Neutral contrast MRI for the detection of peripheral arterial wall calcifications

Background Peripheral arterial disease (PAD) is a potentially debilitating condition affecting more than 200 million people worldwide. CT angiography (CTA) has become the preferred modality of vascular surgeons for the imaging evaluation of PAD, because of its simplicity and widespread availability. However, vessel wall calcifications, frequently present in diabetic and elderly patients, diminish its clinical utility (1). MR angiography (MRA) is also an accurate test for PAD (2). Unlike CTA, vessel wall calcifications are invisible with MRA and do not impair diagnostic accuracy. However, the invisibility of calcifications is also a substantial deficiency given that the distribution and severity of vessel wall calcifications have clinical implications for interventional treatment strategy (3), and the presence of vessel wall calcifications contributes additional risk for morbidity and mortality. In order to overcome this significant limitation, we have implemented a novel “neutral contrast 3D