Keywords:
Vascular, Arteries / Aorta, Musculoskeletal soft tissue, MR-Diffusion/Perfusion, Contrast agent-intravenous, Arteriosclerosis, Ischaemia / Infarction
Authors:
N. Sinkevich, E. Butorova, O. Stukalova, M. Maslennikov, O. Bulkina, S. K. Ternovoy, Y. Karpov; Moscow/RU
Methods and Materials
A total of 25 PAD subjects with claudication symptoms and mean ankle-brachial index (ABI) 0.6±0.15 were studied.
Group characteristic presented at Table 1.
All performed supine plantar flexion exercise in a 1.5T MRI scanner until limiting symptoms with intravenous gadolinium-based contrast media administration (GdDPA,
“Magnevist”) before the medical treatment initiation and 6.9±2 months later.
Peak tissue perfusion (TP),
time-to-peak TP and time-to-peak arterial input flow (AIF) were measured by placing a region of interest in the greatest signal intensity region of a tibialis anterior muscle and tibialis anterior artery respectively (Figure 1).
Data analysis was performed on Siemens Mean Curve Software by time-intensity curves construction (Figure 2)
The standart treatment beside the hypertention and hyperglycaemia correction included antiplatelet therapy,
statins and 10 intravenous infusions of synthetic prostanoid analogues (alprostadil 100 mg daily). All patients would have performed training exercises as predicted.
Neither MRI-associated nor contrast-related complications were matched.
Group characteristic
|
Total number of patients
|
25
|
Age,
years
|
62,44±7
|
Female, n (%)
|
2 (8%)
|
Smoking,n (%)
|
8 (32%)
|
Ischemic heart disease,
n(%)
|
25 (100%)
|
Arterial hypertension,
n(%)
|
25 (100%)
|
Anamnesis of lower limb revascularization,
n(%)
|
4 (16%)
|
Diabetes Mellitus,
n(%)
|
5 (20%)
|
Stroke history,
n(%)
|
2 (8%)
|
Total cholesterol,
mmol/l
|
4.67±1.41
|
Low-density lipoprotein,
mmol/l
|
2.73±1.12
|
Ankle-brachial index
|
0.6±0.15
|
Table 1.
Total patients characteristic.