Contrast enhanced MR venography with gadofosveset trisodium: Evaluation of the intracranial and extracranial venous system

Does the prone sleeping position affect the intracranial dural venous flow?

PURPOSE

There are few studies documenting the effect of posture on intracranial dural venous flow. The aim of the present study was to explore alterations caused by the prone position using magnetic resonance (MR) venography.

METHODS

A total of eight patients (five men and three women) underwent non-contrast MR venography in both supine and prone positions.

RESULTS

In the prone position, an increase in intracranial dural venous flow was found in all patients in the non-dominant transverse and sigmoid sinuses. An increase in venous flow to the straight sinus was observed in 75% of the patients. Flow to the superior ophthalmic vein decreased in three patients. No postural flow alterations were observed in any of the patients in the superior sagittal, dominant transverse, and sigmoid sinuses.

CONCLUSION

Based on results of the study, in the prone sleeping position, part of the intracranial venous flow may be preferentially drained through the straight and non-dominant transverse sinuses.

Contemporary Imaging of Cerebral Arteriovenous Malformations

OBJECTIVE

Brain arteriovenous malformation (AVM) rupture results in substantial morbidity and mortality. The goal of AVM treatment is eradication of the AVM, but the risk of treatment must be weighed against the risk of future hemorrhage.

CONCLUSION

Imaging plays a vital role by providing the information necessary for AVM management. Here, we discuss the background, natural history, clinical presentation, and imaging of AVMs. In addition, we explain advances in techniques for imaging AVMs.

Abdominal vasculature in dynamic contrast-enhanced liver MRI at 3.0T: an intraindividual comparative study using gadoxetate disodium and gadofosveset trisodium

OBJECTIVES

To intraindividually compare gadoxetate disodium and gadofosveset trisodium regarding vessel contrast, image quality and vessel delineation in dynamic contrast-enhanced liver MRI at 3.0T.

METHODS

Twelve patients underwent 3.0T MRI twice (24 examinations) with a single dose of gadoxetate disodium and gadofosveset trisodium, respectively. Signal intensity in abdominal vessels and tissue was determined. Vessel-to-background ratio (VBR) was calculated for each vessel and dynamic phase. All images were evaluated by two radiologists regarding image quality, vessel delineation and anatomic variants or pathologies with digital subtraction angiography as the standard of reference.

RESULTS

Gadofosveset trisodium demonstrated a significantly higher VBR compared to gadoxetate disodium (arterial phase: 0.57±0.12 [SD] vs. 0.46±0.19; portal venous phase: 0.51±0.11 vs. 0.37±0.14; equilibrium phase: 0.48±0.10 vs. 0.31±0.13; p≤0.01). Image quality and vessel delineation were rated equal or better for gadofosveset trisodium in all cases. These differences were not significant for most vessel segments. All anatomic variants were correctly identified by both readers for both contrast agents.

CONCLUSIONS

Although gadofosveset trisodium provides a significantly higher vessel contrast at 3.0T, gadoxetate disodium is equivalent by qualitative measurements. Thus, gadoxetate-enhanced liver MRI at 3.0T enables reliable assessment of the upper abdominal vasculature with the additional benefit of hepatobiliary imaging.