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Published on: June 11, 2019
Pediatric magnetic resonance angiography: to contrast or not to contrast
Erin K Opfer1, Nathan S Artz2, Grace S Mitchell2
1Department of Radiology, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA. ekopfer@cmh.edu.
Abstract:
Magnetic resonance (MR) angiography and MR venography imaging with contrast and non-contrast techniques are widely used for pediatric vascular imaging. However, as with any MRI examination, imaging the pediatric population can be challenging because of patient motion, which sometimes requires sedation. There are multiple benefits of non-contrast MR angiographic techniques, including the ability to repeat sequences if motion is present, the decreased need for sedation, and avoidance of potential risks associated with gadolinium administration and radiation exposure. Thus, MR angiography is an attractive alternative to CT or conventional catheter-based angiography in pediatric populations. Contrast-enhanced MR angiographic techniques have the advantage of increased signal to noise. Blood pool imaging allows long imaging times that result in high-spatial-resolution imaging, and thus high-quality diagnostic images. This article outlines the technique details, indications, benefits and downsides of non-contrast-enhanced and contrast-enhanced MR angiographic techniques to assist in protocol decision-making.
Insights
Non-contrast magnetic resonance (MR) angiography offers benefits for pediatric vascular imaging, reducing sedation needs and risks. This technique provides an attractive alternative to conventional methods for children.
Area of Science:
- Medical Imaging
- Pediatric Radiology
- Vascular Imaging
Background:
- Pediatric vascular imaging frequently utilizes magnetic resonance (MR) angiography and venography.
- Patient motion in pediatric MRI often necessitates sedation, posing challenges.
- Contrast agents carry potential risks, driving interest in alternative techniques.
Purpose of the Study:
- To outline technique details, indications, benefits, and downsides of non-contrast and contrast-enhanced MR angiographic techniques.
- To aid in protocol decision-making for pediatric vascular imaging.
- To compare non-contrast and contrast-enhanced MR angiography in pediatric populations.
Main Methods:
- Review of non-contrast MR angiography techniques.
- Review of contrast-enhanced MR angiography techniques, including blood pool imaging.
- Discussion of advantages and disadvantages of each approach.
Main Results:
- Non-contrast MR angiography allows for sequence repetition, reduces sedation, and avoids gadolinium risks.
- Contrast-enhanced techniques offer improved signal-to-noise ratio and high-spatial-resolution imaging.
- Both methods are presented as viable alternatives to CT and catheter-based angiography.
Conclusions:
- Non-contrast MR angiography is a valuable tool in pediatric vascular imaging, enhancing safety and efficiency.
- Contrast-enhanced MR angiography provides high-quality diagnostic images, particularly with blood pool techniques.
- Informed protocol selection balances technique benefits and patient considerations for optimal pediatric vascular imaging.
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