Turbo spin-echo based enhanced acceleration-selective arterial spin labeling (eAccASL) for the lower extremity MR angiography

Motivation: The lower extremity MR angiography (MRA) without electrocardiography (ECG) or peripheral pulse unit (PPU) triggering and contrast enhancement is useful for diagnosing peripheral arterial disease (PAD), which can avoid synchronization failure and nephrogenic systemic fibrosis (NSF). Goal(s): Our goal was to improve peripheral arterial depiction without ECG or PPU and contrast agent. Approach: TSE-based enhanced acceleration-selective arterial spin labeling (eAccASL) (TSE-Acc) was compared with TFE-based eAccASL (TFE-Acc), and TRANCE as a reference standard by SIR, CNR, and visual inspection. Results: CNR and arterial visibility score for TSE-Acc were higher than TFE-Acc, but no difference compared with TRANCE. Impact: TSE-based enhanced acceleration-selective arterial spin labeling (eAccASL) can provide clear depiction of the peripheral arteries without ECG or PPU and contrast agent, providing sufficient diagnostic performance in PAD patients with arrhythmia and CKD.