Time-of-flight MR angiography of the portal venous system: value compared with other imaging procedures.

Hughes, Linda A.; Hartnell, G.G.; Finn, J. Paul; Longmaid, H. Esterbrook; Volpe, Joseph A.; Wheeler, Hugh G.; Clouse, M E

doi:10.2214/ajr.166.2.8553951

Cited by 49 publications

(15 citation statements)

References 11 publications

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“…Current liver applications cover depiction of the portal venous anatomy, flow measurements, guidance of transjugular intrahepatic portosystemic shunt procedures, or the evaluation before liver transplantation (3,(16)(17)(18). Contrast-enhanced MRA studies using gadolinium chelates have started with non-breath-hold acquisitions and contrast infusion techniques (4,5).…”

Section: Discussionmentioning

confidence: 99%

SPIO‐enhanced 2D‐TOF MR angiography of the portal venous system: Results of an intraindividual comparison

Reimer

Marx

Rummeny

et al. 1997

Magnetic Resonance Imaging

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The purpose of this study was to investigate whether MR angiography (MRA) of the portal venous system may be improved by means of superparamagnetic iron oxides (SPIOs) during accumulation phase imaging and to study the underlying contrast mechanisms. MRA of the portal venous system was performed on 48 patients before and after intravenous injection of a new SPIO (Resovist, Schering AG, Berlin, Germany). Resovist, as a predominantly liver parenchymal darkening agent on T2-weighted MR images with uptake into the reticuloendothelial cell system, was administered intravenously by bolus injection of 8 to 12 micromol Fe/kg body weight. Patients were scanned with breath-hold coronal and axial two-dimensional (2D) time of flight (TOF) MRA (TR = 31.0 msec, TE = 9.8 msec, flip angle (FA) = 50 degrees, and 6.9-second acquisition time per section) sequences. Signal intensity values of liver parenchyma, the portal venous system, and background were obtained for quantitative analysis. The clinical relevance of additional plain and contrast-enhanced MRA studies for surgical planning was assessed by independent reading of three readers. Liver signal-to-noise ratio (SNR) significantly decreased following iv injection of Resovist; however, SNR values of the portal veins or hepatic veins did not change significantly. Visibility of the portal venous system improved significantly (tertiary branches visible: pre in 15.2% versus post in 87.0% of patients). Resovist-enhanced 2D-TOF MRA may improve planning of liver resections by better demonstrating the relationship of central liver lesions and vessels on source images. The decrease in liver SNR at a constant vessel SNR after iv injection of Resovist improves MRA of the liver. SPIO-enhanced 2D-TOF MRA scans are superior to plain 2D-TOF MRA studies and may be added for the workup of preoperative patients.

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Section: Discussionmentioning

confidence: 99%

SPIO‐enhanced 2D‐TOF MR angiography of the portal venous system: Results of an intraindividual comparison

Reimer

Marx

Rummeny

et al. 1997

Magnetic Resonance Imaging

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“…MR angiography with gadopentetate dimeglumine has been shown to be a very promising noninvasive method for the assessment of the portal venous system [77][78][79][80][81][82]. MR angiography appears to be a more accurate diagnostic procedure than Doppler sonography and CT [60,72,83,84].…”

Section: Diagnosismentioning

confidence: 99%

Left-Sided Portal Hypertension

et al. 2007

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Left-sided portal hypertension is a rare clinical syndrome which may lead to bleeding from isolated gastric varices. Pancreatic disease is the most common etiology. Left-sided portal hypertension should be considered in the presence of gastrointestinal bleeding with normal liver function and unexplained splenomegaly. It may be difficult to diagnose this entity both endoscopically and radiologically. While splenectomy is the treatment of choice for cases complicated by variceal bleeding, there is no consensus on the treatment of asymptomatic patients. The prognosis of left-sided portal hypertension mainly depends on the underlying etiology.

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“…Magnetic resonance angiography (MRA) has been reported to be an accurate noninvasive method for evaluating portal venous anatomy and its collateral vessels [4,5]. In fact Kuroiwa et al even reported that gastrointestinal tract endoscopy (ENDO) is unnecessary until collateral vessels are seen on MRA after surgery for BA [6].…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance angiography versus endoscopy for the assessment of gastroesophageal varices in biliary atresia

et al. 2007

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This study was undertaken to compare magnetic resonance angiography (MRA) and gastrointestinal tract endoscopy (ENDO) for detecting varices in postoperative biliary atresia (BA) patients. Thirty-four BA patients were divided into groups according to age and liver function; group 1: 1-4 years old; group 2: 5-9 years old; group 3: over 10 years old; group A: normal liver function; and group B: moderate liver dysfunction. All subjects had MRA and ENDO. ENDO showed esophageal or gastric varices in 16 of 34 subjects. MRA depicted gastroesophageal vessels in 12 of 16 cases with varices on ENDO (sensitivity: 75%). Two subjects appeared to have varices on MRA that could not be confirmed on ENDO. Sixteen subjects had no varices on ENDO and normal MRA (specificity: 88.9%). Sensitivities and specificities of MRA for detecting varices were 20 (1/5) and 100% (6/6) in group 1 (n = 11), 100 (6/6) and 66.7% (4/6) in group 2 (n = 12), 100 (5/5) and 100% (6/6) in group 3 (n = 11), 100 (8/8) and 100% (9/9) in group A (n = 17), 50 (4/8) and 77.8% (7/9) in group B (n = 17), respectively. From these findings, MRA was not accurate in BA patients less than 10 years old or with moderate liver dysfunction. Therefore, periodic endoscopic examination is recommended for the accurate assessment and follow-up of varices in postoperative BA patients.

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Time-of-flight MR angiography of the portal venous system: value compared with other imaging procedures.

Cited by 49 publications

References 11 publications

SPIO‐enhanced 2D‐TOF MR angiography of the portal venous system: Results of an intraindividual comparison

SPIO‐enhanced 2D‐TOF MR angiography of the portal venous system: Results of an intraindividual comparison

Left-Sided Portal Hypertension

Magnetic resonance angiography versus endoscopy for the assessment of gastroesophageal varices in biliary atresia

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