MRA of the Lower Extremities

Clinical History

This patient was a 52-year-old Caucasian female with an unclear lower leg exhaustion after long walks. MRA was performed to exclude a significant stenosis that could explain the clinical symptoms.

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MR Imaging

MR scans were performed on a 1.5T whole-body scanner. Dynamic and steady-state MR angiographies were performed after intravenous injection of gadofosveset.

First-pass MRA with gadofosveset

Fig. 1. First-pass MR angiography, MIP projection. TR = 4.3 ms, TE = 1.4 ms, flip angle 30°, resolution 1.0 x 1.0 x 1.0 mm. Gadofosveset was injected at a rate of 1.0 ml/sec.

Comment: This first-pass MIP with blood-pool subtraction shows the normal vascular anatomy of the lower leg in great detail.

Steady-state MRA with gadofosveset

Fig. 2. MR angiography in steady state after i.v. injection of the blood pool agent. TR = 7.7 ms, TE = 2.6 ms, flip angle 25°, resolution = 0.5 x 0.5 x 0.5 mm, 2 excitations.

Comment: This coronal-targeted MIP image of the lower leg obtained in the extended phase after i.v. injection of the blood pool agent shows the vast amount of detail available in steady-state imaging. With the extended imaging period, spatial resolution can be increased to show even the smallest vascular details.

MR Diagnosis: No significant stenosis of the lower leg arteries.