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

PLoS One. 2018 Jun 20;13(6):e0197559. doi: 10.1371/journal.pone.0197559. eCollection 2018.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Angiography, Digital Subtraction / standards
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / epidemiology*
  • Arterial Occlusive Diseases / physiopathology
  • Arteries / anatomy & histology*
  • Arteries / diagnostic imaging
  • Arteries / pathology
  • Blood Vessels / anatomy & histology*
  • Blood Vessels / diagnostic imaging
  • Blood Vessels / pathology
  • Constriction, Pathologic / diagnostic imaging
  • Constriction, Pathologic / epidemiology*
  • Constriction, Pathologic / physiopathology
  • Contrast Media / therapeutic use
  • Gadolinium / therapeutic use
  • Humans
  • Lower Extremity
  • Magnetic Resonance Angiography / standards
  • Male
  • Middle Aged
  • Reference Values

Substances

  • Contrast Media
  • Gadolinium

Grants and funding

SHIP is part of the Community Medicine Research network of the University of Greifswald which is funded by the Federal Ministry of Education and Research (www.bmbf.de/en/index.html, 01ZZ9603, 01ZZ0103, 01ZZ0403, 01ZZ0701, 03ZIK012), the Ministry of Cultural Affairs (www.regierung-mv.de/Landesregierung/bm) as well as the Social Ministry of the Federal State of Mecklenburg-West Pomerania (www.regierung-mv.de/Landesregierung/sm). Whole-body MR imaging was supported by a joint grant from Siemens Healthcare, Erlangen, Germany, and the Federal State of Mecklenburg-West Pomerania. The University of Greifswald is a member of the ‘Center of Knowledge Interchange’ program of Siemens AG. Contrast-enhanced MRI research is part of the entire whole-body MRI study and was supported by Bayer Healthcare. Furthermore, this work is part of the research project Greifswald Approach to Individualized Medicine (GANI_MED). The GANI_MED (http://www2.medizin.uni-greifswald.de/gani_med/) consortium is funded by the German Federal Ministry of Education and Research as well as by the Ministry of Cultural Affairs of the German Federal State of Mecklenburg – West Pomerania (03IS2061A). This study was further supported by the DZHK (German Centre for Cardiovascular Research, https://dzhk.de/en/).