Possibilities of MRI studies in visualization of the vascular bed of the lower extremities

E.V. Shaidakov¹, A.B. Sannikov^2,3, V.M. Emeliyanenko³, L.N. Kryukova², A.E. Baranova², M.A. Rachkov²

¹N.P. Bekhtereva Institute of the Human Brain of the Russian Academy of Sciences, Saint-Petersburg

²Clinic of Innovative Diagnostics "Medica", Vladimir

³Pirogov Russian National Research Medical University, Moscow

This literature review analyzes the research data on the methodology of magnetic resonance imaging (MRI) in relation to the vascular system and the choice of optimal scan modes. Given that this material is designed primarily for vascular surgeons and phlebologists, the authors briefly describe the essence of the physical phenomena underlying the receipt of MRI images, without which it is not possible to conduct a careful analysis of the benefits and drawbacks of MR-аngiography (MRA) and the search for the optimal scan mode for MR-venography.

When describing the non-contrast and contrast MRA methods, attention is paid to the conservative methods of image processing in 2D mode using pulse sequences: spin-echo, multi-echo, turbo spin-echo, Fast Advanced Spin Echo (FASE), Gradient Echo and Inversion Recovery. Besides, emphasis is placed on the most modern solutions, including: multiplantar reformatting, maximum intensity projection, subvolume maximum intensity, surface rendering, volume rendering and virtual intraluminal endoscopy. In relation to all current methods of conducting MRA, specificity and informativeness are shown with a detailed analysis of benefits and drawbacks. The nuances of understanding the obtained angiographic image in T1 and T2 weighted images and the phenomena of "bright blood" and "dark blood" are shown.

Given that in the Russian literature there is almost no data concerning the MRI possibilities in the diagnosis of hemodynamic disorders in patients with vascular pathology, it seems that this material is relevant and will cause some interest from various specialists.

Of particular interest is the potential use of non-contrast and contrast MRA methods in the study of venous pathology of the lower extremities and pelvis, especially with regard to timely and accurate diagnosis of deep venous thrombosis and venous thromboembolism, which occupy a special position in the structure of patients with chronic venous disorders of the lower extremities.

Keywords: magnetic resonance imaging, magnetic resonance angiography, magnetic resonance venography, computed tomography, computed tomography venography, chronic venous diseases, diagnostics, deep vein thrombosis of the lower extremities, varicosity.

For citation: Shaidakov E.V., Sannikov A.B., Emeliyanenko V.M. et al. Possibilities of MRI studies in visualization of the vascular bed of the lower extremities. RMJ. 2020;13:33–44.