Short summary

Optimise MRI perfusions sequence, ASL, BOLD and DWI with IVIM for measure perfusion in the muscle of the foot. We aim to investigate how the perfusion in the foot is affected by ischemia. We will do perfusion scanners on 18 healthy volunteers in a test/retest study to test the reliability and validity. After that, we will measure the perfusion in 14 patient with claudication intermittence and 24 patient with critical ischemia

Rationale

Peripheral arterial disease (PAD) is a growing problem especially in populations of elderly people with 30% being affected in the Western world. PAD can have many causes with atherosclerosis being the most common. Severe PAD can lead to critical limb ischemia (CLI), a condition that result in pain during both activity and rest, ulcerations, gangrene, amputation of the ischemic area and ultimately death. Patients with these conditions often go undertreated or unrecognized until their condition is chronic and severe, leaving them with aching pain and poor quality of life.

Perfusion can be measured in different ways using various modalities. Magnetic resonance imaging (MRI) offers the dual advantage of being able to depict macroscopic vessels as well as to quantify tissue perfusion without the use of X-rays. Several different scan techniques allow high-quality imaging of the vessels in the lower leg including techniques using gadolinium-based contrast agent as well as methods that do not require intravenous contrast. It is well documented that Dynamic Contrast Enhanced (DCE) MRI has the ability to estimate the perfusion in the lower leg. Patients suffering from reduced kidney function have a higher risk of getting PAD especially for this group of patients it is important to minimize the use of Gadolinium based contrast agent.

The present study aims to develop non-contrast MRI sequences for perfusion of the foot, that can investigate the consequences of ischemia in the muscle of the foot.

Description of the cohort

We will do a pilot study at 16 volunteers to test the validity and reliability of the MRI sequenses. After that we will test if it is possible to

Data and biological material

We will use data from the patient journal and MRI.

Collaborating researchers and departments

Department of Radiology, Lillebaelt Hospital, Kolding.

• Department of Vascular Surgery, Hospital Lillebaelt
• Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
• MR Research Centre, Department of Clinical Medicine, Aarhus University, Denmark

Department of Regional Health Research