Technical Note
Improved Multi-Station Peripheral MR Angiography
With a Dedicated Vascular Coil
Mathias Goyen, MD,
1
*
Stefan G. Ruehm, MD,
1
Jo ¨ rg Barkhausen, MD,
1
Knut Kro ¨ger, MD,
2
Mark E. Ladd, PhD,
1
Karl-Heinz Truemmler, MS,
3
Silke Bosk, RT,
1
Martin Requardt, PhD,
3
Arne Reykowski, PhD,
3
and Jo ¨rg F. Debatin, MD, MBA
1
Delineation of small branch vessels can be crucial for as-
sessing the peripheral arterial system of patients requiring
surgical grafting. Thus signal-to-noise needs to be maxi-
mized. We evaluated the performance of a dedicated pe-
ripheral vascular coil in four subjects by comparing it to
the body coil using DSA as the standard of reference. SNR
and CNR values of the dedicated peripheral coil exceeded
those obtained with the body coil by a mean of 398%, thus
permitting improved delineation of the infrapopliteal ar-
terial morphology. J. Magn. Reson. Imaging 2001;13:
475– 480. © 2001 Wiley-Liss, Inc.
Index terms: magnetic resonance angiography (MRA); periph-
eral arterial occlusive disease (PAOD); peripheral vascular coil;
contrast agent; multi-station
HIGH DIAGNOSTIC ACCURACY, coupled with nonin-
vasiveness and lack of contrast-induced nephrotoxic-
ity, have driven the rapid clinical integration of con-
trast-enhanced three-dimensional MR angiography
(CE 3D MRA) for assessment of virtually all vascular
territories. The technique is based on the availability
of high-performance gradient systems, which are capa-
ble of reducing data collection times sufficiently to
acquire a 3D image set during the intraarterial phase
of intravenously administered extracellular contrast
material (1).
Subsequent parenchymal enhancement and contrast
dose limitations had initially restricted the technique to
the display of the vascular territory contained within a
single 40 –50-cm field of view. Following the implemen-
tation of bolus chase techniques with integrated table
motion algorithms, imaging of up to three contiguous
vascular territories has become possible. Thus the pel-
vic and run-off arteries can be assessed in a single exam
(2,3). Reported results for evaluating the run-off arter-
ies regarding the presence of hemodynamically signifi-
cant disease have been quite promising, with sensitivity
and specificity values ranging from 89% to 95%, and
93% to 98%, respectively (2,3). Careful analysis of the
image data does, however, point to some technique-
related limitations. Reflecting the need to use the body
coil for imaging over several vascular territories, these
limitations relate to a poor signal-to-noise ratio (SNR),
and therefore limited spatial resolution. Thus, delinea-
tion—particularly of small arteries potentially needed
for surgical grafting— can be challenging (4,5).
Recently, dedicated peripheral vascular coils have be-
come available for signal reception. Employing the lat-
est gradient generation, we evaluated the performance
of such a coil in patients with PAOD and compared it to
the body coil. To this end, image data collected with a
single-injection, three-station protocol covering the pe-
ripheral arteries from the level of the inguinal ligament
to the mid foot were qualitatively and quantitatively
assessed.
MATERIALS AND METHODS
MRA of the peripheral arteries was performed on one
healthy male volunteer (30 years old) and three patients
with clinically documented PAOD. The patients, all
men, were between 47 and 64 years old (mean age: 54.2
years). All four subjects underwent MRA of the periph-
eral arterial system twice within one week: once using
the body coil for signal transmission and reception, and
a second time using the peripheral vascular coil for
signal reception and the body coil merely for signal
transmission. Furthermore, digital subtraction angiog-
raphy (DSA) correlation was available in all three exam-
ined patients.
The study protocol was approved by the institutional
review board, and informed consent was obtained from
all subjects.
Coil Design
The coil (peripheral angio array coil), manufactured by
Siemens Medical Systems, extends over 95 cm and
weighs 6 kg (Fig. 1). It is made up of eight separate
circularly polarized elements: four for the right and four
for the left extremity. Thus the coil covers both lower
extremities form the inguinal ligament to the mid foot.
1
Department of Diagnostic Radiology, University Hospital Essen, Es-
sen, Germany.
2
Department of Angiology, University Hospital Essen, Essen, Germany.
3
Siemens Medical Systems, Erlangen, Germany.
*Address reprint requests to: M.G., Department of Diagnostic Radiology
OZ II, University Hospital Essen, Hufelandstrasse 55, 45122 Essen,
Germany. E-mail: mathias.goyen@uni-essen.de
Received May 16, 2000; Accepted September 27, 2000.
JOURNAL OF MAGNETIC RESONANCE IMAGING 13:475– 480 (2001)
© 2001 Wiley-Liss, Inc. 475