Optimal protocol of MR contrast imaging in diabetic foot

Objective: To identify the optimal protocol of MR contrast imaging in diabetic foot.

Methods: 20 patients with diabetic feet were enrolled and examined with 3D FLASH-MRA, 3D VIBE-WE, 2D SE-FS, 2D TSE-FS and 2D FLASH-FS at a 1.5T MR scanner for vascular changes in feet. Their effectiveness in displaying blood vessels, venous aliasing and articular cartilage, as well as the signal-to-noise ratio (SNR) and contrast ratio (CR) of plantar skins calcaneus, flexor digitorum brevis, dorsal artery, and talocalcaneal joint cartilage in diabetic feet were compared.

Results: (1) 3D FLASH-MRA was better in displaying blood vessels and venous aliasing than the others (P < 0.05); (2) 3D VIBE-WE was better in displaying articular cartilage than 2D SE-FS, 2D TSE-FS and 2D FLASH-FS (P < 0.05); (3) 3D VIBE-WE had higher SNR and CR of plantar skins, dorsal artery, talocalcaneal joint cartilage, calcaneus, and flexor digitorum brevis than the others (P < 0.05).

Conclusions: 3D VIBE-WE is the preferred sequence for T1 weighted imaging with contrast in diabetic feet. It can also serve as the supplemental sequence of 3D FLASH-MRA in MR angiography.