Application of TWIST MR angiography to aid successful central venous access in challenging patients: initial single-centre experience.

AIM To investigate whether time-resolved angiography with interleaved stochastic trajectories (TWIST) with GeneRalised Autocalibrating Partially Parallel Acquisitions (GRAPPA) parallel acquisition could be used successfully to non-invasively and efficiently image patients with more complex vascular access issues. MATERIALS AND METHODS TWIST magnetic resonance angiography (MRA) in the GRAPPA algorithm was performed on 15 patients at our centre using the 1.5 T Siemens Magnetom Avanto MRI system. Images were interpreted by cardiac radiologists. RESULTS TWIST provided excellent dynamic imaging of the venous system, demonstrating venous occlusion, stenoses, and collaterals, as well as providing good anatomical detail. CONCLUSION TWIST MRA enables successful identification of candidate sites for central/tunnelled line access, whilst diagnosing complications of long-term access such as venous thrombosis or congenital venous anomalies.

[1]  L. Lönn,et al.  Endovascular aneurysm repair: state-of-art imaging techniques for preoperative planning and surveillance. , 2009, The Journal of cardiovascular surgery.

[2]  G. Laub,et al.  3D Time-Resolved MR Angiography (MRA) of the Carotid Arteries with Time-Resolved Imaging with Stochastic Trajectories: Comparison with 3D Contrast-Enhanced Bolus-Chase MRA and 3D Time-Of-Flight MRA , 2008, American Journal of Neuroradiology.

[3]  E. Merkle,et al.  Respiratory‐Gated Noncontrast SPACE MR Angiography Sequence at 3T for Evaluation of the Central Veins of the Chest: A Feasibility Study , 2015, Journal of magnetic resonance imaging : JMRI.

[4]  N. Rofsky,et al.  Three-dimensional gadolinium-enhanced MR venographic evaluation of patency of central veins in the thorax: initial experience. , 1999, Radiology.

[5]  E. Hecht,et al.  Dynamic MR angiography of upper extremity vascular disease: pictorial review. , 2008, Radiographics : a review publication of the Radiological Society of North America, Inc.

[6]  I. Baumgartner,et al.  Consensus Document of the International Union of Angiology (IUA)-2013. Current concept on the management of arterio-venous management. , 2013, International angiology : a journal of the International Union of Angiology.

[7]  F. Ebner,et al.  Feasibility of Noninvasive Diagnosis and Treatment Planning in a Case Series with Carotid-Cavernous Fistula using High-Resolution Time-Resolved MR-Angiography with Stochastic Trajectories (TWIST) and Extended Parallel Acquisition Technique (ePAT 6) at 3 T , 2015, Clinical Neuroradiology.

[8]  R. Zhai,et al.  Three-dimensional gadolinium-enhanced MR venography to evaluate central venous steno-occlusive disease in hemodialysis patients. , 2012, Clinical radiology.

[9]  H. Ersoy The role of noninvasive vascular imaging in splanchnic and mesenteric pathology. , 2009, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[10]  J. Asquith,et al.  Imaging and management of complications of central venous catheters. , 2013, Clinical radiology.

[11]  U. Klose,et al.  Double Bolus Application in TWIST-MR-Angiography of the Cervical Arteries , 2012, Radiology research and practice.

[12]  G. Becker,et al.  Digital subtraction venography in central venous obstruction. , 1986, AJR. American journal of roentgenology.

[13]  J. Varghese,et al.  Evaluation of dynamic gadolinium-enhanced breath-hold MR angiography in the diagnosis of renal artery stenosis. , 1999, AJR. American journal of roentgenology.

[14]  M. Mauro,et al.  Radiologic placement of long-term central venous catheters: a review. , 1993, Journal of vascular and interventional radiology : JVIR.

[15]  H. Quick,et al.  Contrast-enhanced time-resolved 4D MRA of congenital heart and vessel anomalies: image quality and diagnostic value compared with 3D MRA , 2013, European Radiology.

[16]  D. DeLong,et al.  Central veins of the chest: evaluation with time-resolved MR angiography. , 2008, Radiology.

[17]  H. Abujudeh,et al.  Current status of nephrogenic systemic fibrosis. , 2014, Clinical radiology.

[18]  J Paul Finn,et al.  Time-resolved MR angiography in the evaluation of central thoracic venous occlusive disease. , 2009, AJR. American journal of roentgenology.