Skeletal Muscle Microvascular Flow in Progressive Peripheral Artery DiseaseAssessment With Continuous Arterial Spin-Labeling Perfusion Magnetic Resonance Imaging
Wen-Chau Wu, PhD*,#,
Emile Mohler, III, MD ,
Sarah J. Ratcliffe, PhD ,
Felix W. Wehrli, PhD*,
John A. Detre, MD*,|| and
Thomas F. Floyd, MD ,||,*
* Department of Radiology, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania
Department of Medicine (Vascular Medicine), Hospital of University of Pennsylvania, Philadelphia, Pennsylvania
Department of Biostatistics and Epidemiology, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania
Department of Anesthesiology and Critical Care, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania
|| Department of Neurology, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania
# Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan
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Figure 1 Cross-Sectional Images of the Mid-Calf in a Representative Subject
High-resolution anatomic image (left), echo-planar (EPI) image (middle), and mean hyperemic flow (HF) map (right). The regions of interest for anterior compartment (blue), lateral compartment (green), soleus muscle (yellow), and medial gastrocnemius (red) are overlaid on the anatomic image. Mean HF is the average flow during the hyperemic period.
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Figure 3 Perfusion-Time Curves for Different Muscles and Categories of the Ankle-to-Brachial Index
Vertical dotted lines indicate the time when cuff is released. AC = anterior compartment; GstrcM = medial head of gastrocnemius; LC = lateral compartment; SolM = soleus muscle.
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Figure 4 Relationship Between Flow Indexes, Muscle Group, and Disease Category
Flow indexes: (A) peak hyperemic flow, (B) time-to-peak. Two main effects: "muscle group" and "category" (disease severity assessed by the ankle-to-brachial index). Abbreviations as in Figure 3.
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Figure 5 Relationship Between Time-to-Peak and Peak Hyperemic Flow
Muscle groups are denoted by mark styles (triangle: SolM, square: GstrcM, circle: AC, cross: LC). Categories (peripheral arterial disease stages) are numerically labeled. Abbreviations as in Figure 3.
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