2141 A novel approach for screening atherosclerosis in diabetes: MRI of the superficial femoral artery
© Bourque et al; licensee BioMed Central Ltd. 2008
Published: 22 October 2008
Peripheral arterial disease (PAD) has a high prevalence (29%) in asymptomatic patients with diabetes mellitus (DM) with a significantly increased risk of cardiovascular events and morbidity. Current screening methods are inadequate. The superficial femoral artery (SFA) may be a relatively accessible target for screening of atherosclerosis. Cardiovascular magnetic resonance (CMR) allows direct visualization of atherosclerotic plaque burden noninvasively. We sought to establish the prevalence of peripheral atherosclerosis in a cohort of asymptomatic patients with diabetes and coronary artery disease by CMR of the SFA.
We studied 18 subjects with DM and CAD and no symptoms, manifestations, or history of PAD with 10 age-matched controls without DM or known vascular disease. We collected extensive clinical information and performed ankle-brachial index (ABI) measurements. Patients with positive ABIs were excluded. CMR imaging of both lower extremities was performed utilizing a linear 4-element surface coil array on a 1.5 Tesla Siemens Avanto scanner to create contiguous, interleaved 6 mm axial black blood, T1-weighted, fat-suppressed, spin-echo images of the SFA with a resolution of 0.5 × 0.5 × 3.0 mm. Analysis originated at the bifurcation of the SFA using VesselMass software and included determination of mean wall thickness (WT) and total wall volume indexed to total vessel volume (IWV) to adjust for patient size and vessel length.
The prevalence of atherosclerotic plaque burden in the SFA of patients with DM and CAD, as measured by wall thickness and volume by CMR, is significantly higher than age and gender-matched controls. This finding in the setting of normal ABIs indicates the potential utility of this noninvasive testing to facilitate earlier intervention and prevention of disease complications. Our analysis also suggests that CMR imaging of the SFA in diabetics may be useful for the monitoring of disease regression with lipid lowering or other novel therapies in clinical trials. Further studies with larger patient numbers are warranted, including comparison to presently used screening tools such as carotid-intimal thickening.
This article is published under license to BioMed Central Ltd.