Contrast-enhanced magnetic resonance angiography (MRA) provides excellent assessment of the peripheral arterial vasculature and is considered an important adjunctive diagnostic modality for the assessment of peripheral arterial disease. However, given the high prevalence of chronic kidney disease in patients with peripheral arterial disease, the association of gadolinium contrast media with nephrogenic systemic fibrosis, and recent concern with consequences of long-term deposition of gadolinium in the brain, there has been a renewed interest in noncontrast MRA approaches. Recent improvements in pulse sequences combined with instrumentation have facilitated the development of newer noncontrast MRA sequences that provide high spatial resolution, allowing the evaluation of distal (infrageniculate and pedal) vessels of importance in patients with critical limb ischemia. Further, many of these sequences are time efficient and versatile, allowing rapid evaluation of the entire lower extremity vasculature. In this comprehensive review, we outline historic techniques and compare these with newer approaches such as quiescent interval slice-selective MRA, 3-dimensional fast spin echo , and velocity-sensitive MRA that are emerging as an alternative to computed tomographic angiography or digital subtraction angiography for the evaluation of lower limb arteries in patients with peripheral arterial disease. Technical details and applications in clinical practice will be discussed.

中文翻译：

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非造影磁共振血管造影对周围血管疾病的诊断

造影增强磁共振血管造影（MRA）提供了对外周动脉脉管系统的出色评估，被认为是评估外周动脉疾病的重要辅助诊断手段。但是，鉴于外周动脉疾病患者的慢性肾脏病患病率高、,造影剂与肾源性系统性纤维化的关系以及近期对脑中deposition长期沉积的后果的担忧，引起了人们的新兴趣在非对比MRA方法中。脉冲序列与仪器相结合的最新改进促进了更新型非对比度MRA序列的开发，该序列提供了较高的空间分辨率，可以评估在严重肢体缺血患者中重要的远端血管（脚下肌和脚踏板）。此外，这些序列中的许多序列都是时间高效且通用的，从而可以快速评估整个下肢脉管系统。在这篇全面的综述中，我们概述了历史性技术，并将其与更新的方法进行比较，例如静态间隔切片选择性MRA，3维快速自旋回波和速度敏感型MRA，这些方法正在替代计算机断层血管造影或数字减影血管造影用于评估外周动脉疾病患者的下肢动脉。将讨论技术细节和在临床实践中的应用。可以快速评估整个下肢血管。在这篇全面的综述中，我们概述了历史性技术，并将其与更新的方法进行比较，例如静态间隔切片选择性MRA，3维快速自旋回波和速度敏感型MRA，这些方法正在替代计算机断层血管造影或数字减影血管造影用于评估外周动脉疾病患者的下肢动脉。将讨论技术细节和在临床实践中的应用。可以快速评估整个下肢血管。在这篇全面的综述中，我们概述了历史性技术，并将其与更新的方法进行比较，例如静态间隔切片选择性MRA，3维快速自旋回波和速度敏感型MRA，这些方法正在替代计算机断层血管造影或数字减影血管造影用于评估外周动脉疾病患者的下肢动脉。将讨论技术细节和在临床实践中的应用。以及对速度敏感的MRA逐渐成为计算机断层血管造影或数字减影血管造影的替代产品，用于评估周围动脉疾病患者的下肢动脉。将讨论技术细节和在临床实践中的应用。以及对速度敏感的MRA逐渐成为计算机断层血管造影或数字减影血管造影的替代产品，用于评估周围动脉疾病患者的下肢动脉。将讨论技术细节和在临床实践中的应用。