Abdominal aortic aneurysm. Detection of multilevel vascular pathology by time-resolved multiphase 3D gadolinium MR angiography: initial report.

OBJECTIVE To evaluate multiphasic 3D gadolinium-enhanced magnetic resonance angiography (3D-Gd-MRA) for detection of vascular pathology at multiple levels of the aorta and iliac arteries. METHODS In 18 patients with abdominal aortic aneurysm (n = 13), dissection (n = 3), or both (n = 2), multiphase 3D-Gd-MRA was performed acquiring five consecutive (6.8 seconds) 3D data sets in a single breath-hold. In each of the five time-resolved phases, vessel visibility of the abdominal aortic branches and iliac arteries was assessed. The extent of vessel involvement by the aneurysm or dissection seen on multiphase 3D-Gd-MRA was compared with standard imaging and surgical findings. Digital subtraction angiography was available for comparison in 4 cases, CT angiography in 10 cases. RESULTS Due to the delayed filling of the aortic aneurysm, the proximal aortic branches and the aneurysm neck demonstrated an inversely related enhancement compared with the distal abdominal and iliac vessels (P < 0.001). Review of all five phases of multiphase 3D-Gd-MRA allowed optimal visualization of each vessel segment without any artifacts due to parenchymal or venous overlay. In dissections, review of three phases was required (P < 0.001) for diagnostic evaluation of the true and false lumens. Substantially more vessel involvement was detected on multiphase 3D-Gd-MRA; this was surgically confirmed in 10 of 11 cases and affected therapy management in 11 of 18 cases. CONCLUSIONS Multiphase 3D-Gd-MRA is a convenient, robust, and safe technique for presurgical anatomic mapping of complex aortic aneurysms and dissections.

[1]  M. Bock,et al.  Renal arteries: optimization of three-dimensional gadolinium-enhanced MR angiography with bolus-timing-independent fast multiphase acquisition in a single breath hold. , 1999, Radiology.

[2]  Yi Tang,et al.  Gadolinium‐enhanced breath‐hold three‐dimensional time‐of‐flight MR angiography of the abdominal and pelvic vessels: The value of ultrafast MP‐RAGE sequences , 1997, Journal of magnetic resonance imaging : JMRI.

[3]  J. V. van Engelshoven,et al.  Peripheral vascular tree stenoses: evaluation with moving-bed infusion-tracking MR angiography. , 1998, Radiology.

[4]  D S Paik,et al.  Measurement of the aorta and its branches with helical CT. , 1998, Radiology.

[5]  G Kretschmer,et al.  Evaluation of abdominal aortic aneurysm for stent-graft placement: comparison of gadolinium-enhanced MR angiography versus helical CT angiography and digital subtraction angiography. , 1997, Radiology.

[6]  G D Rubin,et al.  Three-dimensional spiral computed tomographic angiography: an alternative imaging modality for the abdominal aorta and its branches. , 1993, Journal of vascular surgery.

[7]  J. Kaufman,et al.  Initial experience with endovascular aneurysm repair: comparison of early results with outcome of conventional open repair. , 1998, Journal of vascular surgery.

[8]  W. J. Matchett,et al.  Azotemia: gadopentetate dimeglumine as contrast agent at digital subtraction angiography. , 1996, Radiology.

[9]  T. Chenevert,et al.  Breath-hold gadolinium-enhanced MR angiography of the abdominal aorta and its major branches. , 1995, Radiology.

[10]  M V Knopp,et al.  Arterial-phase three-dimensional gadolinium magnetic resonance angiography of the renal arteries. Strategies for timing and contrast media injection: original investigation. , 1998, Investigative radiology.

[11]  S J Riederer,et al.  Fluoroscopically triggered contrast-enhanced three-dimensional MR angiography with elliptical centric view order: application to the renal arteries. , 1997, Radiology.

[12]  G C McKinnon,et al.  Breath-hold, contrast-enhanced, three-dimensional MR angiography. , 1996, Radiology.

[13]  G. White,et al.  Concurrent comparison of endoluminal versus open repair in the treatment of abdominal aortic aneurysms: analysis of 303 patients by life table method. , 1998, Journal of vascular surgery.

[14]  M. Prince.  Gadolinium-enhanced MR aortography. , 1990, Radiology.

[15]  Matthew S. Johnson,et al.  Three-dimensional gadolinium-enhanced MR angiography for aortoiliac inflow assessment plus renal artery screening in a single breath hold. , 1996, Radiology.

[16]  J. Debatin,et al.  Evaluation of the aortoiliac and renal arteries: comparison of breath-hold, contrast-enhanced, three-dimensional MR angiography with conventional catheter angiography. , 1997, Radiology.

[17]  P. Gevenois,et al.  Helical CT of aorta after endoluminal stent-graft therapy: value of biphasic acquisition. , 1998, AJR. American journal of roentgenology.

[18]  T K Foo,et al.  Contrast-enhanced abdominal MR angiography: optimization of imaging delay time by automating the detection of contrast material arrival in the aorta. , 1997, Radiology.

[19]  R Frayne,et al.  Time‐resolved contrast‐enhanced 3D MR angiography , 1996, Magnetic resonance in medicine.

[20]  J. Bakker,et al.  Renal artery stenosis and accessory renal arteries: accuracy of detection and visualization with gadolinium-enhanced breath-hold MR angiography. , 1998, Radiology.

[21]  D C Levin,et al.  Renal artery stenosis: CT angiography--comparison of real-time volume-rendering and maximum intensity projection algorithms. , 1999, Radiology.

[22]  M. Heller,et al.  Contrast‐enhanced, k‐space‐centered, breath‐hold MR angiography of the renal arteries and the abdominal aorta , 1997, Journal of magnetic resonance imaging : JMRI.

[23]  N M Rofsky,et al.  Thoracic aorta: comparison of gadolinium-enhanced three-dimensional MR angiography with conventional MR imaging. , 1997, Radiology.