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Application of TWIST MR angiography to aid successful central venous access in challenging patients: initial
L Armstrong1, J C L Rodrigues1, C B Lawton1
1Cardiac MR Department, NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, Bristol Royal Infirmary, Bristol, UK.
Aim:
To investigate whether time-resolved angiography with interleaved stochastic trajectories (TWIST) with GeneRalised Autocalibrating Partially Parallel Acquisitions (GRAPPA) parallel acquisition could be used successfully to non-invasively and efficiently image patients with more complex vascular access issues.
Materials And Methods:
TWIST magnetic resonance angiography (MRA) in the GRAPPA algorithm was performed on 15 patients at our centre using the 1.5 T Siemens Magnetom Avanto MRI system. Images were interpreted by cardiac radiologists.
Results:
TWIST provided excellent dynamic imaging of the venous system, demonstrating venous occlusion, stenoses, and collaterals, as well as providing good anatomical detail.
Conclusion:
TWIST MRA enables successful identification of candidate sites for central/tunnelled line access, whilst diagnosing complications of long-term access such as venous thrombosis or congenital venous anomalies.
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