Skeletal Muscle Microvascular Flow in Progressive Peripheral Artery Disease: Assessment With Continuous Arterial Spin-Labeling Perfusion Magnetic Resonance Imaging

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• 作者：Wen-Chau Wu ; Emile Mohler III ; Sarah J. Ratcliffe ; Felix W. Wehrli ; John A. Detre ; Thomas F. Floyd
• 关键词：arterial spin-labeling ; magnetic resonance imaging ; peripheral arterial disease ; skeletal muscle
• 刊名：Journal of the American College of Cardiology
• 出版年：2009
• 出版时间：23 June 2009
• 年：2009
• 卷：53
• 期：25
• 页码：2372-2377
• 全文大小：730 K

文摘

Objectives

We present the novel application of continuous arterial spin-labeling (CASL) magnetic resonance imaging (MRI) for the measurement of calf muscle perfusion in subjects with progressive peripheral arterial disease (PAD).

Background

Peripheral arterial disease is largely considered to be a disease of conduit vessels. The impact of PAD upon microvascular flow in the end-organ, muscle, remains unknown. Continuous arterial spin-labeling is a noninvasive MRI method capable of measuring microvascular flow and might assist in our understanding of the impact of PAD upon the microvasculature.

Methods

Forty subjects with varying degrees of PAD and 17 age-matched PAD-free subjects were recruited and underwent measurement of the ankle-to-brachial index (ABI) and CASL. Peak hyperemic flow (PHF) and time-to-peak (TTP) were computed and assessed as a function of ABI and calf muscle group.

Results

An ABI dependence was found in both PHF (p = 0.04) and TTP (p < 10⁻⁴). Whereas TTP increased almost immediately with increasing PAD severity, PHF was, in contrast, relatively well preserved until later stages of disease.

Conclusions

The CASL flow measurements correlate with disease state as measured by ABI and demonstrate preserved microvascular flow reserve in the presence of early to intermediate vascular disease.