Dynamic contrast-enhanced MR imaging of the portal venous system: comparison with x-ray angiography

To compare dynamic contrast material--enhanced multisection magnetic resonance (MR) imaging with x-ray angiography in the evaluation of the portal venous system.

Eighteen patients underwent preoperative x-ray angiography and dynamic contrast-enhanced MR imaging. MR imaging was performed at 1.0 T with a multisection breath-hold fast low-angle shot (FLASH) technique in the coronal-oblique plane, before and after injection of a bolus of gadopentetate dimeglumine. The portal vein, its right and left intrahepatic branches, the splenic veins, and the superior mesenteric veins were examined. The presence of varices was also assessed.

Of the 84 vessels evaluated with both techniques, appearances were similar in 76 (90%). Both examinations showed the main portal vein to be patent in nine patients, occluded in five, and patent but abnormal in two. Findings in the main portal vein were discordant in two patients. In one patient, surgical follow-up helped confirm the findings at MR imaging.

MR imaging can replace x-ray angiography in the preoperative evaluation of portal vein patency in most patients.