed for different vascular di seases, therapy planning, and follow-up studies. Conventional Doppler and color duplex sonography are the most cost-effective procedures to detect or rule out peripheral arterial occlusive disease (PAOD) and to provide specific recommendations for therapy. In the near future, con trast-enhanced MRA (CE MRA) with additional axial two-dimensional time -of-flight studies to search for non-anatomic runoff will replace diag nostic intra-arterial digital subtraction angiography (DSA) for planni ng of reconstructive surgery with acquisition slabs displaying project ions similar to intra-arterial DSA. Color duplex sonography should als o be the first non-invasive technique applied for the detection of per ipheral aneurysms. Preoperative or preinterventional therapy planning of aneurysms may be performed by CTA or CE MRA. Compression ultrasound is the imaging procedure of choice in deep venous thrombosis (DVT). I n the preoperative assessment of venous incompetence, color duplex son ography is the imaging technique which is sufficient in most cases.