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Wall morphology, blood flow and wall shear stress: MR findings in patients with peripheral artery disease

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To investigate the influence of atherosclerotic plaques on femoral haemodynamics assessed by two-dimensional (2D) phase-contrast (PC) magnetic resonance imaging (MRI) with three-directional velocity encoding.

Methods

During 1 year, patients with peripheral artery disease and an ankle brachial index <1.00 were enrolled. After institutional review board approval and written informed consent, 44 patients (age, 70 ± 12 years) underwent common femoral artery MRI. Patients with contra-indications for MRI were excluded. Sequences included 2D time-of-flight, proton-density, T1-weighted and T2-weighted MRI. Electrocardiogram (ECG)-gated 2D PC-MRI with 3D velocity encoding was acquired. A radiologist classified images in five categories. Blood flow, velocity and wall shear stress (WSS) along the vessel circumference were quantified from the PC-MRI data.

Results

The acquired images were of good quality for interpretation. There were no image quality problems related to poor ECG-gating or slice positioning. Velocities, oscillatory shear stress and total flow were similar between patients with normal arteries and wall thickening/plaque. Patients with plaques demonstrated regionally increased peak systolic WSS and enhanced WSS eccentricity.

Conclusions

Combined multi-contrast morphological imaging of the peripheral arterial wall with PC-MRI with three-directional velocity encoding is a feasible technique. Further study is needed to determine whether flow is an appropriate marker for altered endothelial cell function, vascular remodelling and plaque progression.

Key Points

• Femoral plaques are associated with altered dynamics of peripheral blood flow.

• Multi-contrast MRI can investigate the presence and type of atherosclerotic plaques.

• Three-dimensional velocity-encoding phase-contrast MRI can investigate flow and wall shear stress.

• Atherosclerotic peripheral arteries demonstrate increased systolic velocities and wall shear stress.

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Abbreviations

WSS:

wall shear stress

PAD:

peripheral arterial disease

OSI:

oscillatory shear index

TOF:

time-of-flight

PD:

proton density

PC:

phase contrast

LR/NC:

lipid-rich/necrotic core

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Acknowledgments

Supported by funding from the National Heart, Lung, and Blood Institute (R01-HL083064, R01HL115828 and R01-HL109244); NUCATS Institute NIH grant UL1RR025741, and the Northwestern Memorial Foundation Dixon Translational Research Grants Initiative; American Heart Association Scientist Development Grant 13SDG14360004.

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Authors and Affiliations

  1. Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Mauricio S. Galizia, Alex Barker, Jeremy Collins, James Carr & Michael Markl

  2. Department of Preventive Medicine, Northwestern University’s Feinberg School of Medicine, Chicago, IL, USA

    Yihua Liao & Mary M. McDermott

  3. Department of Medicine, Northwestern University’s Feinberg School of Medicine, Chicago, IL, USA

    Mary M. McDermott

  4. Department Biomedical Engineering, McCormick School of Engineering, Northwestern University, 737 N. Michigan Avenue Suite 1600, Chicago, IL, 60611, USA

    Michael Markl

Authors
  1. Mauricio S. Galizia
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  2. Alex Barker
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  3. Yihua Liao
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  4. Jeremy Collins
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  5. James Carr
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  6. Mary M. McDermott
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  7. Michael Markl
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Correspondence to Michael Markl.

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Galizia, M.S., Barker, A., Liao, Y. et al. Wall morphology, blood flow and wall shear stress: MR findings in patients with peripheral artery disease. Eur Radiol 24, 850–856 (2014). https://doi.org/10.1007/s00330-013-3081-x

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  • DOI: https://doi.org/10.1007/s00330-013-3081-x

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