Reference values of vessel diameters, stenosis prevalence, and arterial variations of the lower limb arteries in a male population sample using contrast-enhanced MR angiography

Introduction Morphological characterization of leg arteries is of significant importance to detect vascular remodeling triggered by atherosclerotic changes. We determined reference values of vessel diameters and assessed prevalence of stenosis and arterial variations of the lower limb arteries in a healthy male population sample. Methods Gadolinium-enhanced magnetic resonance angiography at 1.5 Tesla was performed in 756 male participants (median age = 52 years, range = 21–82 years) of the population-based Study of Health in Pomerania. Vessel diameters were measured in 9 predefined segments of the pelvic and leg arteries and 95th percentiles were used for upper reference values of means of left and right side arteries. Results Reference values of vascular diameters decreased from proximal to distal arteries: common iliac = 1.18cm; internal iliac = 0.75cm; external iliac = 1.03cm; proximal femoral = 1.02cm; distal femoral = 0.77cm; popliteal = 0.69cm; anterior tibial = 0.42cm; posterior tibial = 0.38cm; fibular = 0.40cm. Body-surface area indexed reference values increased with age in all segments. A number of 53 subjects (7.0%) had at least one stenosis, mainly in the lower leg arteries anterior tibial (n = 28, 3.7%), posterior tibial (n = 18, 2.4%) and fibular (n = 20, 2.6%). The risk of stenosis increased considerably with age (odds ratio = 1.08; p<0.001). The most common arterial variant was type I-A in both legs (n = 620, 82%). Conclusion We present reference values for different pelvic and leg artery segment diameters in men that decrease from proximal to distal and increase with age. Stenoses were most prevalent in lower leg arteries and type I-A was the most common variant in the lower leg.

[1]  T. Hoogeboom,et al.  How to determine leg dominance: The agreement between self-reported and observed performance in healthy adults , 2017, PloS one.

[2]  Bernd Hamm,et al.  Initial experience with imaging of the lower extremity arteries in an open 1.0 Tesla MRI system using the triggered angiography non-contrast-enhanced sequence (TRANCE) compared to digital subtraction angiography (DSA) , 2016, Biomedizinische Technik. Biomedical engineering.

[3]  H. Völzke,et al.  Cardiovascular risk factors and thoracic aortic wall thickness in a general population. , 2015, Journal of vascular and interventional radiology : JVIR.

[4]  B. Schnackenburg,et al.  Non-invasive ECG-triggered 2D TOF MR angiography of the pelvic and leg arteries in an open 1.0-tesla high-field MRI system in comparison to conventional DSA , 2014, Biomedizinische Technik. Biomedical engineering.

[5]  G. Pera,et al.  Ankle-brachial index and the incidence of cardiovascular events in the Mediterranean low cardiovascular risk population ARTPER cohort , 2013, BMC Cardiovascular Disorders.

[6]  Matthias F Kriegel,et al.  Distribution, determinants, and normal reference values of thoracic and abdominal aortic diameters by computed tomography (from the Framingham Heart Study). , 2013, The American journal of cardiology.

[7]  S. Moebus,et al.  Body-surface adjusted aortic reference diameters for improved identification of patients with thoracic aortic aneurysms: results from the population-based Heinz Nixdorf Recall study. , 2013, International journal of cardiology.

[8]  H. Völzke,et al.  Claudication, in contrast to angina pectoris, independently predicts mortality risk in the general population. , 2012, VASA. Zeitschrift fur Gefasskrankheiten.

[9]  W. Rathmann,et al.  Cohort profile: the study of health in Pomerania. , 2011, International journal of epidemiology.

[10]  J. Jesberger,et al.  Time-resolved and bolus-chase MR angiography of the leg: branching pattern analysis and identification of septocutaneous perforators. , 2010, AJR. American journal of roentgenology.

[11]  D. Thijssen,et al.  Impact of age, sex and exercise on brachial and popliteal artery remodelling in humans. , 2010, Atherosclerosis.

[12]  Harald Darius,et al.  Mortality and Vascular Morbidity in Older Adults With Asymptomatic Versus Symptomatic Peripheral Artery Disease , 2009, Circulation.

[13]  N Hosten,et al.  Whole-Body Magnetic Resonance Imaging of Healthy Volunteers: Pilot Study Results from the Population-Based SHIP Study , 2009, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[14]  L. Vatten,et al.  The association between diabetes mellitus and the prevalence of intermittent claudication: the HUNT study , 2008, Vascular medicine.

[15]  F. Kronenberg,et al.  Intermittent claudication in the Erfurt Male Cohort (ERFORT) Study: its determinants and the impact on mortality. A population-based prospective cohort study with 30 years of follow-up. , 2008, Atherosclerosis.

[16]  Dawn Craig,et al.  Duplex ultrasonography, magnetic resonance angiography, and computed tomography angiography for diagnosis and assessment of symptomatic, lower limb peripheral arterial disease: systematic review , 2007, BMJ : British Medical Journal.

[17]  R. Orme,et al.  Popliteal artery branching patterns -- an angiographic study. , 2006, Clinical radiology.

[18]  L. Vatten,et al.  The association between smoking and the prevalence of intermittent claudication , 2005, Vascular medicine.

[19]  M. Szpinda External diameters of the crural arteries in patients with chronic critical limb ischaemia. , 2005, Folia morphologica.

[20]  J. Debatin,et al.  Whole-body 3D MR angiography of patients with peripheral arterial occlusive disease. , 2004, AJR. American journal of roentgenology.

[21]  M. Reiser,et al.  Dynamic contrast-enhanced MR angiography from the distal aorta to the ankle joint with a step-by-step technique. , 2000, AJR. American journal of roentgenology.

[22]  A. Levey,et al.  A More Accurate Method To Estimate Glomerular Filtration Rate from Serum Creatinine: A New Prediction Equation , 1999, Annals of Internal Medicine.

[23]  T Länne,et al.  The diameter of the common femoral artery in healthy human: influence of sex, age, and body size. , 1999, Journal of vascular surgery.

[24]  B. Sonesson,et al.  Factors predicting the diameter of the popliteal artery in healthy humans. , 1998, Journal of Vascular Surgery.

[25]  M. Gulisano,et al.  The calibers of the common femoral, popliteal, and posterior tibialis arteries: a statistical investigation in 100 healthy subjects by color Doppler ultrasonography. , 1994, Italian journal of anatomy and embryology = Archivio italiano di anatomia ed embriologia.

[26]  D. Kim,et al.  Surgical significance of popliteal arterial variants. A unified angiographic classification. , 1989, Annals of surgery.

[27]  D. DuBois,et al.  A formula to estimate the approximate surface area if height and weight be known , 1989 .

[28]  R. Vogelzang,et al.  Normal aortoiliac diameters by CT. , 1988, Journal of computer assisted tomography.

[29]  A. Leicht,et al.  Association of obesity and metabolic syndrome with the severity and outcome of intermittent claudication. , 2007, Journal of vascular surgery.

[30]  U. John,et al.  Study of Health in Pomerania (SHIP): A health examination survey in an east German region: Objectives and design , 2005, Sozial- und Präventivmedizin.

[31]  E. F. Du Bois,et al.  A formula to estimate the approximate surface area if height and weight be known. 1916. , 1989, Nutrition.