Advances in diagnostic imaging for peripheral arterial disease

Abstract

Refinements in both noninvasive and invasive imaging techniques have led to significant improvements in both the diagnosis and treatment of peripheral arterial disease. Multiple complementary imaging modalities are available for evaluating these patients. This article reviews the advantages, disadvantages and recent advances in the commonly used clinical applications of duplex ultrasonography, magnetic resonance angiography, computed tomographic angiography, digital subtraction angiography and intravascular ultrasound for arterial imaging in the lower extremities. It also discusses experimental imaging techniques more recently applied to peripheral arterial disease such as PET, hyperspectral imaging and molecular imaging of atherosclerosis. As more is understood about both lesion and patient characteristics that affect their response to peripheral interventions, clinician selection of the various imaging modalities as well as different peripheral interventions will allow for more effective treatment of patients with peripheral arterial disease.

Keywords::

• computed tomography angiography
• digital subtraction angiography
• duplex ultrasonography
• intravascular ultrasound
• magnetic resonance angiography
• peripheral arterial disease
• peripheral endovascular intervention

Acknowledgements

Duplex images were provided by Eugene Zierler, Director of the University of Washington and Harborview Medical Center Vascular Laboratories. MRA images were provided by Jeffrey Maki, Associate Professor of Radiology at the University of Washington.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.