MRI of the Peripheral Vasculature - The New Gold Standard?-MRI of the Peripheral Vasculature

MRI of the Peripheral Vasculature - The New Gold Standard?

Video Transcription

Video Summary

The speaker argues that lower extremity MRA, especially contrast-enhanced MRA, is now the gold standard for imaging peripheral arterial disease. He reviews PAD epidemiology, symptoms, and why imaging is needed mainly for treatment planning. Multiple studies and meta-analyses from 1995 to 2010 showed very high sensitivity and specificity for contrast MRA, often comparable to intra-arterial DSA and better than duplex ultrasound or CTA. He discusses gadolinium agents, noting NSF concerns and improved safety with newer agents. Practical techniques include moving-table bolus chase, split-bolus protocols, and time-resolved imaging to optimize timing and reduce venous contamination. Non-contrast methods are also useful in renal failure. Finally, he highlights MRA’s value in complex anatomy and critical limb ischemia, including potential assessment of tissue perfusion.

Keywords

lower extremity MRA

peripheral arterial disease

contrast-enhanced MRA

gadolinium safety

time-resolved imaging

critical limb ischemia