MR-ANGIOGRAPHY OF THE ILIOFEMORAL ARTERY SYSTEM

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 iliofe moral arteries has been rather poor. New developments in MRA like EGG- triggered sequences and the occurrence of contrast-enhanced MRA has ov ercome most of these limitations. Therefore, a major advance in clinic al use of these diagnostic tools can be predicted. This paper discusse d the advantages of ECG-gated 2D-Phase contrast, EGG-gated 2D-Time-of- flight and contrast enhanced FLASH 3D angiography sequences from a cli nical point of view. 2D-PC-MRA is a robust technique, which provides a n overview of the iliofemoral artery system in less than 5 minutes. li mitations are the true 2D impression of the sequence and the partial v enous 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 provide s high resolution images in less than 30 sec. However contrast bolus t iming might be a problem. In conclusion the authors suggest a combinat ion of 2D-PC-MRA and additional 2D-TOF sequences at questionable vacul ar areas as the modality of choice, due to the fact, that MRA of the i liofemoral arteries ist mostly only one step of a complete lower limb examination. Contrast MRA might become the method of choice in the fut ure however problems with multiple contrast injections and upper limit s of contrast dose have to be solved.