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Nagpal P, Grist TM. MR Angiography: Contrast-Enhanced Acquisition Techniques. Magn Reson Imaging Clin N Am 2023; 31:493-501. [PMID: 37414474 DOI: 10.1016/j.mric.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Contrast-enhanced MR angiography (CE-MRA) is a frequently used MR imaging technique for evaluating cardiovascular structures. In many ways, it is similar to contrast-enhanced computed tomography (CT) angiography, except a gadolinium-based contrast agent (instead of iodinated contrast) is injected. Although the physiological principles of contrast injection overlap, the technical factors behind enhancement and image acquisition are different. CE-MRA provides an excellent alternative to CT for vascular evaluation and follow-up without requiring nephrotoxic contrast and ionizing radiation. This review describes the physical principles, limitations, and technical applications of CE-MRA techniques.
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Affiliation(s)
- Prashant Nagpal
- Cardiovascular Imaging, Department of Radiology, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53705, USA.
| | - Thomas M Grist
- Radiology, University of Wisconsin Madison, E3/366 600 Highland Avenue, Madison, WI 53792, USA
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Maupu C, Lebas H, Boulaftali Y. Imaging Modalities for Intracranial Aneurysm: More Than Meets the Eye. Front Cardiovasc Med 2022; 9:793072. [PMID: 35242823 PMCID: PMC8885801 DOI: 10.3389/fcvm.2022.793072] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/17/2022] [Indexed: 11/21/2022] Open
Abstract
Intracranial aneurysms (IA) are often asymptomatic and have a prevalence of 3 to 5% in the adult population. The risk of IA rupture is low, however when it occurs half of the patients dies from subarachnoid hemorrhage (SAH). To avoid this fatal evolution, the main treatment is an invasive surgical procedure, which is considered to be at high risk of rupture. This risk score of IA rupture is evaluated mainly according to its size and location. Therefore, angiography and anatomic imaging of the intracranial aneurysm are crucial for its diagnosis. Moreover, it has become obvious in recent years that several other factors are implied in this complication, such as the blood flow complexity or inflammation. These recent findings lead to the development of new IA imaging tools such as vessel wall imaging, 4D-MRI, or molecular MRI to visualize inflammation at the site of IA in human and animal models. In this review, we will summarize IA imaging techniques used for the patients and those currently in development.
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Clark TJ, Wilson GJ, Maki JH. Relationship Between Simulated Gadolinium-Based Contrast Agent Injection Profile and Achievable Resolution Metrics in Contrast-Enhanced Magnetic Resonance Angiography. J Magn Reson Imaging 2021; 55:1797-1807. [PMID: 34694039 DOI: 10.1002/jmri.27966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/08/2021] [Accepted: 10/13/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Contrast bolus variation during contrast-enhanced magnetic resonance angiography (CE-MRA) acquisition may lead to vessel blurring. PURPOSE To combine knowledge of how contrast signal intensity (SI) evolves for different injection strategies with anatomically familiar parametric computer models to measure and visually assess the effects of a wide range of variables on modeled CE-MRA, and in doing so develop contrast rate injection guidelines. STUDY TYPE Computer modeling. PHANTOM Digital three-dimensional phantom consisting of orthogonal "aorta," 7 mm diameter "renal arteries" (with 57% and 86% diameter stenoses), and 7 mm diameter "superior mesenteric artery" (with 57% diameter stenosis). FIELD STRENGTH/SEQUENCE One millimeter in-plane resolution arterial CE-MRA imaging at 3 T. ASSESSMENT "Background" (time invariant) and "vascular" (time varying) components of the phantom were each Fourier transformed into the spatial frequency domain, the latter modulated by the SI evolution of a contrast bolus of varying "plateau" lengths and "tail" heights. Data are presented as surface plots of stenosis measurement error and blurring vs. a reference-standard injection. STATISTICAL TESTS Descriptive. RESULTS Shorter plateau lengths and lower tail heights resulted in increased measured stenosis error and blurring vs. the reference standard. Under a 44-second acquisition, full width half maximum stenosis error of the 86% stenosis with 25% plateau length and 25% tail height is 24% as compared to that from the reference standard. As plateau length and tail height approach 100%, stenosis error and blurring approach a floor defined by the MR acquisition's limitations. DATA CONCLUSION We propose that to achieve minimal degradation with CE-MRA, one can create a contrast bolus with either 60% plateau and 50% tail height or 80% plateau with any tail. These considerations may well prove to be of practical importance, possibly via manipulating the tail by means of multiphasic contrast injections. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Toshimasa J Clark
- Department of Radiology, Abdominal Imaging Section, University of Colorado, Aurora, Colorado, USA
| | | | - Jeffrey H Maki
- Department of Radiology, Abdominal Imaging Section, University of Colorado, Aurora, Colorado, USA
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Settecase F, Rayz VL. Advanced vascular imaging techniques. HANDBOOK OF CLINICAL NEUROLOGY 2021; 176:81-105. [DOI: 10.1016/b978-0-444-64034-5.00016-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Londy FJ, Lowe S, Stein PD, Weg JG, Eisner RL, Leeper KV, Woodard PK, Sostman HD, Jablonski KA, Fowler SE, Hales CA, Hull RD, Gottschalk A, Naidich DP, Chenevert TL. Comparison of 1.5 and 3.0 T for contrast-enhanced pulmonary magnetic resonance angiography. Clin Appl Thromb Hemost 2011; 18:134-9. [PMID: 21993980 DOI: 10.1177/1076029611419840] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE In a recent multi-center trial of gadolinium contrast-enhanced magnetic resonance angiography (Gd-MRA) for diagnosis of acute pulmonary embolism (PE), two centers utilized a common MRI platform though at different field strengths (1.5T and 3T) and realized a signal-to-noise gain with the 3T platform. This retrospective analysis investigates this gain in signal-to-noise of pulmonary vascular targets. METHODS Thirty consecutive pulmonary MRA examinations acquired on a 1.5T system at one institution were compared to 30 consecutive pulmonary MRA examinations acquired on a 3T system at a different institution. Both systems were from the same MRI manufacturer and both used the same Gd-MRA pulse sequence, although there were some protocol adjustments made due to field strength differences. Region-of-interests were manually defined on the main pulmonary artery, 4 pulmonary veins, thoracic aorta, and background lung for objective measurement of signal-to-noise, contrast-to-noise, and bolus timing bias between centers. RESULTS The 3T pulmonary MRA protocol achieved higher spatial resolution yet maintained significantly higher signal-to-noise ratio (≥13%, p = 0.03) in the main pulmonary vessels relative to 1.5T. There was no evidence of operator bias in bolus timing or patient hemodynamic differences between groups. CONCLUSION Relative to 1.5T, higher spatial resolution Gd-MRA can be achieved at 3T with a sustained or greater signal-to-noise ratio of enhanced vasculature.
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Shimada K, Isoda H, Okada T, Kamae T, Arizono S, Hirokawa Y, Shibata T, Togashi K. Non-contrast-enhanced hepatic MR angiography: Do two-dimensional parallel imaging and short tau inversion recovery methods shorten acquisition time without image quality deterioration? Eur J Radiol 2011; 77:137-42. [DOI: 10.1016/j.ejrad.2009.05.051] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2009] [Accepted: 05/28/2009] [Indexed: 10/20/2022]
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Unenhanced MR Portography With a Half-Fourier Fast Spin-Echo Sequence and Time-Space Labeling Inversion Pulses: Preliminary Results. AJR Am J Roentgenol 2009; 193:106-12. [DOI: 10.2214/ajr.08.1626] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Shimada K, Isoda H, Okada T, Kamae T, Arizono S, Hirokawa Y, Shibata T, Togashi K. Non-contrast-enhanced MR portography with time-spatial labeling inversion pulses: Comparison of imaging with three-dimensional half-fourier fast spin-echo and true steady-state free-precession sequences. J Magn Reson Imaging 2009; 29:1140-6. [DOI: 10.1002/jmri.21753] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Shimada K, Isoda H, Okada T, Maetani Y, Arizono S, Hirokawa Y, Kamae T, Togashi K. Non-contrast-enhanced hepatic MR angiography with true steady-state free-precession and time spatial labeling inversion pulse: Optimization of the technique and preliminary results. Eur J Radiol 2009; 70:111-7. [DOI: 10.1016/j.ejrad.2007.12.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2007] [Revised: 11/29/2007] [Accepted: 12/12/2007] [Indexed: 11/24/2022]
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Shimada K, Isoda H, Okada T, Kamae T, Maetani Y, Arizono S, Hirokawa Y, Shibata T, Togashi K. Non-contrast-enhanced MR angiography for selective visualization of the hepatic vein and inferior vena cava with true steady-state free-precession sequence and time-spatial labeling inversion pulses: Preliminary results. J Magn Reson Imaging 2009; 29:474-9. [DOI: 10.1002/jmri.21636] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sainani NI, Catalano OA, Holalkere NS, Zhu AX, Hahn PF, Sahani DV. Cholangiocarcinoma: current and novel imaging techniques. Radiographics 2008; 28:1263-87. [PMID: 18794305 DOI: 10.1148/rg.285075183] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The radiologic manifestations of cholangiocarcinomas are extremely diverse, since these tumors vary greatly in location, growth pattern, and histologic type. Familiarity with the imaging manifestations of cholangiocarcinomas is important for accurate detection and characterization of these tumors and assessment of resectability. Advances in imaging techniques have led to the availability of an array of modalities that, used independently or in combination, can aid in the accurate diagnosis and evaluation of cholangiocarcinomas in preparation for advanced surgical procedures and treatment planning. Response to novel targeted therapies can also be assessed with newer imaging tools. Hence, knowledge of current and emerging imaging applications is essential for correct diagnosis and appropriate management of these tumors.
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Affiliation(s)
- Nisha I Sainani
- Division of Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital-Harvard Medical School, Boston, MA 02114, USA
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Abstract
Arteriovenous malformations (AVM) are complex inborn malformations of the vascular system. In the brain they can lead to severe complications, such as parenchymal haemorrhaging, epileptic seizures or neurologic failure, which necessitates a safe diagnosis and therapy. In addition to conventional angiography, magnetic resonance imaging (MRI) and MR angiography (MRA) have now been established as the gold standard diagnostic procedures. Using MRA the angioarchitecture of malformations can be captured and with a parallel imaging of the parenchyme the method is very well suited for therapy planning and monitoring. This review summarizes the present day possibilities of multimodal MRT diagnosis of AVM and describes the purely morphologic as well as the physiologic and pathophysiologic characteristics. The various MR angiographic techniques will be firstly described with respect to the basic technical principles and the results obtained so far will be summarized. The principle of functional MRT will be described and the diagnostic possibilities with respect to AVM will be discussed.
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Affiliation(s)
- M Essig
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
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Rehwald WG, Wagner A, Sievers B, Kim RJ, Judd RM. Cardiovascular MRI: its current and future use in clinical practice. Expert Rev Cardiovasc Ther 2007; 5:307-21. [PMID: 17338674 DOI: 10.1586/14779072.5.2.307] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cardiovascular magnetic resonance (CMR) imaging is a comprehensive clinical tool for assessing a large variety of cardiovascular diseases. Using the clinical service of the Duke Cardiovascular Magnetic Resonance Center as an example, we describe how to perform image contractile function, myocardial perfusion at stress and rest, myocardial viability, cardiovascular morphology, vascular anatomy and blood flow tests. The emergence of successful dedicated CMR services presents an opportunity to optimize patient throughput by streamlining the user interface of CMR scanners, standardizing the viewing format and reporting software, and customizing training programs to focus on the standardized CMR approaches. Accordingly, we discuss potential pathways to create these standards. Finally, we discuss several promising new CMR techniques we expect will complement existing clinical procedures.
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Croisille P, Revel D, Saeed M. Contrast agents and cardiac MR imaging of myocardial ischemia: from bench to bedside. Eur Radiol 2006; 16:1951-63. [PMID: 16633792 DOI: 10.1007/s00330-006-0244-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2005] [Revised: 02/07/2006] [Accepted: 03/02/2006] [Indexed: 01/14/2023]
Abstract
This review paper presents, in the first part, the different classes of contrast media that are already used or are in development for cardiac magnetic resonance imaging. A classification of the different types of contrast media is proposed based on the distribution of the compounds in the body, their type of relaxivity and their potential affinity to particular molecules. In the second part, the different uses of the extracellular type of T1-enhancing contrast agent for myocardial imaging is covered from the detection of stable coronary artery disease to the detection and characterization of chronic infarction. A particular emphasis is placed on the clinical use of gadolinium-chelates, which are the universally used type of MRI contrast agent in the clinical routine. Both approaches, first-pass magnetic resonance imaging (FP-MRI) as well as delayed-enhanced magnetic resonance imaging (DE-MRI), are covered in the different situations of acute and chronic myocardial infarction.
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Affiliation(s)
- Pierre Croisille
- Hôpital Cardiologique L. Pradel, Department of Radiology, Creatis, UMR CNRS 5515 & INSERM U630, 59, Boulevard du Doyen Lépine, 69394, Lyon, Montchat, France.
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Kubo S, Levantini E, Kobayashi S, Kocher O, Halmos B, Tenen DG, Takahashi M. Three-dimensional magnetic resonance microscopy of pulmonary solitary tumors in transgenic mice. Magn Reson Med 2006; 56:698-703. [PMID: 16902979 DOI: 10.1002/mrm.21006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We attempted to accurately detect pulmonary solitary tumors and other complicated pulmonary disorders in aging inbred transgenic mice by cardiac- and respiratory-gated MR microscopy at 4.7 Tesla. A comparison of in vivo MR images with histological results demonstrated that submillimeter lung tumors and most of the nontumor lesions could be detected by screening with two-dimensional (2D) gradient echo (GRE) imaging. Subsequently performed 2D spin-echo (SE) imaging provided higher image contrast, which distinguished the tumors from the surrounding complications. On the 3D GRE images and the generated maximum intensity projection (MIP) and volume-rendered (VR) images, proper spatial localization of solitary tumors relative to the orientation of the pulmonary vessels was exhibited, and the tumor volume could also be measured. This promising method is noninvasive and has the potential to eventually replace invasive histopathology because it obviates the need to kill groups of animals at multiple time points.
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Affiliation(s)
- Shigeto Kubo
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, and Ireland Cancer Center, University Hospitals of Cleveland/Case Western Reserve University, OH, USA
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Peripheral MR angiography. Magn Reson Imaging Clin N Am 2004. [DOI: 10.1016/j.mric.2004.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Katoh M, Buecker A, Stuber M, Günther RW, Spuentrup E. Free-breathing renal MR angiography with steady-state free-precession (SSFP) and slab-selective spin inversion: Initial results. Kidney Int 2004; 66:1272-8. [PMID: 15327427 DOI: 10.1111/j.1523-1755.2004.00882.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of our study was the investigation of a novel navigator-gated three-dimensional (3D) steady-state free-precession (SSFP) sequence for free-breathing renal magnetic resonance angiography (MRA) without contrast medium, and to examine the advantage of an additional inversion prepulse for improved contrast. METHODS Eight healthy volunteers (mean age 29 years) and eight patients (mean age 53 years) were investigated on a 1.5 Tesla MR system (ACS-NT, Philips, Best, The Netherlands). Renal MRA was performed using three navigator-gated free-breathing cardiac-triggered 3D SSFP sequences [repetition time (TR) = 4.4 ms, echo time (TE) = 2.2 ms, flip angle 85 degrees, spatial resolution 1.25 x 1.25 x 4.0 mm(3), scanning time approximately 1 minute 30 seconds]. The same sequence was performed without magnetization preparation, with a non-slab selective and a slab-selective inversion prepulse. Signal-to-noise ratio (SNR), contrast-to-noise (CNR) vessel length, and subjective image quality were compared. RESULTS Three-dimensional SSFP imaging combined with a slab-selective inversion prepulse enabled selective and high contrast visualization of the renal arteries, including the more distal branches. Standard SSFP imaging without magnetization preparation demonstrated overlay by veins and renal parenchyma. A non-slab-selective prepulse abolished vessel visualization. CNR in SSFP with slab-selective inversion was 43.6 versus 10.6 (SSFP without magnetization preparation) and 0.4 (SSFP with non-slab-selective inversion), P < 0.008. CONCLUSION Navigator-gated free-breathing cardiac-triggered 3D SSFP imaging combined with a slab-selective inversion prepulse is a novel, fast renal MRA technique without the need for contrast media.
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Affiliation(s)
- Marcus Katoh
- Department of Diagnostic Radiology, University Hospital, University of Technology, Aachen, Germany.
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Chen Q, Quijano CV, Mai VM, Krishnamoorthy SK, Li W, Storey P, Edelman RR. On Improving Temporal and Spatial Resolution of 3D Contrast-enhanced Body MR Angiography with Parallel Imaging. Radiology 2004; 231:893-9. [PMID: 15163824 DOI: 10.1148/radiol.2313021113] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Use of a parallel imaging technique to improve temporal and spatial resolution at three-dimensional contrast-enhanced magnetic resonance (MR) angiography was investigated. Thirty experiments were performed in five groups of healthy subjects. In groups 1-3, the technique was used to improve imaging speed by a factor of two or four while maintaining spatial resolution. Contrast agent concentration was two to four times higher than at standard MR angiography, to take advantage of the faster imaging speed. In groups 4 and 5, the technique was used to double spatial resolution in the phase-encoding direction while maintaining imaging speed and contrast agent concentration. At a two to four times faster imaging speed, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) almost equaled those at standard MR angiography, likely a result of increased contrast agent concentration. The use of parallel imaging to achieve higher spatial resolution was also proved feasible, but with substantial reduction in SNR and CNR.
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Affiliation(s)
- Qun Chen
- Department of Radiology, Evanston Northwestern Healthcare, Evanston, Illinois, USA.
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Coenegrachts KL, Hoogeveen RM, Vaninbroukx JA, Bosmans HT, Bielen DJ, Maleux G, Maes F, Hamaekers P, Oyen RH, Marchal GJ. High-Spatial-Resolution 3D Balanced Turbo Field-Echo Technique for MR Angiography of the Renal Arteries: Initial Experience. Radiology 2004; 231:237-42. [PMID: 14990821 DOI: 10.1148/radiol.2311030044] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To compare a multislab balanced turbo field-echo magnetic resonance (MR) angiographic technique, without the use of a contrast agent, with digital subtraction angiography (DSA) for imaging of the renal arteries. MATERIALS AND METHODS Twenty-five randomly selected patients (eight women and 17 men; age range, 27-88 years; mean age, 72 years) suspected of having renal artery stenosis underwent both DSA and balanced turbo field-echo MR angiography. A consensus result was obtained among three radiologists in evaluation of main renal arteries on balanced turbo field-echo images and DSA images. Sensitivity, specificity, and negative and positive predictive values of the balanced turbo field-echo technique were calculated, and receiver operating characteristic analysis was performed for depiction of hemodynamically significant stenosis. Cohen kappa analysis was used to assess agreement between the two imaging methods in grading of stenoses and depiction of significant stenosis. Accessory renal arteries also were evaluated. RESULTS Fifty main renal arteries and 11 accessory arteries were fully depicted with DSA. DSA depicted 11 stenotic lesions in the main renal arteries. In comparison, balanced turbo field-echo MR angiography enabled visualization of 46 of 50 main renal arteries to their first branching points and depicted 10 of 11 accessory arteries. Sensitivity, specificity, negative predictive value, and positive predictive value of this technique for depiction of significant stenosis were 100% (four of four), 98% (41 of 42), 100% (41 of 41), and 80% (four of five), respectively. The area under the receiver operating characteristic curve was 0.988. kappa was 0.782 for grading of stenoses and 0.877 for depiction of significant stenosis. CONCLUSION Multislab balanced turbo field-echo imaging has potential as an MR angiography technique for depiction of normal and diseased renal arteries.
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Affiliation(s)
- Kenneth L Coenegrachts
- Department of Radiology and Laboratory of Medical Imaging Research, University Hospitals Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.
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Caldana RP, Bezerra ASDA, Soares AFDF, D'Ippolito G. Angiografia por ressonância magnética: aspectos técnicos de um método de estudo vascular não-invasivo. Radiol Bras 2004. [DOI: 10.1590/s0100-39842004000100010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
As primeiras técnicas de angiografia por ressonância magnética (angio-RM) utilizavam seqüências sensíveis ao fluxo sanguíneo para estabelecimento do contraste vascular. Há três técnicas fundamentadas neste princípio: contraste de fase ("phase-contrast"), TOF ("time-of-flight") e as técnicas de sangue escuro ("black blood"). Estas seqüências, de aquisição demorada, são mais suscetíveis a artefatos de movimento, perda de sinal em áreas de estenoses ou turbilhonamento de fluxo, e apresentam ainda baixa sensibilidade à detecção do fluxo lento. O uso do contraste paramagnético para estudos angiográficos pela ressonância magnética ofereceu um método simples, rápido e de excelente detalhamento vascular, baseando o contraste da imagem no realce do sinal vascular em oposição à supressão dos demais tecidos. Metodologias modernas que priorizam a obtenção do espaço k central, responsável pelo contraste da imagem, e o aperfeiçoamento das técnicas de planejamento do intervalo temporal para aquisição dos dados foram fatores fundamentais para o aprimoramento técnico da angio-RM. O papel atual da angio-RM como ferramenta diagnóstica merece destaque na avaliação de anomalias anatômicas, estenoses, oclusões e complicações vasculares pós-cirúrgicas, principalmente nos casos de transplantes de órgãos. Suas principais vantagens estão na não utilização do contraste iodado ou radiação ionizante, rapidez e fácil execução, mínima invasividade e possibilidade de avaliar complementarmente o parênquima de órgãos adjacentes de interesse diagnóstico.
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Abstract
Peripheral arterial occlusive disease is a chronic and progressive disease with a reported incidence rate from 4.5% to 8.8% in men over 55 years of age. The diagnosis is usually made clinically, but for treatment planning and control, imaging of the peripheral arteries is required. Since its introduction in 1994, contrast-enhanced MR angiography has demonstrated a high diagnostic confidence and has replaced the invasive intra-arterial DSA, which is still the current gold standard for many different indications. For the peripheral arteries, clinical use of MR angiography was hampered for some years by the unsolved problem of the large imaging volume and the small diameter of the distal arteries. However, since the availability of ultra-fast high-gradient sequences and the possibility of moving-bed imaging, contrast-enhanced MR angiography, over the last few years, has shown its enormous potential and high accuracy in the diagnosis and follow-up of patients suffering from peripheral arterial occlusive disease. Exciting innovations in hardware and software allows very fast, very accurate, and very robust noninvasive imaging of the peripheral arteries, and both treatment planning as well as follow-up can be performed using contrast-enhanced MR angiography. The following review introduces the basic concepts of peripheral MR angiography--focusing on contrast enhanced imaging--and presents the different techniques as well as some potential limitations and how they could be solved. Finally, this article provides a look into the already-begun future of peripheral contrast-enhanced MR angiography with hybrid and combination techniques.
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Affiliation(s)
- Christian Loewe
- Department of Radiology, Section of Angiography and Interventional Radiology, University of Vienna, Vienna, Austria.
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Spuentrup E, Manning WJ, Börnert P, Kissinger KV, Botnar RM, Stuber M. Renal arteries: navigator-gated balanced fast field-echo projection MR angiography with aortic spin labeling: initial experience. Radiology 2002; 225:589-96. [PMID: 12409599 DOI: 10.1148/radiol.2252011366] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A cardiac-triggered free-breathing three-dimensional balanced fast field-echo projection magnetic resonance (MR) angiographic sequence with a two-dimensional pencil-beam aortic labeling pulse was developed for the renal arteries. For data acquisition during free breathing in eight healthy adults and seven consecutive patients with renal artery disease, real-time navigator technology was implemented. This technique allows high-spatial-resolution and high-contrast renal MR angiography and visualization of renal artery stenosis without exogenous contrast agent or breath hold. Initial promising results warrant larger clinical studies.
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Affiliation(s)
- Elmar Spuentrup
- Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass., USA.
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Spuentrup E, Buecker A, Meyer J, Günther RW, Stuber M. Navigator-gated free-breathing 3D balanced FFE projection renal MRA: Comparison with contrast-enhanced breath-hold 3D MRA in a swine model. Magn Reson Med 2002; 48:739-43. [PMID: 12353294 DOI: 10.1002/mrm.10271] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A cardiac-triggered, free-breathing, 3D balanced FFE projection renal MR angiography (MRA) technique with a 2D pencil beam aortic labeling pulse for selective aortic spin tagging was developed. For respiratory motion artifact suppression during free breathing, a prospective real-time navigator was implemented for renal MRA. Images obtained with the new approach were compared with standard contrast-enhanced (CE) 3D breath-hold MRA in seven swine. Signal properties and vessel visualization were analyzed. With the presented technique, high-resolution, high-contrast renal projection MRA with superior vessel length visualization (including a greater visible number of distal branches of the renal arteries) compared to standard breath-hold CE-MRA was obtained. The present results warrant clinical studies in patients with renal artery disease.
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Affiliation(s)
- Elmar Spuentrup
- Department of Diagnostic Radiology, Technical University of Aachen, Germany.
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24
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Krings T, Hans FJ, Möller-Hartmann W, Thiex R, Brunn A, Scherer K, Stein KP, Meetz A, Dreeskamp H, Allery E, Thron A. Time-of-flight-, phase contrast and contrast enhanced magnetic resonance angiography for pre-interventional determination of aneurysm size, configuration, and neck morphology in an aneurysm model in rabbits. Neurosci Lett 2002; 326:46-50. [PMID: 12052535 DOI: 10.1016/s0304-3940(02)00308-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We describe three different magnetic resonance (MR)-angiography techniques to evaluate aneurysm size, configuration, and neck morphology of experimentally created aneurysms in a rabbit model. In five New Zealand White rabbits an aneurysm was created by endovascular occlusion of the right common carotid artery (CCA) using a pliable balloon and subsequent endoluminal incubation of elastase within the proximal CCA above the balloon and distal ligation of the vessel. In all animals, time-of-flight (TOF), phase contrast and contrast enhanced (CE) MR angiographies (MRA) were performed and compared to conventional digital subtraction angiography results. We found, that aneurysms are best visualized employing CE MRA, however, neck morphology was also found to demonstrate interpretable results when evaluating the axial source data of the TOF MRA. The animal model we used can be employed for testing endovascular devices such as new coil material, or covered stents. The described MRA techniques might then be helpful for pre-interventional planning and maybe even for the follow-up of the thus treated aneurysms.
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Affiliation(s)
- Timo Krings
- Department of Neuroradiology, University Hospital of the University of Technology, Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany.
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25
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Bradbury MS, Kavanagh PV, Chen MY, Weber TM, Bechtold RE. Noninvasive assessment of portomesenteric venous thrombosis: current concepts and imaging strategies. J Comput Assist Tomogr 2002; 26:392-404. [PMID: 12016369 DOI: 10.1097/00004728-200205000-00014] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Rapid, noninvasive imaging strategies, especially multidetector spiral CT and CT angiography (CTA) as well as gadolinium-enhanced MR angiography (MRA), have facilitated early diagnosis of splanchnic venous thrombosis, a potentially lethal cause of intestinal ischemia. Single breath-hold volumetric acquisitions permit superior temporal and contrast resolution while eliminating motion artifact and suppressing respiratory misregistration. Increased spatial resolution is aided by thinner slice collimation. These cross-sectional imaging techniques are becoming a preferred noninvasive alternative to conventional selective mesenteric angiography with delayed imaging for venous evaluation and should be considered the primary diagnostic modalities for evaluating patients with high clinical suspicion of nonsurgical mesenteric ischemia.
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Affiliation(s)
- Michelle S Bradbury
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1088, USA
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26
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Foo TK, Ho VB, Hood MN, Marcos HB, Hess SL, Choyke PL. High-spatial-resolution multistation MR imaging of lower-extremity peripheral vasculature with segmented volume acquisition: feasibility study. Radiology 2001; 219:835-41. [PMID: 11376279 DOI: 10.1148/radiology.219.3.r01jn11835] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A method of three-station three-dimensional magnetic resonance (MR) angiography of the lower extremities with segmented volume acquisition is presented. Three-dimensional MR angiographic data were acquired in two passes, with the central k-space views acquired during the arterial phase for the more proximal stations. This allowed a faster bolus injection rate and potentially improved visualization of the tibioperoneal arteries.
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Affiliation(s)
- T K Foo
- Applied Science Laboratory, GE Medical Systems, 600 N Wolfe St, Rm 110-MRI, Baltimore, MD 21287, USA.
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27
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Goyen M, Ruehm SG, Barkhausen J, Kröger K, Ladd ME, Truemmler KH, Bosk S, Requardt M, Reykowski A, Debatin JF. Improved multi-station peripheral MR angiography with a dedicated vascular coil. J Magn Reson Imaging 2001; 13:475-80. [PMID: 11241825 DOI: 10.1002/jmri.1069] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Delineation of small branch vessels can be crucial for assessing the peripheral arterial system of patients requiring surgical grafting. Thus signal-to-noise needs to be maximized. We evaluated the performance of a dedicated peripheral vascular coil in four subjects by comparing it to the body coil using DSA as the standard of reference. SNR and CNR values of the dedicated peripheral coil exceeded those obtained with the body coil by a mean of 398%, thus permitting improved delineation of the infrapopliteal arterial morphology.
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Affiliation(s)
- M Goyen
- Department of Diagnostic Radiology, University Hospital Essen, Essen, Germany.
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28
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Abstract
Technological breakthroughs have advanced the fields of urology, radiology, and minimally invasive surgery. Today, the various imaging modalities are increasingly applied to guiding therapy. Among the procedures now in use or under development are percutaneous cyst drainage or sclerotherapy; tissue ablation with high-intensity focused ultrasound, cold, heat, or photon radiation; and conformal radiation and brachytherapy. As current limitations are overcome, image-guided therapy will expand.
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Affiliation(s)
- D Y Chan
- Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland 21218, USA
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29
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Kellar KE, Fujii DK, Gunther WH, Briley-Saebø K, Bjørnerud A, Spiller M, Koenig SH. NC100150 Injection, a preparation of optimized iron oxide nanoparticles for positive-contrast MR angiography. J Magn Reson Imaging 2000; 11:488-94. [PMID: 10813858 DOI: 10.1002/(sici)1522-2586(200005)11:5<488::aid-jmri4>3.0.co;2-v] [Citation(s) in RCA: 121] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
A preparation of monocrystalline iron oxide nanoparticles with an oxidized starch coating, currently in clinical trials (NC100150 Injection; CLARISCAN), was characterized by magnetization measurements, relaxometry, and photon correlation spectroscopy. By combining the results with a measure of iron content, one can obtain the size and magnetic attributes of the iron cores, including the relevant correlation times for outer sphere relaxation (tau(SO) and tau(D)), and information about the interaction of the organic coating with both core and solvent. The results are 6.43 nm for the iron oxide core diameter, a magnetic moment of 4.38x10(-17) erg/G, and a water-penetrable coating region of oxidized oligomeric starch fragments and entrained water molecules. The latter extends the hydrodynamic diameter to 11.9 nm and lowers the average diffusivity of solvent about 64% (which increases tau(D) accordingly). The nanoparticles show little size-polydispersity, evidenced by the lowest value of r(2)/r(1) at 20 MHz reported to date, an asset for magnetic resonance angiography.
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Affiliation(s)
- K E Kellar
- Nycomed Amersham Imaging, Wayne, Pennsylvania 19087-8630, USA
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30
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Clarke SE, Weinmann HJ, Dai E, Lucas AR, Rutt BK. Comparison of two blood pool contrast agents for 0.5-T MR angiography: experimental study in rabbits. Radiology 2000; 214:787-94. [PMID: 10715047 DOI: 10.1148/radiology.214.3.r00mr25787] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate two experimental blood pool agents for potential use in equilibrium phase abdominal magnetic resonance (MR) angiography. MATERIALS AND METHODS MR imaging at 0.5 T was performed in 37 rabbits before and after intravenous injection of a gadolinium-based blood pool contrast agent (SH L 643 A), superparamagnetic iron oxide blood pool agent (SH U 555 C), or gadopentetate dimeglumine. T1-weighted fast spoiled gradient-echo images from the renal arteries to below the iliac bifurcation were obtained. The aorta-to-tissue signal difference-to-noise ratio (SDNR) was measured over time. RESULTS Both blood pool agents yielded excellent demonstration of the rabbit abdominal aorta. At a dose of 0.1 mmol/kg, both provided a statistically significant increase in aorta-to-tissue SDNR in comparison with that achieved with gadopentetate dimeglumine (200% increase for SH L 643 A, 95% increase for SH U 555 C; P < .05). A 0.1 mmol/kg dose of SH L 643 A provided a 24% increase in SDNR relative to the increase with a 0.37 mmol/kg dose of gadopentetate dimeglumine. Time-dependent enhancement properties of the blood pool agents differed due to differences in elimination method. CONCLUSION Both blood pool agents were found to be promising contrast agents for 0.5-T MR angiography; however, their clinical applicability warrants further investigation. The gadolinium-based agent had several advantages over the iron oxide compound, including less T2* dephasing, lack of susceptibility artifacts, and fast renal elimination.
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Affiliation(s)
- S E Clarke
- Robarts Research Institute, Imaging Research Laboratories, London, Ontario, Canada
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31
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Naganawa S, Ito T, Iwayama E, Fukatsu H, Ishiguchi T, Ishigaki T, Ichinose N. Magnitude subtraction vs. complex subtraction in dynamic contrast-enhanced 3D-MR angiography: basic experiments and clinical evaluation. J Magn Reson Imaging 1999; 10:813-20. [PMID: 10548793 DOI: 10.1002/(sici)1522-2586(199911)10:5<813::aid-jmri28>3.0.co;2-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Magnitude subtraction and complex subtraction in dynamic contrast-enhanced three-dimensional magnetic resonance (3D-MR) angiography were compared using a phantom and 23 human subjects. In phantom studies, complex subtraction showed far better performance than magnitude subtraction, especially for longer echo times, with thicker slices, and without fat suppression. With complex subtraction, non-fat-suppressed studies showed contrast-to-noise ratios comparable to those in fat-suppressed studies. In human subjects, complex subtraction was superior to magnitude subtraction in 9 subjects, but comparable to magnitude subtraction in 14 subjects. There were no cases in which magnitude subtraction was superior to complex subtraction. Although the differences observed in human studies when complex subtraction was applied with thinner slices, shorter echo times, and the fat-suppression technique were not as pronounced as those seen in phantom studies, complex subtraction should be performed in dynamic contrast-enhanced 3D-MR angiography because there are no drawbacks in complex subtraction. Further research is necessary to assess the feasibility of dynamic contrast-enhanced 3D-MR angiography without fat suppression in human subjects using complex subtraction, as suggested by the results of phantom studies. If it is found to be feasible, dynamic contrast-enhanced 3D-MR angiography without fat suppression using complex subtraction may prove to be a robust technique that eliminates the need for shimming and can reduce the acquisition time. J. Magn. Reson. Imaging 1999;10:813-820.
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Affiliation(s)
- S Naganawa
- Department of Radiology, Nagoya University School of Medicine, Nagoya 466-8550, Japan.
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32
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Dong Q, Schoenberg SO, Carlos RC, Neimatallah M, Cho KJ, Williams DM, Kazanjian SN, Prince MR. Diagnosis of renal vascular disease with MR angiography. Radiographics 1999; 19:1535-54. [PMID: 10555673 DOI: 10.1148/radiographics.19.6.g99no041535] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Renal magnetic resonance (MR) angiography allows accurate evaluation of patients suspected to have renal artery stenosis without the risks associated with nephrotoxic contrast agents, ionizing radiation, or arterial catheterization. Other applications of renal MR angiography are mapping the vascular anatomy for planning renal revascularization, planning repair of abdominal aortic aneurysms, assessing renal bypass grafts and renal transplant anastomoses, and evaluating vascular involvement by renal tumors. A variety of pulse sequences provide complementary information about kidney morphology, arterial anatomy, blood flow, and renal function and excretion. Three-dimensional gadolinium-enhanced MR angiography can be combined with several other sequences to produce a comprehensive approach to renal MR angiography. This comprehensive approach is designed to allow hemodynamic characterization of renal artery stenosis with a single MR imaging examination that can be easily completed in 1 hour. Three-dimensional gadolinium-enhanced MR angiography demonstrates the renal arteries along with the abdominal aorta, iliac arteries, and mesenteric arteries in a 20-30-second acquisition that can be performed during breath holding. Numerous projections are reconstructed from a single three-dimensional volume of data acquired with a single injection of contrast material to obtain perpendicular and optimized views of each renal artery.
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Affiliation(s)
- Q Dong
- Department of Radiology, Weill Medical College, Cornell University, New York, NY 10021, USA
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33
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Lin CW, Lee RC, Cheng HC, Soong TC, Ko JS, Teng MM. MR angiography of persistent sciatic artery. J Vasc Interv Radiol 1999; 10:1119-21. [PMID: 10496717 DOI: 10.1016/s1051-0443(99)70201-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- C W Lin
- Department of Radiology, Veterans General Hospital-Taipei, Taiwan, Republic of China
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34
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Abstract
The purpose of this review is to outline recent developments in contrast agents for magnetic resonance angiography (MRA) and to give some idea of what the future might hold. Up to now, non-binding gadolinium (Gd) chelates have been the agents used for MRA. Modified paramagnetic Gd-based agents with varying degrees of protein interaction have been developed, and these, together with new superparamagnetic compounds, are currently under clinical evaluation. It is likely that two different types of contrast agent will soon be available: extracellular agents for first-pass MRA and intravascular agents mainly for steady-state MRA. Several agents also exhibit certain tissue specific properties in addition to conventional extracellular properties. This will lead to more comprehensive imaging approaches.
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Affiliation(s)
- M V Knopp
- Department of Radiology, German Cancer Research Center, 69120 Heidelberg, Germany.
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35
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Noninvasive Diagonsis of Renal Artery Stenosis: Which Test to Use When. J Vasc Interv Radiol 1999. [DOI: 10.1016/s1051-0443(99)71073-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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