Direct contrast enhanced MR in the study of central venous accesses in children receiving total parenteral nutrition

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Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
06:02

Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens

Published on: April 18, 2013

Lorenzo Pagnan1, Giuseppe Tona, Manuel Belgrano

  • 1Unità Clinica Operativa di Radiologia, Ospedale di Cattinara, Trieste. pagny@inwind.it

La Radiologia Medica
|October 4, 2005
PubMed

Insights

Direct contrast-enhanced MR-venography is a new, reliable method for studying central venous accesses in patients with intestinal failure. This minimally invasive technique offers panoramic views without radiation, comparable to traditional phlebography.

Area of Science:

  • Radiology
  • Vascular Imaging
  • Medical Technology

Background:

  • Central venous catheter use is common in patients with severe intestinal failure requiring total parenteral nutrition.
  • Assessing central venous access patency is crucial for managing these patients.
  • Conventional phlebography is the gold standard but involves ionizing radiation and iodinated contrast agents.

Purpose of the Study:

  • To introduce and evaluate direct contrast-enhanced Magnetic Resonance Venography (MRV) as a novel method for studying central venous accesses.
  • To assess the diagnostic reliability and safety of this new MRV technique.

Main Methods:

  • MR-angiography was performed on six adolescent patients (15-18 years) with indwelling central venous catheters.
  • A 1.5T MRI scanner was used with simultaneous injection of gadolinium-based contrast agent (Gd-DTPA) diluted with saline.
  • Images were processed using maximum intensity projections and compared to prior phlebographic studies.

Main Results:

  • The MRV technique successfully identified central venous occlusions in 4 cases (superior vena cava) and 2 cases (inferior vena cava).
  • Image quality was comparable to conventional phlebography.
  • The procedure was well-tolerated by all patients.

Conclusions:

  • Direct contrast-enhanced MR venography is a minimally invasive, panoramic, and diagnostically reliable method for evaluating central venous accesses.
  • It is a suitable first-choice imaging modality for patients with intestinal failure on total parenteral nutrition.
  • Advantages include avoidance of ionizing radiation and iodinated contrast, with a relatively short examination time (30-40 minutes).
Abstract

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