Contrast‐enhanced 3D MRA with centric ordering in k space: A preliminary clinical experience in imaging the abdominal aorta and renal and peripheral arterial vasculature

Abstract

The objective of this study was to determine the clinical utility of a contrast-enhanced, centric reordered, three-dimensional (3D) MR angiography (MRA) pulse sequence in imaging the abdominal aorta and renal and peripheral lower extremity arteries. Twenty-eight MRA studies were performed on 23 patients and four volunteers at 1.5 T using a 3D contrast-enhanced, centric reordered pulse sequence. In 20 patients, the abdominal aorta and renal arteries were imaged, and in seven patients, the lower extremity arteries were imaged. In 19 patients, a total of 51 renal vessels were evaluated (33 renal arteries using .1 mmol/kg of gadopentetate dimeglumine and 18 renal arteries using .2 mmol/kg of gadoteridol). A total of 70 peripheral arterial segments were assessed using .2 mmol/kg of gadoteridol. Correlation with conventional angiography was made for the following 14 cases: renal artery stenosis (four cases), abdominal aortic stenosis (one case), arteriovenous fistula in a transplant kidney (one case), renal arteriovenous malformation (one case), common iliac artery aneurysms (one case), and peripheral lower extremity (six cases). Of the 70 peripheral arterial segments evaluated, in 35, there was correlation with x-ray angiography. The mean percent of aortic signal enhancement was significantly higher in the .2 mmol/kg dose group (370.8 +/- 190.3) than in the .1 mmol/kg dose group (184.5 +/- 128.9) (P = .02). However, there was no apparent difference between the two doses for visualization of the renal and accessory renal arteries. There was concordance between the contrast-enhanced 3D MRA studies and conventional angiography in all cases of renal artery and peripheral arterial stenoses and occlusions, including visualization of reconstituted peripheral arterial segments. There was no evidence of spin dephasing effects at sites of stenoses on the 3D contrast-enhanced MRA studies. Contrast-enhanced, centric reordered, 3D MRA can rapidly image the abdominal aorta and renal and accessory renal arteries, as well as peripheral lower extremity arteries, with high resolution. Accurate depiction of the vascular lumen at sites of stenosis is made because of the lack of spin dephasing effects, even with hemodynamically significant stenoses. Additional larger clinical trials are required with this promising technique.

Time-resolved two-dimensional thick-slice magnetic resonance digital subtraction angiography in assessing brain tumors

“…Dynamic CE MRA has rapidly become the technique of choice in the neck, pelvis, and extremities as well as in the trunk [9,10,11,12,13,14,15,16,17,18,19,20,21], and several authors have proposed contrast-enhanced time-resolved MRA or MRDSA [15,27,28,29]. Most of them used 3D acquisition with concentrating data sampling in the center of the k-space.…”

“…Conventional catheter angiography or intra-arterial digital subtraction angiography (IADSA) has been performed to obtain this hemodynamic information. But this method is invasive with a complication rate of 0.5±1 % [3,4].Although non-contrast time-of-flight magnetic resonance angiography (MRA) is an established method for non-invasive evaluation of arteries [5,6,7,8], dynamic contrast-enhanced magnetic resonance angiography (CE MRA) has rapidly become the technique of choice, not only in the aorta and its branches [9, 10] but also in the neck, pelvis, and extremities [11,12,13,14,15,16,17,18,19,20,21]. Most CE MRAs are performed with three-dimensional (3D) acquisition and development of MR technology has enabled 3D CE MRA with high temporal resolution.…”

Dynamic Contrast-Enhanced MR Angiography from the Distal Aorta to the Ankle Joint with a Step-by-Step Technique

“…Gadolinium-enhanced three-dimensional gradient-echo MR angiography is known as a useful and accurate technique in imaging of the aorta and the iliac arteries [7,8]. However, the field of view is restricted to a maximum of 40-50 cm.…”

“…However, both methods are time-consuming, especially if a field of view from the level of aortic bifurcation to the distal lower leg is to be covered. Another disadvantage of TOF techniques and phase-contrast MR angiography is the tendency to overestimate the degree of stenosis because both are flow-related techniques [6].Gadolinium-enhanced three-dimensional gradient-echo MR angiography is known as a useful and accurate technique in imaging of the aorta and the iliac arteries [7,8]. However, the field of view is restricted to a maximum of 40-50 cm.…”

Potential Use of MR Angiography for Diagnosis and Postinterventional Follow-Up of a Posttraumatic Arteriovenous Fistula

“…An additional MRI examination provides information on adjacent involved structures [2]. As an MRA, it can also help to depict feeding and draining vessels three-dimensionally [3][4][5][6][7]. Additionally, if a vascular fistula is located in the abdomen, Doppler ultrasound may be difficult to per- form due to the patient's physical appearance as well as due to gastrointestinal gas amounts.…”