Preoperative Evaluation of the Entire Hepatic Vasculature in Living Liver Donors with Use of Contrast-enhanced MR Angiography and True Fast Imaging with Steady-state Precession

Carr, James C.; Nemcek, Albert A.; Abecassis, Michael; Blei, A; Clarke, Lori A.; Pereles, F. Scott; McCarthy, Richard M.; Finn, J. Paul

doi:10.1097/01.rvi.0000064853.87207.42

Cited by 60 publications

(45 citation statements)

References 47 publications

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“…Meanwhile, true SSFP is based on a gradient echosequence and recycles steady-state transverse magnetization in long T2 substances. The steady-state signal is dependent on the T2-to-T1 ratio, which is relatively high for blood and has been used successfully in vascular imaging (17,18). It allows visualization of the vessels with high flow velocity and narrow diameter, such as the hepatic artery, without an intravenous contrast agent (11).…”

Section: Discussionmentioning

confidence: 99%

“…For better visualization of blood in the body region, 3D half-Fourier fast spin-echo (FSE) sequence and true steady-state freeprecession (SSFP) sequences are widely used for non-CE MRA (11)(12)(13)(14)(15)(16)(17)(18)(19). They allow coronal acquisition that is not possible with time-of-flight imaging, especially for body MRA, and thus reduces acquisition time.…”

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confidence: 99%

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Non‐contrast‐enhanced MR portography with time‐spatial labeling inversion pulses: Comparison of imaging with three‐dimensional half‐fourier fast spin‐echo and true steady‐state free‐precession sequences

Shimada

Isoda

Okada

et al. 2009

Magnetic Resonance Imaging

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Purpose:To compare and evaluate images acquired with two different MR angiography (MRA) sequences, three-dimensional (3D) half-Fourier fast spin-echo (FSE) and 3D true steady-state free-precession (SSFP) combined with two time-spatial labeling inversion pulses (T-SLIPs), for selective and non-contrast-enhanced (non-CE) visualization of the portal vein. Materials and Methods:Twenty healthy volunteers were examined using half-Fourier FSE and true SSFP sequences on a 1.5T MRI system with two T-SLIPs, one placed on the liver and thorax, and the other on the lower abdomen. For quantitative analysis, vessel-to-liver contrast (Cv-l) ratios of the main portal vein (MPV), right portal vein (RPV), and left portal vein (LPV) were measured. The quality of visualization was also evaluated. Results:In both pulse sequences, selective visualization of the portal vein was successfully conducted in all 20 volunteers. Quantitative evaluation showed significantly better Cv-l at the RPVs and LPVs in half-Fourier FSE (P Ͻ 0.0001). At the MPV, Cv-l was better in true SSFP, but was not statistically different. Visualization scores were significantly better only at branches of segments four and eight for half-Fourier FSE (P ϭ 0.001 and 0.03, respectively). Conclusion:Both 3D half-Fourier FSE and true SSFP scans with T-SLIPs enabled selective non-CE visualization of the portal vein. Half-Fourier FSE was considered appropriate for intrahepatic portal vein visualization, and true SSFP may be preferable when visualization of the MPV is required.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Non‐contrast‐enhanced MR portography with time‐spatial labeling inversion pulses: Comparison of imaging with three‐dimensional half‐fourier fast spin‐echo and true steady‐state free‐precession sequences

Shimada

Isoda

Okada

et al. 2009

Magnetic Resonance Imaging

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“…Preprocedural cross-sectional imaging of the liver and portal system can detect important contraindications to TIPS placement, such as multiple or huge hepatic cysts or hepatocellular carcinomas or obstruction or thrombosis of the portal or hepatic veins. 1,[9][10][11][12][13][14] Many researchers have investigated the relationships between diameter of the portal vein and portal pressure, 16 ‰ow direction, 17 development of the shunting vessels, 18 diameter of the shunting vessels and gastroesophageal bleeding, 19 or onset of encephalopathy. 20 Ito and associates 21 recently reported decreased diameter and hepatopetal ‰ow of the left gastric vein and the presence of non-variceal portosystemic shunt as predictive factors for variceal relapse after endoscopic therapies.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12][13][14] We aimed to assess whether MR imaging evaluation of portosystemic collateral shunts can be used to predict therapeutic eŠectiveness of, complications after, and technical di‹culty during TIPS creation.…”

Section: Introductionmentioning

confidence: 99%

MR Evaluation of Portal Hypertensive Collateral Shunting Vessels for Predicting Outcome after Transjugular Intrahepatic Portosystemic Shunt

Yoshikawa

Mitchell

2011

magn reson med sci

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Purpose: We assessed whether magnetic resonance (MR) imaging evaluation of portosystemic collateral shunts can aid prediction of therapeutic eŠectiveness and complications after creation of a transjugular portosystemic shunt (TIPS), and technical di‹culty during the TIPS procedure.Materials and Methods: We retrospectively reviewed 32 patients (27 men, 5 women; mean age, 56.4 years) who underwent TIPS creation following gadolinium-enhanced MR examination. We measured the diameters of pre-existing portosystemic collateral shunting vessels, added the measurements together to generate a shunting collateral score for each patient, and divided patients into 2 groups by score of 4 or greater or less than 4. We then compared therapeutic eŠectiveness, technical di‹culty and complications of the TIPS procedure, and portal venous (PV) pressure, PV-inferior vena cava (IVC) pressure gradient, and PV diameter between the groups.Results: The patients with a pre-existing large portosystemic shunt showed insigniˆcant trends toward higher technical di‹culty of the shunt procedure and rate of shunt dysfunction. The 2 groups showed no signiˆcant diŠerence in early mortality rate, onset or worsening rate of hepatic encephalopathy after TIPS creation, PV pressure, PV-IVC pressure gradient, or PV diameter.Conclusion: Gadolinium-enhanced MR imaging may help in predicting technical di‹-culty and complications of TIPS.

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“…Another advantage is that contrast in bTFE depends mainly on the relatively high T2/T1 ratio of the blood, which allows blood vessels to maintain a dramatically intense signal over a longer distance compared to conventional time-of-flight (TOF) imaging. A number of investigators have highlighted the potential of bTFE to produce high-quality noncontrast MR angiograms (4,5). The technology has been tested successfully in trials with renal and coronary arteries, but has yet to be studied with respect to carotid arteries (6 -8).…”

mentioning

confidence: 99%

Initial experience with balanced turbo field echo in depicting carotid artery stenosis: Comparison with multiple overlapping thin slab acquisition and 3D contrast‐enhanced magnetic resonance angiography

Gupta

Swaminathan

DeMarco

2005

Magnetic Resonance Imaging

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Purpose:To compare balanced turbo field echo (bTFE) with multiple overlapping thin slice acquisition (MOTSA) and contrast-enhanced MR angiography (CE-MRA) in depicting carotid artery stenosis. Materials and Methods:In this study 86 patients with cerebrovascular disease, who had been referred for a carotid examination, were imaged. All of the patients underwent MOTSA and one of four bTFE sequences followed by CE-MRA. Formatted maximum intensity projections (MIPs) and source images were read in a blinded fashion by a radiologist. Interand intrasequence statistical analyses were performed. Results:We first compared image quality (IQ) and fat, background, and venous suppression using four distinct bTFE protocols in 118 carotid arteries, and found that bTFE4 performed the best. We then compared IQ, grades of stenosis, and background and venous suppression among bTFE4, MOTSA, and CE-MRA. bTFE produced significantly better IQ and venous suppression (P Ͻ 0.001), and higher SNR and CNR (P Ͻ 0.05) when compared to MOTSA. Conclusion:The bTFE sequence is robust and provides high-quality images in patients with mild to moderate carotid artery stenosis. Even though there is a tendency to overestimate stenosis with bTFE compared to CE-MRA, the shorter scan time of bTFE coupled with enhanced SNR and CNR measurements validates it as a clinically useful adjunct to MOTSA, if not a replacement.

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Preoperative Evaluation of the Entire Hepatic Vasculature in Living Liver Donors with Use of Contrast-enhanced MR Angiography and True Fast Imaging with Steady-state Precession

Cited by 60 publications

References 47 publications

Non‐contrast‐enhanced MR portography with time‐spatial labeling inversion pulses: Comparison of imaging with three‐dimensional half‐fourier fast spin‐echo and true steady‐state free‐precession sequences

Non‐contrast‐enhanced MR portography with time‐spatial labeling inversion pulses: Comparison of imaging with three‐dimensional half‐fourier fast spin‐echo and true steady‐state free‐precession sequences

MR Evaluation of Portal Hypertensive Collateral Shunting Vessels for Predicting Outcome after Transjugular Intrahepatic Portosystemic Shunt

Initial experience with balanced turbo field echo in depicting carotid artery stenosis: Comparison with multiple overlapping thin slab acquisition and 3D contrast‐enhanced magnetic resonance angiography

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