3D Gadolinium-enhanced MRI Venography: Evaluation of Central Chest Veins and Impact on Patient Management

Noncontrast 3D Steady State Free Precession Magnetic Resonance Angiography of the Thoracic Central Veins Using Nonselective Radiofrequency Excitation Over a Large Field of View

“…[1][2][3] This technique is invasive and can only assess one single venous drainage system for each injection, and the major draining vessels, such as the internal jugular veins, remain inaccessible even if contrast material is injected simultaneously in both upper limbs. 4,5 Color Doppler ultrasonography of the neck and chest veins is a useful bedside technique, but overlying osseous and lung parenchyma hinder reliable assessment of the brachiocephalic veins and superior vena cava (SVC). 4 Contrast-enhanced (CE) computed tomography venography is increasingly used to evaluate central thoracic veins, 6,7 but the technique requires higher contrast dose, correct timing for adequate opacification of veins, and ideally contrast injection from both antecubital fossa.…”

“…4,5 Color Doppler ultrasonography of the neck and chest veins is a useful bedside technique, but overlying osseous and lung parenchyma hinder reliable assessment of the brachiocephalic veins and superior vena cava (SVC). 4 Contrast-enhanced (CE) computed tomography venography is increasingly used to evaluate central thoracic veins, 6,7 but the technique requires higher contrast dose, correct timing for adequate opacification of veins, and ideally contrast injection from both antecubital fossa. Similar to conventional venography, computed tomography is also associated with exposure to ionizing radiation and nephrotoxic iodinated contrast material.…”

Vascular CT and MRI: a practical guide to imaging protocols

“…The most common reason for dedicated imaging of the thoracic venous circulation is in the evaluation of suspected superior vena cava (SVC) obstruction or thrombosis. Contrast-enhanced MR venography (CE-MRV) allows better differentiation of intraluminal thrombus from contrast mixing than CT venography (CTV), is equivalent to conventional venography in the assessment of central venous obstruction and is the non-invasive imaging modality of choice (CT SVC, Table 1 ; MR SVC, Table 2 ) [ 113 , 114 ]. In patients who have difficulty with breath-holding, the post-contrast imaging can be performed free-breathing with respiratory gated navigator MRA [ 115 ].…”

Time‐resolved MR venography of the pulmonary veins precatheter‐based ablation for atrial fibrillation

“…Contrast-enhanced MRA (CE-MRA) can visualize the left atrium and pulmonary veins with high spatial resolution, which enables accurate measurement of pulmonary vein ostia to be made with depiction of their relationship to other structures (1,5). CE-MRA has been shown to be as sensitive and specific for showing stenoses and occlusions as conventional CT angiography (15)(16)(17)(18). Unfortunately, conventional 3D gradient echo sequences have relatively long acquisition times which necessitates that the gadolinium-based contrast agent (GBCA) bolus injection be long and large enough to ensure adequate visualization of the left atrium and pulmonary vein complex (LA-PV complex).…”