Assessment of skeletal muscle perfusion by contrast medium first-pass magnetic resonance imaging: Technical feasibility and preliminary experience in healthy volunteers

Purpose To probe the potential and pitfalls of contrast medium first‐pass skeletal muscle perfusion imaging under reproducible stress conditions. Materials and Methods Magnetic resonance (MR) signal dynamics in calf muscle and lower‐leg arteries of 20 healthy volunteers were analyzed under postarterial occlusion reactive hyperemia and concurrent contrast medium first pass, using a saturation recovery spoiled gradient‐echo type sequence without heartbeat synchronization. The signal vs. time curves were analyzed descriptively and by two‐compartment deconvolution analysis. Results Highly significant changes in calf muscle signal dynamics in the hyperemic leg vs. those in the contralateral leg at rest were found in phenomenological and deconvolution analysis. Although a distortion of the arterial signal derived input function by inflow effects was found to cause large variations of the deconvolution results, the magnitude of the observed effects suggested a potential for immediate visual detection of areas with reduced tissue perfusion. Conclusion The first‐pass approach appeared promising for visual evaluation. However, a disentanglement of inflow and contrast medium‐induced effects on arterial signal intensity was deemed a prerequisite for input function‐based numerical assessment. J. Magn. Reson. Imaging 2004;20:111–121. © 2004 Wiley‐Liss, Inc.