The second part will discuss developments and exciting perspectives of DCE-MRI regarding the assessment of perfusion in the extremities. Basic fundamentals will be explained including the physical and physiological concepts behind DCE-MRI. The first part of this review will elucidate the fundamentals of data acquisition and interpretation of DCE-MRI, two areas that often remain baffling to the clinical and investigating physician because of their complexity. Lately, DCE-MRI has also been adopted to examine the peripheral vascular and muscular system. Since its initial presentation the approach has mainly been applied in studies of the myocardium ( 11), the brain ( 12- 15) and oncological research ( 11, 16- 21). Two frequently used techniques, blood oxygen level-dependent (BOLD) MRI and arterial spin labeling (ASL), are limited to the measurement of energy consumption and perfusion but are unable to ascertain information regarding vessel permeability or volume fractions ( 5- 8).ĭCE-MRI however, provides the possibility for multiple and quantifiable parameters pertaining to tissue perfusion and microvascular status ( 9, 10). Accepted for publication Feb 08, 2014.ĭynamic magnetic resonance imaging (MRI) has been applied for over a decade to extract functional information regarding the peripheral vascular system ( 1- 4). Keywords: Magnetic resonance imaging (MRI) dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) peripheral artery disease Emerging clinical applications of DCE-MRI will be reviewed with a special focus on investigation of physiology and pathophysiology of the microvascular and vascular systems of the extremities. Review outline: The first part of this review will elucidate the fundamentals of data acquisition and interpretation of DCE-MRI, two areas that often remain baffling to the clinical and investigating physician because of their complexity. These unique features have recently found growing application in the study of the peripheral vascular system and most notably in the diagnosis and treatment of peripheral arterial occlusive disease (PAOD).
More over the method is capable of not only assessing blood flowing through an organ, but in contrast to other noninvasive methods, the actual tissue perfusion. Over the last two decades the spectrum of ailments, which have been studied with DCE-MRI, has been extensively broadened and has come to include pathologies of the heart notably infarction, stroke and further cerebral afflictions, a wide range of neoplasms with an emphasis on antiangiogenic treatment and early detection, as well as investigations of the peripheral vascular and musculoskeletal systems.Īpplications to peripheral perfusion: DCE-MRI possesses an unparalleled capacity to quantitatively measure not only perfusion but also other diverse microvascular parameters such as vessel permeability and fluid volume fractions. Similar to other functional magnetic resonance imaging (MRI) techniques such as arterial spin labeling (ASL) and blood oxygen level-dependent (BOLD) MRI, dynamic contrast-enhanced MRI (DCE-MRI) was at first restricted to studies of the brain. Introduction: The ability to ascertain information pertaining to peripheral perfusion through the analysis of tissues’ temporal reaction to the inflow of contrast agent (CA) was first recognized in the early 1990’s.
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