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MRA in peripheral arterial occlusive disease

Case Study
Busch, Hans-Peter, M.D. Krankenhaus der Barmherzigen Brüder • Germany
Hoffmann, Hans Georg, Dr. Krankenhaus der Barmherzigen Brüder • Germany

Patient history

A 69-year-old male smoker presented at the Krankenhaus der Barmherzigen Brüder in Trier, Germany, with intermittent left calf claudication and a pain-free walking distance limited to 100 meters.
Ultrasound indicated an occlusion of the left superficial femoral artery (SFA) and a high-grade stenosis of the right SFA. MRA was requested to help in treatment planning.

MR examination

The examination was performed using the Ingenia 3.0T with Posterior and Anterior coils. The patient was in the supine position with feet and lower legs fixed on the MobiTrak accessory set.

The MobiFlex protocol used:

Pelvis: with breath hold, scan time of 15.1 sec and Recon voxel size of 0.77 x 0.77 x 1.70 mm.

Upper leg: scan time of 16.2 sec and Recon voxel size of 0.81 x 0.81 x 1.50 mm.

Lower leg: scan time of 45.3 sec and Recon voxel size of 0.64 x 0.64 x 0.90 mm.

View ExamCard

Images

MR Results

MRA shows a 145 mm long occlusion of the mid portion of the left SFA, collaterals from the deep femoral artery indicating the occlusion to be older. A short high-grade stenosis is seen in the mid portion of the right SFA. Posterior tibial arteries are partially occluded on both calves.
Source images in the pelvis region show irregular atherosclerotic plaque material covering the posterior wall of the distal aorta, possible origin of peripheral embolism.

Diagnosis

Peripheral arterial occlusive disease stage Fontaine IIb on the left and IIa on the right.

Clinical impact of MR imaging

After the MRA examination, the patient underwent a femoro-popliteal bypass operation of the left thigh. Later, the right SFA stenosis was treated with a PTA examination.

Related reading



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Case Study
Ingenia 3.0T
Release 4
Anterior coil, MobiFlex, peripheral artery disease, Peripheral MRA, Posterior coil, SFA, stenosis, Vascular
 

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