Gadolinium enhanced three-dimensional magnetic resonance portography with subtraction

The aim was to evaluate a subtraction technique for breath-hold gadolinium enhanced three-dimensional magnetic resonance portography (3D-MRP). 26 patients with gastric and/or duodenal varices related to portal hypertension were investigated by 3D-MRP with two phase acquisitions. A partial volume maximum intensity projection (MIP) image after subtracting selective arterial phase images from subsequent portal venous phase images (subtraction 3D-MRP) was compared with the partial volume MIP without subtraction (non-subtraction 3D-MRP) to assess visualization of the portal vein and its collaterals. Subtraction 3D-MRP depicted excellent visualization of the portal vein, although this was not significantly better than non-subtraction 3D-MRP. However, subtraction 3D-MRP gave superior visualization of portal collaterals, with effective suppression of arterial and renal signal intensities, compared with non-subtraction 3D-MRP (p<0.001).