In Vivo Quantification of Femoral-Popliteal Compression During Isometric Thigh Contraction: Assessment Using MR Angiography

Purpose: To quantify femoral-popliteal vessel deformation during thigh contraction. Materials and Methods: Eleven subjects underwent a magnetic resonance (MR) examination of the femoral-popliteal vasculature on a 1.5T system. A custom 31) balanced steady-state free precession (SSFP) sequence was implemented to image a 15-20-cm segment of the vasculature during relaxation and voluntary isometric thigh contraction. The arterial and venous lumina were outlined using a semiautomated method. For the artery, this outline was fit to an ellipse whose aspect ratio was used to describe arterial deformation, while venous deformation was characterized by its cross-sectional area. Results: Focal compression of the femoral-popliteal artery during contraction was observed 94-143 mm superior to the condyle that corresponds to the distal adductor canal (AC) immediately superior to the adductor hiatus. This was illustrated by a significant reduction (P <= 0.05) in aspect ratio from 0.88 +/- 0.06 during relaxation to 0.77 +/- 0.09 during contraction. A negligible change in arterial aspect ratio was observed inferior to the AC and in the proximal AC. Similarly, venous area was dramatically reduced in the distal AC region during contraction. Conclusion: Rapid 3D SSFP MR angiography of the femoral-popliteal vasculature during thigh contraction demonstrated focal compression of the artery in the distal AC region. This may help explain the high stent failure rate and the high likelihood of atherosclerotic disease in the AC.