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Retrograde Perfusion and Filling of Mouse Coronary Vasculature as Preparation for Micro Computed Tomography Imaging
Published on: February 10, 2012
[Magnetic resonance angiography with three-dimensional dynamic technique after contrast media administration for the
E Squillaci1, C Mazzoleni, G Sodani
1Dipartimento di Diagnostica per Immagini e Radiologia Interventistica, Università degli Studi di Roma Tor Vergata, Rome, Italy.
Purpose:
To evaluate the feasibility of a contrast enhanced MR angiography (MRA) technique, using the latest 1.5 T MR tomoscan, to obtain optimal imaging of the portal system and compare the angiographic images with those obtained by color-Doppler and DSA.
Material And Methods:
Thirty patients (9 women and 21 men: average 53 years old) underwent contrast MRA of the portal vein, after portal hypertension had been diagnosed on the basis of clinical and chemical data and by color-Doppler. We used a dynamic 3D FFE T1-weighted breath - hold sequence during the arterial and venous phase after administering. 0.2 mmol/Kg of gadolinium-DTPA were at the rate of 2 ml/s. The contrast bolus was monitored using a 2D FFE T1-weighted sequence on a coronal plane. A FFE T1-weighted sequence was performed on axial plane before and after the dynamic sequence to obtain evaluate the a hepatic parenchyma. In the post processing phase MIP (maximum intensity projection) were reconstructed. We considered the patency of the portal venous system and the presence of cavernomatous and collateral circles; portal thrombosis was classified as partial or complete and as proximal or distal.
Results:
Good quality MR angiographic images were obtained in 28 of the 30 cases examined; in 2 patients movement artefacts compromised the image quality. We observed a concordance between MRA and Doppler ultrasound in 79 vessels out of 84 (94%). A 97.5% concordance was found between MRA and DSA (82 vessels out of 84) with a sensitivity of 100% and a specificity of 97.3%. MRA was superior to DSA and Doppler ultrasound for evaluating large collateral shunts, above all gastro-esophageal and paraumbilical shunts, and complex anatomical conditions.
Conclusions:
Where available, advanced MRA technology with contrast enhancement should be used as a routine modality to study the anatomy and pathology and the portal system in all patients in whom Doppler ultrasound has yielded doubtful information. MRA is well-suited to obtain good vascular imaging before surgical or interventional procedures.
Insights
Contrast-enhanced MR angiography (MRA) provides optimal imaging of the portal system. This advanced MRA technique demonstrates high accuracy in evaluating portal vein anatomy and pathology, outperforming Doppler ultrasound and DSA.
Area of Science:
- Radiology
- Medical Imaging
- Vascular Imaging
Context:
- Portal hypertension is a serious condition requiring accurate diagnosis.
- Conventional imaging techniques like Doppler ultrasound and DSA have limitations in visualizing the portal system.
- Advanced Magnetic Resonance (MR) angiography offers potential for improved portal system imaging.
Purpose:
- To assess the feasibility of contrast-enhanced MR angiography (MRA) using a 1.5 T MR tomoscan for optimal portal system imaging.
- To compare MRA-derived images with those obtained via color-Doppler and digital subtraction angiography (DSA).
Summary:
- Thirty patients with diagnosed portal hypertension underwent contrast-enhanced MRA using a 3D FFE T1-weighted breath-hold sequence.
- Images were analyzed for portal venous system patency, thrombosis, and collateral circulation.
- MRA achieved good image quality in 28/30 patients, demonstrating high concordance with Doppler ultrasound (94%) and DSA (97.5%).
Impact:
- Contrast-enhanced MRA is highly accurate for portal system evaluation, surpassing Doppler ultrasound and DSA in visualizing collateral shunts.
- This advanced MRA technology is recommended as a routine imaging modality when Doppler ultrasound provides uncertain results.
- MRA is valuable for pre-procedural planning in surgical or interventional cases involving the portal system.
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