Academic Commons

Theses Doctoral

Non-contrast Magnetic Resonance Angiography for Evaluation of Peripheral Arterial Disease

Atanasova, Iliyana

Peripheral arterial disease (PAD) is a major cause of morbidity and mortality in the USA with an estimated prevalence of up to 20% in those over 75 years. Vascular disease and kidney impairment frequently coexist; prevalence of moderate to severe renal dysfunction in PAD patients is estimated at 27-36%. Knowledge of location, severity, and extent of PAD is imperative for accurate diagnosis and treatment planning. However, all established imaging modalities that are routinely used for treatment planning are contra-indicated in kidney disease patients. Contrast-enhanced x-ray and CT angiography are unsafe due to exposure to nephrotoxic contrast material and ionizing radiation. Recently, the FDA has also warned against the use of gadolinium-enhanced MRA (Gd-MRA) due to evidence that gadolinium could trigger a life-threatening condition known as nephrogenic systemic fibrosis (NSF) in patients with moderate to severe kidney dysfunction. There is a clinical need to develop vascular imaging techniques that are safe in patients with coexisting PAD and renal insufficiency. The focus of this thesis was the development of a non-contrast alternative to Gd-MRA for imaging of peripheral vessels from renal to pedal arteries with MRI. A new imaging sequence for non-contrast visualization of the abdominal and pelvic arteries was designed, implemented, and validated in a small cohort of PAD patients against Gd-MRA. In addition, an existing fast spin-echo based technique for unenhanced imaging of the lower extremities was optimized for improved performance in a clinical setting.

Files

  • thumnail for Atanasova_columbia_0054D_11113.pdf Atanasova_columbia_0054D_11113.pdf application/pdf 4.06 MB Download File

More About This Work

Academic Units
Biomedical Engineering
Thesis Advisors
Laine, Andrew F.
Degree
Ph.D., Columbia University
Published Here
August 14, 2013
Academic Commons provides global access to research and scholarship produced at Columbia University, Barnard College, Teachers College, Union Theological Seminary and Jewish Theological Seminary. Academic Commons is managed by the Columbia University Libraries.