학술논문
Validation of MRI assessment of foot perfusion for improving treatment of patients with peripheral artery disease.
Document Type
Academic Journal
Author
Bisgaard M; Department of Radiology, Kolding Hospital, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Health Sciences Research Centre, UCL University College, Odense M, Denmark. Electronic address: Malene.bisgaard@rsyd.dk.; Houlind KC; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Department of Vascular Surgery, Kolding Hospital, Kolding, Denmark. Electronic address: Khoulind@health.sdu.dk.; Blankholm AD; Department of Radiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark. Electronic address: Anneblan@rm.dk.; Ringgaard S; MR Research Center, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark. Electronic address: Steffen@clin.au.dk.; Christensen J; Department of Radiology, Kolding Hospital, Kolding, Denmark. Electronic address: Johnny.Christensen@rsyd.dk.; Precht H; Department of Radiology, Kolding Hospital, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Health Sciences Research Centre, UCL University College, Odense M, Denmark. Electronic address: helle.precht@rsyd.dk.
Source
Publisher: Elsevier B.V Country of Publication: Netherlands NLM ID: 9604102 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-2831 (Electronic) Linking ISSN: 10788174 NLM ISO Abbreviation: Radiography (Lond) Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Information on tissue perfusion in the foot is important when treating patients with chronic limb-threatening ischemia. This study aims to test the reliability of different magnetic resonance sequences when measuring perfusion in the foot.
Methods: Sixteen healthy volunteers had their right foot scanned in a test/retest study with six different magnetic resonance sequences (BOLD, multi-echo gradient echo (mGRE), 2D and 3D pCASL, PASL FAIR, and DWI with intravoxel incoherent motion (IVIM) with quantitative measurements of perfusion. For five sequences, cuff-induced ischemia followed by a hyperactive response was measured. Images of the feet were segmented into angiosomes and perfusion data were extracted from the five angiosomes.
Results: BOLD, PASL FAIR, mGRE, and DWI with IVIM had low mean differences between the first and second scans, while the results of 2D and 3D pCASL had the highest differences. Based on a paired t-test, BOLD, and FAIR were able to distinguish between perfusion and no perfusion in all angiosomes with p-values below 0.01. This was not the case with 2D and 3D pCASL with p-values above 0.05 in all angiosomes. The mGRE could not distinguish between perfusion and no perfusion in the lateral side of the foot.
Conclusion: BOLD, mGRE, pASL FAIR, and DWI with IVIM seem to give more robust results compared to 2D and 3D pCASL. Further studies on patients with peripheral artery disease should explore if the sequences can have clinical relevance when assessing tissue ischemia and results of revascularization.
Implications for Practice: This study provides knowledge that could be used to improve the diagnosis of patient with chronic limb-threatening ischemia to explore tissue perfusion.
Competing Interests: Conflict of interest statement None.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Methods: Sixteen healthy volunteers had their right foot scanned in a test/retest study with six different magnetic resonance sequences (BOLD, multi-echo gradient echo (mGRE), 2D and 3D pCASL, PASL FAIR, and DWI with intravoxel incoherent motion (IVIM) with quantitative measurements of perfusion. For five sequences, cuff-induced ischemia followed by a hyperactive response was measured. Images of the feet were segmented into angiosomes and perfusion data were extracted from the five angiosomes.
Results: BOLD, PASL FAIR, mGRE, and DWI with IVIM had low mean differences between the first and second scans, while the results of 2D and 3D pCASL had the highest differences. Based on a paired t-test, BOLD, and FAIR were able to distinguish between perfusion and no perfusion in all angiosomes with p-values below 0.01. This was not the case with 2D and 3D pCASL with p-values above 0.05 in all angiosomes. The mGRE could not distinguish between perfusion and no perfusion in the lateral side of the foot.
Conclusion: BOLD, mGRE, pASL FAIR, and DWI with IVIM seem to give more robust results compared to 2D and 3D pCASL. Further studies on patients with peripheral artery disease should explore if the sequences can have clinical relevance when assessing tissue ischemia and results of revascularization.
Implications for Practice: This study provides knowledge that could be used to improve the diagnosis of patient with chronic limb-threatening ischemia to explore tissue perfusion.
Competing Interests: Conflict of interest statement None.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)