3D peripheral subtraction MRA using flow-spoiled ECG-triggered balanced SSFP

Peripheral arterial disease (PAD) is a major cause of diminished functional capacity and quality of life in a large portion of western populations. While 3D contrast-enhanced (CE) MRA is becoming a modality of choice for clinical PAD examinations, the potential for nephrogenic systemic fibrosis (NSF) in patients with renal insufficiency has triggered a renaissance of interest in non-contrast enhanced (NCE) MRA. Various NCE-MRA strategies employing 3D half-Fourier FSE [1] or balanced SSFP (bSSFP) [2] have shown great promise. Recently, flow-sensitizing dephasing-prepared (FSD) bSSFP was proposed for vessel wall imaging [3]. The present work aimed to investigate the feasibility of MRA in lower legs utilizing FSD-bSSFP combined with ECG-triggering and image subtraction.