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Non-contrast MRI of micro-vascularity of the feet and toes

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Abstract

Purpose

This study aimed to develop novel non-contrast MR perfusion techniques for assessing micro-vascularity of the foot in human subjects.

Methods

All experiments were performed on a clinical 3 T scanner using arterial spin labeling (ASL). Seven healthy subjects (30–72 years old, 5 males and 2 females) were enrolled and bilateral feet were imaged with tag-on and tag-off alternating inversion recovery spin labeling for determining micro-vascularity. We compared an ASL technique with 1-tag against 4-tag pulses. For perfusion, we determined signal increase ratio (SIR) at varying inversion times (TI) from 0.5 to 2 s. SIR versus TI data were fit to determine perfusion metrics of peak height (PH), time to peak (TTP), full width at half maximum (FWHM), area under the curve (AUC), and apparent blood flow (aBF) in the distal foot and individual toes. Using analysis of variance (ANOVA), effects of tag pulse and region of interest (ROI) on the mean perfusion metrics were assessed. In addition, a 4-tag pulse perfusion experiment was performed on patients with peripheral artery disease (PAD) and Raynaud’s disease.

Results

Using our MR perfusion techniques, SIR versus TI data showed well-defined leading and trailing edges, with a peak near TI of 0.75–1.0 s and subsiding quickly to near zero by TI of 2 s, particularly when 4-tag pulses were used. When imaged with 4-tag pulse, we found significantly greater values in perfusion metrics, as compared to 1-tag pulse. The patients with PAD and Raynaud’s disease showed a reduced or scattered perfusion curves compared to the healthy control.

Conclusion

MR perfusion imaging of the distal foot shows greater SIR and perfusion metrics with the 4-tag pulse compared to the 1-tag pulse technique. This will likely benefit those with low perfusion due to aging, PAD, diabetic foot, and other vascular diseases.

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Acknowledgements

Research reported in this publication was supported by the National Institute of Heart, Lung, Blood Institute R01HL154092 and Canon Medical grant to Mitsue Miyazaki and by National Institute of Arthritis and Musculoskeletal and Skin Diseases P30 AR073761 in support of Mitsue Miyazaki and Won Bae. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or Veterans Affairs.

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Authors and Affiliations

  1. Department of Radiology, University of California-San Diego, La Jolla, CA, USA

    Won C. Bae, Vadim Malis, Diana Vucevic & Mitsue Miyazaki

  2. Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA

    Won C. Bae

  3. Department of Radiology, Teikyo University, Tokyo, Japan

    Asako Yamamoto

  4. Kyoritsu Tobata Hospital, Kitakyusyu, Fukuoka, Japan

    Katsumi Nakamura

  5. Department of Surgery, University of California-San Diego, La Jolla, CA, USA

    John Lane

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  1. Won C. Bae
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Correspondence to Mitsue Miyazaki.

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Conflict of interest

Dr. Bae received research funding from General Electric Healthcare and Canon Medical Systems, USA. Dr. Miyazaki received research funding from Canon Medical Systems Corp., Japan. The remaining coauthors have no conflicts of interest.

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Bae, W.C., Malis, V., Vucevic, D. et al. Non-contrast MRI of micro-vascularity of the feet and toes. Jpn J Radiol (2024). https://doi.org/10.1007/s11604-024-01553-z

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