Skip to main content
SpringerLink
Log in

The role of CT and MRI in the assessment of peripheral vascular disease

  • Inverventional Cardiology
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Atherosclerosis is a serious health problem in developed countries and the main cause of morbidity and mortality. Treatment strategies such as surgical procedures, percutaneous catheter-based interventions or pharmacologic options depend on the accurate classification of atherosclerotic disease with respect to location, extent, and severity of arterial involvement. For this purpose, several imaging techniques are in clinical use. Due to recent improvements in scanner technology, noninvasive imaging modalities are now widely available for evaluating atherosclerotic lesions throughout the body. This article focuses on the clinical role of these imaging modalities in the assessment of peripheral vascular disease, including the aorta and extracranial arteries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Yusuf S, Reddy S, Ounpuu S, Anand S:Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization.Circulation 2001,104:2746–2753.

    Article  PubMed  CAS  Google Scholar 

  2. Rubin GD:Techniques for performing multidetector-row computed tomographic angiography.Tech Vasc Interv Radiol 2001,4:2–14.

    Article  PubMed  CAS  Google Scholar 

  3. Chicoskie C, Tello R:Gadolinium-enhanced MDCT angiography of the abdomen: feasibility and limitations.AJR Am J Roentgenol 2005,184:1821–1828.

    PubMed  Google Scholar 

  4. Zanzonico P, Rothenberg LN, Strauss HW:Radiation exposure of computed tomography and direct intracoronary angiography: risk has its reward.J Am Coll Cardiol 2006,47:1846–1849.

    Article  PubMed  Google Scholar 

  5. Rubin GD, Schmidt AJ, Logan LJ, Sofilos MC:Multidetector row CT angiography of lower extremity arterial inflow and runoff: initial experience.Radiology 2001,221:146–158.

    Article  PubMed  CAS  Google Scholar 

  6. Willmann JK, Mayer D, Banyai M, et al.,Evaluation of peripheral arterial bypass grafts with multi-detector row CT angiography: comparison with duplex US and digital subtraction angiography.Radiology 2003,229:465–474.

    Article  PubMed  Google Scholar 

  7. Greess H, Lutze J, Nomayr A, et al.,Dose reduction in subsecond multislice spiral CT examination of children by online tube current modulation.Eur Radiol 2004,14:995–999.

    Article  PubMed  CAS  Google Scholar 

  8. Wintersperger B, Jakobs T, Herzog P, et al.,Aorto-iliac multidetector-row CT angiography with low kV settings: improved vessel enhancement and simultaneous reduction of radiation dose.Eur Radiol 2005,15:334–341.

    Article  PubMed  CAS  Google Scholar 

  9. McCollough CH:Patient dose in cardiac computed tomography.Herz 2003,28:1–6.

    Article  PubMed  Google Scholar 

  10. Nash K, Hafeez A, Hou S:Hospital-acquired renal insufficiency.Am J Kidney Dis 2002,39:930–936.

    Article  PubMed  Google Scholar 

  11. McCullough PA, Wolyn R, Rocher LL, et al.,Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality.Am J Med 1997,103:368–375.

    Article  PubMed  CAS  Google Scholar 

  12. McCullough PA, Adam A, Becker CR, et al.,Epidemiology and prognostic implications of contrast-induced nephropathy.Am J Cardiol 2006,98:5K-13K.

    Article  PubMed  CAS  Google Scholar 

  13. Mehran R, Aymong ED, Nikolsky E, et al.,A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation.J Am Coll Cardiol 2004,44:1393–1399.

    PubMed  Google Scholar 

  14. US Food and Drug Administration.Public health advisory: gadolinium-containing contrast agents for magnetic resonance imaging (MRI): Omniscan, OptiMARK, Magnevist, ProHance, and MultiHance. Information for Healthcare Professionals. Available at: http://www.fda.gov/cder/drug/ advisory/gadolinium_agents.htm. Accessed June 20, 2007.

  15. Qureshi AI, Alexandrov AV, Tegeler CH, et al.,Guidelines for screening of extracranial carotid artery disease: a statement for healthcare professionals from the multidisciplinary practice guidelines committee of the American Society of Neuroimaging; cosponsored by the Society of Vascular and Interventional Neurology.J Neuroimaging 2007,17:19–47.

    Article  PubMed  Google Scholar 

  16. MRC European Carotid Surgery Trial:interim results for symptomatic patients with severe (70–99%) or with mild (0–29%) carotid stenosis. European Carotid Surgery Trialists’ Collaborative Group.Lancet 1991,337:1235–1243.

    Article  Google Scholar 

  17. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators.N Engl J Med 1991,325:445–453.

  18. Barnett HJ, Taylor DW, Eliasziw M, et al.,Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators.N Engl J Med 1998,339:1415–1425.

    Article  PubMed  CAS  Google Scholar 

  19. Willinsky RA, Taylor SM, TerBrugge K, et al.,Neurologic complications of cerebral angiography: prospective analysis of 2,899 procedures and review of the literature.Radiology 2003,227:522–528.

    Article  PubMed  Google Scholar 

  20. Bartlett ES, Walters TD, Symons SP, Fox AJL:Quantification of carotid stenosis on CT angiography.AJNR Am J Neuroradiol 2006,27:13–19.

    PubMed  CAS  Google Scholar 

  21. Nandalur KR, Baskurt E, Hagspiel KD, et al.,Carotid artery calcification on CT may independently predict stroke risk.AJR Am J Roentgenol 2006,186:547–552.

    Article  PubMed  Google Scholar 

  22. Jenkins RH, Mahal R, MacEneaney PM:Noninvasive imaging of carotid artery disease: critically appraised topic.Can Assoc Radiol J 2003,54:121–123.

    PubMed  Google Scholar 

  23. Of major importance Chalela JA, Kidwell CS, Nentwich LM, et al.,Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison.Lancet 2007,369:293–298. This prospective study reports superiority of MRI imaging of acute ischemia in a large patient population with suspected acute stroke in a clinical setting leading to the conclusion that in these patients MRI should be the preferred test.

    Article  PubMed  Google Scholar 

  24. White PM, Wardlaw JM, Easton V:Can noninvasive imaging accurately depict intracranial aneurysms? A systematic review.Radiology 2000,217:361–370.

    PubMed  CAS  Google Scholar 

  25. Sommer T, Fehske W, Holzknecht N, et al.,Aortic dissection: a comparative study of diagnosis with spiral CT, multiplanar transesophageal echocardiography, and MR imaging.Radiology 1996,199:347–352.

    PubMed  CAS  Google Scholar 

  26. Of importance Barbant SD, Eisenberg MJ, Schiller NB:The diagnostic value of imaging techniques for aortic dissection.Am Heart J 1992,124:541–543. Study comparing the diagnostic value of several imaging techniques (angiography, CT, MRI, and TEE) for aortic dissection utilizing Bayes’ theorem for calculating predictive values and accuracies. Performance of these imaging modalities was better in high-risk populations than in patients of low-risk.

    Article  PubMed  CAS  Google Scholar 

  27. Yucel EK, Steinberg FL, Egglin TK, et al.,Penetrating aortic ulcers: diagnosis with MR imaging.Radiology 1990,177:779–781.

    PubMed  CAS  Google Scholar 

  28. Sawhney R, Kerlan RK, Wall SD, et al.,Analysis of initial CT findings after endovascular repair of abdominal aortic aneurysm.Radiology 2001,220:157–160.

    PubMed  CAS  Google Scholar 

  29. Engellau L, Albrechtsson U, Dahlstrom N, et al.,Measurements before endovascular repair of abdominal aortic aneurysms. MR imaging with MRA vs. angiography and CT.Acta Radiol 2003,44:177–184.

    Article  PubMed  CAS  Google Scholar 

  30. Gorich J, Rilinger N, Soldner J, et al.,Endovascular repair of aortic aneurysms: treatment of complications.J Endovasc Surg 1999,6:136–146.

    Article  PubMed  CAS  Google Scholar 

  31. Wicky S, Fan CM, Geller SC, et al.,MR angiography of endoleak with inconclusive concomitant CT angiography.AJR Am J Roentgenol 2003,181:736–738.

    PubMed  CAS  Google Scholar 

  32. Safian RD, Textor SC:Renal-artery stenosis.N Engl J Med 2001,344:431–442.

    Article  PubMed  CAS  Google Scholar 

  33. Halpern EJ, Rutter CM, Gardiner GA, Jr. et al.:Comparison of Doppler US and CT angiography for evaluation of renal artery stenosis.Acad Radiol 1998,5:524–532.

    Article  PubMed  CAS  Google Scholar 

  34. Johnson PT, Halpern EJ, Kuszyk BS, et al.,Renal artery stenosis: CT angiography—comparison of real-time volume-rendering and maximum intensity projection algorithms.Radiology 1999,211:337–343.

    PubMed  CAS  Google Scholar 

  35. Willmann JK, Wildermuth S, Pfammatter T, et al.,Aortoiliac and renal arteries: prospective intraindividual comparison of contrast-enhanced three-dimensional MR angiography and multi-detector row CT angiography.Radiology 2003,226:798–811.

    Article  PubMed  Google Scholar 

  36. Fraioli F, Catalano C, Bertoletti L, et al.,Multidetector-row CT angiography of renal artery stenosis in 50 consecutive patients: prospective interobserver comparison with DSA.Radiol Med (Torino) 2006,111:459–468.

    Article  CAS  Google Scholar 

  37. Raza SA, Chughtai AR, Wahba M, et al.,Multislice CT angiography in renal artery stent evaluation: prospective comparison with intra-arterial digital subtraction angiography.Cardiovasc Intervent Radiol 2004,27:9–15.

    Article  PubMed  Google Scholar 

  38. Eklof H, Ahlstrom H, Bostrom A, et al.,Renal artery stenosis evaluated with 3D-Gd-magnetic resonance angiography using transstenotic pressure gradient as the standard of reference. A multireader study.Acta Radiol 2005,46:802–809.

    Article  PubMed  CAS  Google Scholar 

  39. Prince MR, Schoenberg SO, Ward JS, et al.,Hemodynamically significant atherosclerotic renal artery stenosis: MR angiographic features.Radiology 1997,205:128–136.

    PubMed  CAS  Google Scholar 

  40. Hagspiel KD, Leung DA, Nandalur KR, et al.,Contrast-enhanced MR angiography at 1.5 T after implantation of platinum stents: in vitro and in vivo comparison with conventional stent designs.AJR Am J Roentgenol 2005,184:288–294.

    PubMed  Google Scholar 

  41. Of major importance Vasbinder GB, Nelemans PJ, Kessels AG, et al.,Accuracy of computed tomographic angiography and magnetic resonance angiography for diagnosing renal artery stenosis.Ann Intern Med 2004,141:674–682. Large prospective multicenter study in hypertensive patients comparing the diagnostic performance of CTA and MRA versus DSA for renal artery disease assessment. CTA and MRA were not reproducible or sensitive enough to rule out renal artery stenosis in this particular patient population.

    PubMed  Google Scholar 

  42. Pentecost MJ, Criqui MH, Dorros G, et al.,Guidelines for peripheral percutaneous transluminal angioplasty of the abdominal aorta and lower extremity vessels. A statement for health professionals from a Special Writing Group of the Councils on Cardiovascular Radiology, Arteriosclerosis, Cardio-Thoracic and Vascular Surgery, Clinical Cardiology, and Epidemiology and Prevention, the American Heart Association.J Vasc Interv Radiol 2003,14(9 Pt 2):S495-S515.

    Article  PubMed  Google Scholar 

  43. Ofer A, Nitecki SS, Linn S, et al.,Multidetector CT angiography of peripheral vascular disease: a prospective comparison with intraarterial digital subtraction angiography.AJR Am J Roentgenol 2003,180:719–724.

    PubMed  Google Scholar 

  44. Ouwendijk R, Kock MC, Visser K, et al.,Interobserver agreement for the interpretation of contrast-enhanced 3D MR angiography and MDCT angiography in peripheral arterial disease.AJR Am J Roentgenol 2005,185:1261–1267.

    Article  PubMed  Google Scholar 

  45. Of major importance Ouwendijk R, de Vries M, Pattynama PM et al.,Imaging peripheral arterial disease: a randomized controlled trial comparing contrast-enhanced MR angiography and multi-detector row CT angiography.Radiology 2005,236:1094–1103. Prospective study comparing clinical utility of MRA and CTA for initial assessment of peripheral artery disease showing slight advantages for CTA.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, University of Florida, College of Medicine, 655 West Eighth Street, 32209, Jacksonville, FL, USA

    Marco A. Costa MD, PhD

Authors
  1. Franz von Ziegler MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marco A. Costa MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marco A. Costa MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

von Ziegler, F., Costa, M.A. The role of CT and MRI in the assessment of peripheral vascular disease. Curr Cardiol Rep 9, 412–419 (2007). https://doi.org/10.1007/BF02938369

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02938369

Keywords

Search

Navigation