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Contrast-enhanced three-dimensional magnetic resonance angiography of the mesenteric vasculature
J G Baden1, D J Racy, T M Grist
1Department of Radiology, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin 53792-3252, USA.
Abstract:
The diagnosis and treatment of mesenteric occlusive disease is important due to the high morbidity and mortality associated with ischemia of the bowel. This article describes the application of magnetic resonance angiography (MRA) as a minimally invasive tool for diagnosing mesenteric and portal vascular disease. The techniques for three-dimensional (3D) contrast-enhanced MRA and flow measurement of the mesenteric circulation are described. Excellent image quality is obtained using sagittal contrast-enhanced 3D MRA of the aorta and proximal mesenteric vessels. Delineation of the small distal mesenteric branch vessels is still limited due to the finite spatial resolution of MRA. The application of MRA techniques to the diagnosis of mesenteric ischemia, revascularization, transplantation, and portal hypertension are demonstrated. Finally, the merits of various acquisition techniques and future contrast agents are discussed. MR angiography using intravenously administered contrast agents provides the clinician with a powerful, minimally invasive method for diagnosing mesenteric vascular disease.
Insights
Magnetic resonance angiography (MRA) offers a powerful, minimally invasive method for diagnosing mesenteric vascular diseases. This technique aids in evaluating conditions like mesenteric ischemia and portal hypertension with excellent image quality for major vessels.
Area of Science:
- Vascular Imaging
- Medical Diagnostics
Background:
- Mesenteric occlusive disease presents significant morbidity and mortality risks.
- Accurate diagnosis and treatment are crucial for managing bowel ischemia.
Purpose of the Study:
- To detail the application of magnetic resonance angiography (MRA) for diagnosing mesenteric and portal vascular disease.
- To describe techniques for 3D contrast-enhanced MRA and mesenteric flow measurement.
Main Methods:
- Utilized three-dimensional (3D) contrast-enhanced MRA.
- Performed flow measurements of the mesenteric circulation.
- Acquired sagittal contrast-enhanced 3D MRA of the aorta and proximal mesenteric vessels.
Main Results:
- Achieved excellent image quality for the aorta and proximal mesenteric vessels.
- Demonstrated MRA's utility in diagnosing mesenteric ischemia, revascularization, transplantation, and portal hypertension.
- Noted limitations in delineating small distal mesenteric branch vessels due to spatial resolution.
Conclusions:
- Intravenously administered contrast-enhanced MR angiography is a potent, minimally invasive diagnostic tool for mesenteric vascular disease.
- Further advancements in acquisition techniques and contrast agents are anticipated.