MR Imaging of Aortic and Peripheral Vascular Disease

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Cardiac-Interventional Radiography: 0.75
Procedures: 0.75
Diagnostic and Conduction System Studies: 0.75

Computed Tomography: 1.50
Procedures: 1.50
Neck and Chest: 0.75
Abdomen and Pelvis: 0.75

Magnetic Resonance Imaging: 3.00
Image Production: 1.00
Data Acquisition, Processing, and Storage: 1.00
Procedures: 2.00
Body: 1.00
Musculoskeletal: 1.00

Registered Radiologist Assistant: 2.00
Procedures: 2.00
Neurological, Vascular, and Lymphatic Sections: 2.00

Sonography: 1.00
Procedures: 1.00
Abdomen: 0.50
Superficial Structures and Other Sonographic Procedures: 0.50

Vascular-Interventional Radiography: 1.50
Procedures: 1.50
Vascular Diagnostic Procedures: 0.75
Vascular Interventional Procedures: 0.75

Vascular Sonography: 1.00
Procedures: 1.00
Abdominal/Pelvic Vasculature: 0.50
Arterial Peripheral Vasculature: 0.25
Venous Peripheral Vasculature: 0.25

Outline

1. Introduction
2. MR Angiography Tehniques
   1. Black-Blood Vascular Imaging
   2. Phase-Contrast Imaging
   3. TOF MR Angiography
   4. Dynamic Contrast-Enhanced MR Angiography
3. MR Angiography of Peripheral Arteries
   1. Three-Station, Moving-Table Contrast-Enhanced MR Angiography
   2. Hybrid Methods
4. Clinical Applications
   1. Aortic Disease
   2. Peripheral Artery Disease
5. New Develpments
6. Conclusion

Objectives

Upon completion of this course, students will:

1. be familiar with the benefits of vascular imaging with MRI and CT
2. know the MRI techniques commonly used to evaluate vessels
3. know which MRA technique is used most commonly
4. understand how intra-mural hematoma is best demonstrated
5. know what type of vascular sequence is characterized by dual inversion pulses
6. know which vascular sequence is commonly prescribed perpendicular to the vessel or interest
7. be familiar with the type of sequence that flow quantification is done using
8. be familiar with the characteristics of 2D-phase contrast imaging
9. know which pulse sequence replaced time-of-flight for most applications
10. understand the phenomena behind time-of-flight imaging
11. know how many separate combined scans phase-contrast sequences consist of
12. be familiar with the benefits of contrast-enhanced MRA
13. know the results of incorrect timing for contrast-enhanced MRA
14. know how to eliminate bright signal from fat in contrast-enhanced MRA
15. understand which pulse sequence is used in contrast-enhanced MRA
16. be familiar with what gradient spoiling is used for
17. know how to improve a patients breath holding ability
18. be familiar with the accuracy of the various methods for calculating delay timing
19. understand why time-of-flight is often used in conjunction with contrast-enhanced MRA
20. understand the characteristics of the hybrid contrast-enhanced MRA technique for runoff vessels
21. know the common indications for aortic MRA 
22. be familair with what aortic aneurysms most commonly occur secondary to
23. know where artherosclerotic aneurysms are most common
24. know where mycotic aneurysms are most commonly found
25. be familiar with the type of aneurysms Marfan syndrome typically causes
26. be familiar with what mycotic aneurysms are typically secondary to
27. be familair with what aortic dissections are commonly secondary to
28. know when Dissection is most critical
29. understand which artery of the leg is most susceptible to aneurysm
30. know the clinical areas in which MRA is typically superior to conventional angiography
31. understand what type of imaging is best at visualizing vessel walls
32. know the type of flow phase-contrast images show as black pixels
33. understand what ghosting of pulsatile vessels is characteristic of
34. understand how pulsatile ghosting can be overcome
35. know what type of MRA a tracking presaturation band is used for
36. understand the causes of ringing artifacts on a contrast-enhanced MRA
37. know the key factors for achieving T1-weighting in contrast-enhanced MRA
38. know what tibial arterial disease is particularly common secondary to
39. understand what structure is particularly important to demonstrate in patients requiring tibial bypass
40. know the biggest pitfall in bypass graft evaluation