Technology Insight: magnetic resonance angiography for the evaluation of patients with peripheral artery disease.

Peripheral arterial disease (PAD) is a common manifestation of systemic atherosclerosis. Although clinical history in conjunction with ankle-brachial index and evaluation of segmental pressures/waveforms is sufficient to diagnose PAD in a large percentage of patients, imaging is required for disease localization and treatment planning. Contrast-enhanced magnetic resonance angiography (CE-MRA) is a noninvasive, three-dimensional technique that has emerged as a front-line imaging approach for comprehensive evaluation of PAD. Technical advances such as parallel imaging and moving-table, time-resolved angiography and extended field-of-view approaches have greatly improved the accuracy of CE-MRA. In the clinical setting, CE-MRA can be extremely helpful in the initial diagnosis as well as subsequent management of patients with PAD. Continued hardware and software improvements will enable further refinements in imaging protocol for peripheral MRA, consolidating its clinical role for the evaluation of patients with PAD.