Evaluation of skeletal muscle perfusion changes in patients with peripheral artery disease before and after percutaneous transluminal angioplasty using multiparametric MR imaging

Abstract

Purpose: To evaluate muscle perfusion in patients with peripheral artery disease (PAD) before and after percutaneous transluminal angioplasty (PTA) of the limb by means of MR arterial spin labeling (ASL) and intravoxel incoherent motion (IVIM) under the resting state.

Methods: Twenty-eight patients with lower extremity PAD were enrolled. Skeletal muscles in lower extremities were examined at rest by using ASL and IVIM at 3.0 T. Imaging metrics, including blood flow (BF), perfusion fraction f, diffusion coefficient D, and pseudodiffusion coefficient D^⁎, were measured in the anterior, lateral, soleus, and gastrocnemius muscle groups. Paired t-test was used to compare the imaging parameters before and after PTA. Pearson correlation analysis was conducted between imaging parameter changes and ankle brachial index (ABI) changes after PTA.

Results: ABI was significantly improved after PTA (P < 0.001). For ASL and IVIM imaging, significant changes were noted in ASL-BF and IVIM-D values in the lateral, soleus, and gastrocnemius muscle groups (all P < 0.0125) when comparing pre- and postoperative measurements. Changes in ASL-BF and IVIM-f values in the anterior muscle group, and in IVIM-D^⁎ value in the anterior and soleus muscle groups after PTA, were found to be significantly correlated with ABI improvement (all P < 0.05).

Conclusion: Multiparametric MR techniques including ASL and IVIM can detect the perfusion changes of lower limb tissue before and after PTA in patients with PAD under resting state.

Keywords: Arterial spin labeling; Calf muscle; Cardiovascular magnetic resonance; Diffusion-weighted imaging; Percutaneous transluminal angioplasty; Perfusion.