One study lauded IVUS for its ability to evaluate the arterial lumen for intimal change and potential irreparable mural damage that may be missed with conventional US [16]. In functional PAES, IVUS is beneficial in determining the magnitude of extrinsic muscular compression [16]. Variant 2: Suspected external iliac artery endofibrosis. Initial imaging. CTA Lower Extremity CTA is uncommonly used in the diagnosis of EIAE and has not demonstrated diagnostic superiority to MRA combined with US [21]. CTA allows assessment of arterial kinking, arterial wall thickening, stenosis, and extent of involved arterial segment. MRA Lower Extremity The superior contrast resolution inherent to MRA allows for optimal visualization of extravascular anatomy in suspected EIAE. Like CTA, MRA allows assessment of arterial length and kinking, albeit with improved soft- tissue characterization. MRA is less sensitive than US for detecting intravascular lesions. MRA has proven useful in diagnosing EIAE when used in conjunction with US, a combination that was found to be superior or equal to CTA alone [21]. US Duplex Doppler Lower Extremity The ability to visualize changes in both flow dynamics and vessel caliber in real time has been paramount in diagnosing EIAE in endurance athletes [21,22]. Dynamic use of US duplex Doppler and segmental Doppler pressures in both hip flexion and extension can accurately depict flow disturbance [21], while its use pre- and Nonatherosclerotic Peripheral Arterial Disease postexercise may demonstrate associated exercise-induced vasospasm [20,22]. US duplex Doppler has been found to be superior to MRA in detecting intravascular lesions; however, its sensitivity may be limited in patients with only mildly symptomatic disease [21]. US Intravascular Lower Extremity There is no relevant literature regarding the use of IVUS in the evaluation of EIAE. Arteriography Lower Extremity The role of DSA in the evaluation of EIAE is not as well established.
Nonatherosclerotic Peripheral Arterial Disease. One study lauded IVUS for its ability to evaluate the arterial lumen for intimal change and potential irreparable mural damage that may be missed with conventional US [16]. In functional PAES, IVUS is beneficial in determining the magnitude of extrinsic muscular compression [16]. Variant 2: Suspected external iliac artery endofibrosis. Initial imaging. CTA Lower Extremity CTA is uncommonly used in the diagnosis of EIAE and has not demonstrated diagnostic superiority to MRA combined with US [21]. CTA allows assessment of arterial kinking, arterial wall thickening, stenosis, and extent of involved arterial segment. MRA Lower Extremity The superior contrast resolution inherent to MRA allows for optimal visualization of extravascular anatomy in suspected EIAE. Like CTA, MRA allows assessment of arterial length and kinking, albeit with improved soft- tissue characterization. MRA is less sensitive than US for detecting intravascular lesions. MRA has proven useful in diagnosing EIAE when used in conjunction with US, a combination that was found to be superior or equal to CTA alone [21]. US Duplex Doppler Lower Extremity The ability to visualize changes in both flow dynamics and vessel caliber in real time has been paramount in diagnosing EIAE in endurance athletes [21,22]. Dynamic use of US duplex Doppler and segmental Doppler pressures in both hip flexion and extension can accurately depict flow disturbance [21], while its use pre- and Nonatherosclerotic Peripheral Arterial Disease postexercise may demonstrate associated exercise-induced vasospasm [20,22]. US duplex Doppler has been found to be superior to MRA in detecting intravascular lesions; however, its sensitivity may be limited in patients with only mildly symptomatic disease [21]. US Intravascular Lower Extremity There is no relevant literature regarding the use of IVUS in the evaluation of EIAE. Arteriography Lower Extremity The role of DSA in the evaluation of EIAE is not as well established.