MR angiography of the hand and wrist

MR angiographic techniques that visualize the arterial anatomy of the hand and wrist currently are available. Further refinements are necessary to ensure that diagnostic studies are routine. In my experience, the most detailed anatomy is obtained with gadolinium-enhanced 3-D sequences. The specific role of MR angiography of the hand and wrist has yet to be defined. Currently, it is used in my practice as a screen for certain vascular disorders and in those patients in whom the risk/benefit considerations of conventional arteriography are deemed unacceptable to the referring surgeon. Future applications may include a quantitative component. This information could prove beneficial in the serial follow up of patients with vasospastic disorders that require intermittent vasodilator therapy. It is hoped that quantitative information might provide a means to direct therapy prior to the onset of debilitating symptoms. Clinical efficacy must be established with comparative studies to the reference standard of conventional angiography. If reliable MR angiography can be obtained with sufficient information for clinical decision making, it is likely that it will have a cost and safety advantage over conventional angiography.