Gadolinium-enhanced magnetic resonance angiography of abdominal aortic aneurysms

• Published in: Journal of vascular surgery Vol. 21; no. 4; pp. 656 - 669
• Main Authors: Prince, Martin R., Narasimham, Dasika L., Stanley, James C., Wakefield, Thomas W., Messina, Louis M., Zelenock, Gerald B., Jacoby, William T., Marx, M.Victoria, Williams, David M., Cho, Kyung J.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.04.1995; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Angiography; Aorta, Abdominal - diagnostic imaging; Aorta, Abdominal - pathology; Aortic Aneurysm, Abdominal - diagnosis; Aortic Aneurysm, Abdominal - diagnostic imaging; Aortic Aneurysm, Abdominal - surgery; Aortic Diseases - diagnosis; Aortic Diseases - diagnostic imaging; Arterial Occlusive Diseases - diagnosis; Arterial Occlusive Diseases - diagnostic imaging; Biological and medical sciences; Cardiovascular system; Celiac Artery - diagnostic imaging; Celiac Artery - pathology; Contrast Media; Female; Gadolinium; Humans; Iliac Artery - diagnostic imaging; Iliac Artery - pathology; Image Enhancement; Investigative techniques, diagnostic techniques (general aspects); Lumbar Vertebrae - blood supply; Magnetic Resonance Angiography; Male; Medical sciences; Mesenteric Arteries - diagnostic imaging; Mesenteric Arteries - pathology; Middle Aged; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Renal Artery - diagnostic imaging; Renal Artery - pathology; Sensitivity and Specificity; Tomography, X-Ray Computed; Ultrasonography; Human; Radiodiagnosis; Angiography; Aneurysm; Cardiovascular disease; Exploration; Gadolinium; Nuclear magnetic resonance imaging; Arterial disease; Vascular disease; Abdominal aorta; Preoperative; Aortic disease; Contrast media
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/S0741-5214(95)70197-4

Purpose: The objective of this study was to assess the usefulness of gadolinum-enhanced magnetic resonance angiography (MRA) for defining anatomic features relevant to performing aortic surgery for aneurysmal disease. Methods: Anatomic data defined by MRA, including abdominal aortic aneurysm (AAA) size and character, as well as the status of the celiac, mesenteric, renal, and iliac arteries, were correlated with angiography, ultrasonography, computed tomography, or operative data in 43 patients. Five MRA sequences were obtained in an hour-long examination optimized for aortoiliac, splanchnic, and renal artery imaging at 1.5 T in a body coil. Four of the sequences were performed during or after infusion of gadolinium to improve image quality. Results: MRA correctly defined the maximum aneurysm diameter, as well as its proximal and distal extent in all patients. MRA detected 33 of 35 significant stenoses among 153 splanchnic, renal, or iliac branches examined (sensitivity = 94% and specificity = 98%). MRA did not resolve the degree of aortic branch stenotic disease sufficiently to precisely grade its severity. MRA did not reliably define the status of the inferior mesenteric artery, lumbar arteries or internal iliac arteries. One ruptured AAA and one inflammatory AAA were correctly diagnosed by MRA. No patient had a contrast reaction or contrast-induced renal toxicity related to administration of gadolinium. Conclusion: Gadolinium-enhanced MRA of AAA provides appropriate, essential anatomic information for aortic reconstructive surgery in a 1-hour examination devoid of contrast-related renal toxicity or catheterization-related complications attending conventional arteriography. (J V ASC S URG 1995;21:656-69.)