Evaluation of Local Vascular Perfusion in the Lower Extremities on Intravoxel Incoherent Motion Imaging Before and After Endovascular Therapy
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Purpose: To evaluate improvement in local vascular perfusion of the lower limbs on intravoxel incoherent motion (IVIM) imaging after endovascular therapy (EVT).
Materials And Methods: IVIM imaging was performed on 20 lower limbs of 16 patients with lower extremity arterial diseases before and after EVT. To estimate IVIM, diffusion-weighted lower-limb axial images (number of slices = 25 and slice thickness = 3.5 mm) were acquired using different b values (0, 300, and 1000 s/mm). IVIM imaging with the simplified IVIM techniques was performed. The perfusion-related coefficient (D* [10 mm/s]), perfusion fraction (f [%]), and D*f product (10 mm/s %) were calculated before and 2-3 days after EVT. The ankle brachial index (ABI), mean D* (10 mm/s), mean f (%), and mean D*f product (10 mm/s %) before and after EVT were compared.
Results: Successful revascularization was achieved in all cases. After EVT, the mean ABI significantly increased from 0.59 ± 0.19 to 0.87 ± 0.15 (p < 0.001, paired t test). The mean D* (10 mm/s) (22.08 ± 3.26 versus 24.87 ± 2.65, p = 0.005, paired t test), and D*f product (10 mm/s%) (551.03 ± 79.02 versus 634.55 ± 76.96, p = 0.002, paired t-test) of the lower limbs significantly increased after EVT, whereas f (%) (25.00 ± 1.28 versus 25.52 ± 1.61, p = 0.261, paired t-test) did not significantly increased after EVT.
Conclusion: D* (10 mm/s) and D*f product (10 mm/s %) on IVIM imaging could evaluate improvement in local vascular perfusion of the lower limbs after EVT.
Level Of Evidence: Level 4, Case Series.