Skip to main content
SpringerLink
Log in

Whole-body MR vascular screening detects unsuspected concomitant vascular disease in coronary heart disease patients

  • Vascular-Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Coronary heart disease (CHD) patients often show atherosclerotic vascular disease in other vascular territories. We evaluated how often whole-body MR imaging detects concomitant arterial pathologies in CHD patients, and how often these pathologies were not known to the patients previously. Of 4,814 participants in the population-based Heinz Nixdorf Recall Study, 327 reported CHD (i.e., previous coronary bypass surgery, angioplasty); of those, 160 patients (mean age 66.4 years) were examined using MR of the brain, the heart (excluding the coronary arteries), and whole-body MR angiography. The prevalence of each vascular pathology was assessed, correlated to the others and compared to patients’ histories. Of the 160 CHD patients, 16 (10%) showed MR signs of stroke, and 77 (48.1%) had a stenosis >50% in at least one extracerebral peripheral artery (other than the coronaries), including 28 (17.5%) with relevant renal artery stenoses, and 20 (12.5%) with relevant extracerebral internal carotid artery stenoses. False negative histories were reported in 12 of 81 cases with myocardial infarctions, and in 11 of 16 cases with cerebrovascular infarctions. This whole-body atherosclerosis MR screening program allows previously unknown concomitant vascular disease to be detected in coronary heart disease patients. Its prospective value should be assessed in further studies.

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

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Nikolsky E, Mehran R, Mintz GS (2004) Impact of symptomatic peripheral arterial disease on 1-year mortality in patients undergoing percutaneous coronary interventions. J Endovasc Ther 11:60–70

    Article  PubMed  Google Scholar 

  2. Januzzi JL Jr, Buros J, Cannon CP (2005) Tactics TIMI 18 investigators. Peripheral arterial disease, acute coronary syndromes, and early invasive management: the TACTICS TIMI 18 trial. Clin Cardiol 28:238–242

    Article  PubMed  Google Scholar 

  3. Hodara M, Bonithon-Kopp C, Courbon D, Guerin F, Richard J (1998) [Extra-coronary atherosclerosis in documented coronary patients]. Arch Mal Coeur Vaiss 91:201–207

    PubMed  CAS  Google Scholar 

  4. Hirsch AT, Criqui MH, Treat-Jacobson D et al (2001) Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA 286:1317–1324

    Article  PubMed  CAS  Google Scholar 

  5. Cohen MG, Pascua JA, Garcia-Ben M (2005) A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization. Am Heart J 150:1204–1211

    Article  PubMed  Google Scholar 

  6. Rockman CB, Jacobowitz GR, Gagne PJ (2004) Focused screening for occult carotid artery disease: patients with known heart disease are at high risk. J Vasc Surg 39:44–51

    Article  PubMed  Google Scholar 

  7. Decrinis M, Doder S, Stark G, Pilger E (1994) A prospective evaluation of sensitivity and specificity of the ankle/brachial index in the follow-up of superficial femoral artery occlusions treated by angioplasty. Clin Invest 72:592–597

    Article  CAS  Google Scholar 

  8. Council of the European Union (1997) Council Directive 97/43/EURATOM of 30 June 1997, article 3

  9. Portugaller HR, Schoellnast H, Hausegger KA, Tiesenhausen K, Amann W, Berghold A (2004) Multislice spiral CT angiography in peripheral arterial occlusive disease: a valuable tool in detecting significant arterial lumen narrowing? Eur Radiol 14:1681–1687

    Article  PubMed  Google Scholar 

  10. Newman AB, Siscovick DS, Manolio TA et al (1993) Ankle-arm index as a marker of atheroscerlosis in the Cardiovascular Health Study. Circulation 88:837–845

    PubMed  CAS  Google Scholar 

  11. Rigatelli G (2004) Aortoiliac angiography during coronary artery angiography detects relevant occult aortoiliac and renal artery atherosclerosis in patients with coronary atherosclerosis. Int J Cardiovasc Imaging 20:299–303

    Article  PubMed  Google Scholar 

  12. Lanzer P (2003) [Vascular multimorbidity in patients with a documented coronary artery disease]. Z Kardiol 92:650–659

    Article  PubMed  CAS  Google Scholar 

  13. Zierler RE, Bergelin RO, Polissar NL et al (1998) Carotid and lower extremity arterial disease in patients with renal artery atherosclerosis. Arch Intern Med 158:761–767

    Article  PubMed  CAS  Google Scholar 

  14. von Kemp K, van den Brande P, Peterson T et al (1997) Screening for concomitant diseases in peripheral vascular patients. Results of a systematic approach. Int Angiol 16:114–122

    Google Scholar 

  15. Goyen M, Quick HH, Debatin JF et al (2002) Whole-body three-dimensional MR angiography with a rolling table platform: initial clinical experience. Radiology 224:270–277

    Article  PubMed  Google Scholar 

  16. Barkhausen J, Quick HH, Lauenstein T et al (2001) Whole-body MR imaging in 30 seconds with real-time true FISP and a continously rolling table platform: feasibility study. Radiology 220:252–256

    PubMed  CAS  Google Scholar 

  17. Schmidt GP, Haug AR, Schoenberg SO, Reiser MF (2006) Whole-body MRI and PET-CT in the management of cancer patients. Eur Radiol 16(6):1216–25

    Article  PubMed  Google Scholar 

  18. Fenchel M, Jost D, Kramer U et al (2006) [Cardiovascular whole-body MR imaging in patients with symptomatic peripheral arterial occlusive disease.] Rofo 178:491–499

    PubMed  CAS  Google Scholar 

  19. Meaney JF, Ridgway JP, Chakraverty S et al (1999) Stepping-table gadolinium-enhanced digital subtraction MR angiography of the aorta and lower extremity arteries: preliminary experience. Radiology 211:59–67

    PubMed  CAS  Google Scholar 

  20. Schoenberg SO, Essig M, Hallscheidt P et al (2002) Multiphase magnetic resonance angiography of the abdominal and pelvic arteries: results of a bicenter multireader analysis. Invest Radiol 37:20–28

    Article  PubMed  Google Scholar 

  21. Borisch I, Horn M, Butz B et al (2003) Preoperative evaluation of carotid artery stenosis: comparison of contrast-enhanced MR angiography and duplex sonography with digital subtraction angiography. AJNR Am J Neuroradiol 24:1117–1122

    PubMed  Google Scholar 

  22. van der Wall EE, van Rugge FP, Vliegen HW, Reiber JH, de Roos A, Bruschke AV (1997) Ischemic heart disease: value of MR techniques. Int J Card Imaging 13:179–189

    Article  PubMed  Google Scholar 

  23. Barkhausen J, Ruehm SG, Goyen M, Buck T, Laub G, Debatin JF (2001) MR evaluation of ventricular function: true fast imaging with steady-state precession versus fast low-angle shot cine MR imaging: feasibility study. Radiology 219:264–269

    PubMed  CAS  Google Scholar 

  24. Hunold P, Brandt-Mainz K, Freudenberg L et al (2002) [Evaluation of myocardial viability with contrast-enhanced magnetic resonance imaging-comparison of the late enhancement technique with positron emission tomography.] Rofo 174:867–873

    PubMed  CAS  Google Scholar 

  25. Imaizumi T, Horita Y, Hashimoto Y, Niwa J (2004) Dotlike hemosiderin spots on T2*-weighted magnetic resonance imaging as a predictor of stroke recurrence: a prospective study. J Neurosurg 101:915–920

    Article  PubMed  Google Scholar 

  26. Fiehler J, Remmele C, Kucinski T et al (2005) Reperfusion after severe local perfusion deficit precedes hemorrhagic transformation: an MRI study in acute stroke patients. Cerebrovasc Dis 19:117–124

    Article  PubMed  Google Scholar 

  27. Schmermund A, Mohlenkamp S, Stang A et al (2002) Assessment of clinically silent atherosclerotic disease and established and novel risk factors for predicting myocardial infarction and cardiac death in healthy middle-aged subjects: rationale and design of the Heinz Nixdorf RECALL Study. Risk factors, evaluation of coronary calcium and lifestyle. Am Heart J 144:212–218

    Article  PubMed  Google Scholar 

  28. Goehde SC, Forsting M, Debatin JF (2005) Full body cardiovascular and tumor MR imaging for early detection of disease: feasibility and initial experience in 298 subjects. AJR Am J Roentgenol 184:598–611

    PubMed  Google Scholar 

  29. Bryan RN, Wells SW, Elster A et al (1997) Infarctlike lesions in the brain. Prevalence and anatomic characteristics at MR imaging of the elderly. Data from the Cardiovascular Health Study (CHS). Radiology 202:47–54

    PubMed  CAS  Google Scholar 

  30. [No authors] (1996) Endarterectomy for moderate symptomatic carotid stenosis: interim results from the MRC European Carotid Surgery Trial Lancet 347:1591–1593

  31. Kent KM, Rosing DR, Ewels CJ, Lipson L, Bonow R, Epstein SE (1982) Prognosis of asymptomatic or mildly symptomatic patients with coronary artery disease. Am J Cardiol 49:1823–1831

    Article  PubMed  CAS  Google Scholar 

  32. Gopal AS, Schnellbaecher MJ, Shen Z, Boxt LM, Katz J, King DL (1997) Freehand three-dimensional echocardiography for determination of left ventricular volume and mass in patients with abnormal ventricles: comparison with magnetic resonance imaging. J Am Soc Echocardiogr 10:853–861

    Article  PubMed  CAS  Google Scholar 

  33. Hufnagel G, Pankuweit S, Richter A, Schonian U, Maisch B (2000) The European Study of Epidemiology and Treatment of Cardiac Inflammatory Diseases (ESETCID). First epidemiological results. Herz 25:279–285

    Article  PubMed  CAS  Google Scholar 

  34. Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP (1990) Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 322:1561–1566

    Article  PubMed  CAS  Google Scholar 

  35. Agewall S, Henareh L, Jogestrand T (2005) Intima-media complex of both the brachial artery and the common carotid artery are associated with left ventricular hypertrophy in patients with previous myocardial infarction. J Hypertens 23:119–125

    Article  PubMed  CAS  Google Scholar 

  36. Kanjwal MK, Cooper C, Bashir R (2004) Peripheral arterial disease-the silent killer. JK-Practitioner 11:225–232

    Google Scholar 

  37. Bryan RN, Manolio TA, Schertz LD et al (1994) A method for using MR to evaluate the effects of cardiovascular disease on the brain. The Cardiovascular Health Study. AJNR Am J Neuroradiol 15:1625–1633

    PubMed  CAS  Google Scholar 

  38. Willinek WA, von Falkenhausen M, Born M et al (2005) Noninvasive detection of steno-occlusive disease of the supra-aortic arteries with three-dimensional contrast-enhanced magnetic resonance angiography: a prospective, intra-individual comparative analysis with digital subtraction angiography. Stroke 36:38–43

    Article  PubMed  Google Scholar 

  39. Scarabino T, Carriero A, Magarelli N et al (1998) MR angiography in carotid stenosis: a comparison of three techniques. Eur J Radiol 28:117–125

    Article  PubMed  CAS  Google Scholar 

  40. Randoux B, Marro B, Koskas F et al (2001) Carotid artery stenosis: prospective comparison of CT, three-dimensional gadolinium-enhanced MR, and conventional angiography. Radiology 220:179–185

    PubMed  CAS  Google Scholar 

  41. Rigatelli G, Rigatelli G (2005) Malpractice in invasive cardiology: is angiography of abdominal aorta or subclavian artery appropriate in patients undergoing coronary angiography? A meta analysis. Int J Cardiovasc Imaging 21:591–598

    Article  PubMed  Google Scholar 

  42. Metcalfe W, Reid AW, Geddes CC (1999) Prevalence of angiographic atherosclerotic renal artery disease and its relationship to the anatomical extent of peripheral vascular atherosclerosis. Nephrol Dial Transplant 14:105–108

    Article  PubMed  CAS  Google Scholar 

  43. Sakaguchi M, Kitagawa K, Nagai Y et al (2003) Equivalence of plaque score and intima-media thickness of carotid ultrasonography for predicting severe coronary artery lesion. Ultrasound Med Biol 29:367–371

    Article  PubMed  Google Scholar 

  44. Beinfeld MT, Wittenberg E, Gazelle GS (2005) Cost-effectiveness of whole-body T screening. Radiology 234:415–422

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany

    Susanne C. Ladd, Michael Nuefer, Elke Gizewski, Isabel Wanke, Mark E. Ladd & Michael Forsting

  2. University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany

    Joerg F. Debatin

  3. Medical Faculty, Institute of Medical Epidemiology, Biometry and Informatics, Martin-Luther University, 06112, Halle-Wittenberg, Germany

    Andreas Stang

  4. European Commission, DG INFSO, 1049, Brussels, Belgium

    Katja Bromen

  5. Institute of Medical Informatics, Biometry and Epidemiology, University Hospital, 45122, Essen, Germany

    Susanne Moebus & Karl-Heinz Jöckel

  6. Department of Neuroradiology, University of Erlangen Medical School, 91054, Erlangen, Germany

    Arnd Doerfler

  7. Department of Neurology, University Hospital, 45122, Essen, Germany

    Jens Benemann

  8. Department of Cardiology, University Hospital, 45122, Essen, Germany

    Raimund Erbel & Axel Schmermund

Authors
  1. Susanne C. Ladd
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joerg F. Debatin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andreas Stang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Katja Bromen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Susanne Moebus
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michael Nuefer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Elke Gizewski
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Isabel Wanke
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Arnd Doerfler
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Mark E. Ladd
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Jens Benemann
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Raimund Erbel
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Michael Forsting
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Axel Schmermund
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Karl-Heinz Jöckel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Susanne C. Ladd.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ladd, S.C., Debatin, J.F., Stang, A. et al. Whole-body MR vascular screening detects unsuspected concomitant vascular disease in coronary heart disease patients. Eur Radiol 17, 1035–1045 (2007). https://doi.org/10.1007/s00330-006-0434-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-006-0434-8

Keywords

Search

Navigation