Superior arterial signal suppression in lower extremity magnetic resonance venography: A comparative study of tracking and fixed saturation pulses.

Purpose: This study aimed to compare the suppression of arterial signal intensity between tracking and fixed saturation pulses in lower extremity magnetic resonance venography (MRV).

Methods: Forty patients with varicose veins who underwent 2D true fast imaging with steady-state free precession using tracking and fixed saturation pulses on MRV were included. A fixed saturation pulse was applied from April 2020 to May 2021, and a tracking saturation pulse was applied from June 2021 to July 2022. The arterial, venous, and muscle signal intensities obtained at the femoral and popliteal levels were used to calculate the contrast ratios between veins and arteries (CR_VA) and veins and muscles (CR_VM). Two experienced radiologists graded the images based on vein-artery contrast, suppression of arterial signal intensity, and visualization of lower leg perforators using a 9-point scale.

Results: Tracking saturation pulse images yielded significantly superior CR_VA and CR_VM compared with fixed saturation pulse images at both the femoral and popliteal levels. For the same saturation pulse type, the CR_VA was higher at the femoral level than at the popliteal level, while the CR_VM was comparable between the two levels. MRV with a tracking saturation pulse showed significantly superior vein-artery contrast, arterial signal suppression, and lower leg perforator visualization. Most scores for vein-artery contrast and arterial signal suppression with the tracking saturation pulse were positive (3.5-5), whereas few scores with the fixed saturation pulse were positive.

Conclusion: Tracking saturation pulse was more effective in suppressing arterial signal intensity in lower extremity MRV.