Mesenteric circulation: three-dimensional MR angiography with a gadolinium-enhanced multiecho gradient-echo technique.

Abstract

To evaluate the mesenteric circulation with magnetic resonance (MR) angiography, the authors examined 16 individuals (12 patients, four volunteers) with a gadolinium-enhanced, breath-hold, fat-saturated, multiecho, three-dimensional, gradient-echo sequence. Twenty examinations were performed. Grades of 3 or 4 (on a five-point scale [4 = best seen, 0 = not seen]) were applicable to 17 (85%) of 20 MR angiograms obtained in superior mesenteric artery trunks, 15 (75%) in celiac arteries, five (25%) in inferior mesenteric arteries; 15 (75%) of first-order branching, 12 (60%) of second-order branching, and 10 (50%) of third-order branching; 17 (85%) in superior mesenteric veins; and 17 (85%) in portal veins. MR angiography with this technique depicted the mesenteric arterial and venous circulation and the portal vein with excellent resolution in a short time.

Detection of Thrombosis in the Portal Venous System: Comparison of Contrast-enhanced MR Angiography with Intraarterial Digital Subtraction Angiography

“…Recently, the use of gadolinium-enhanced MR angiography for the depiction of the portal venous system has been advocated (6,17,18). Rodgers et al (6) compared dynamic contrast-enhanced breath-hold two-dimensional fast lowangle shot MR angiography with intraarterial DSA in 18 patients for the evaluation not only of the portal vein but also of the splenic and superior mesenteric veins.…”

Comparing Contrast-Enhanced Breath-Hold MR Angiography and Conventional Angiography

“…The first abdominal applications of breath-hold gadolinium-enhanced MR angiography were the aorta and the renal arteries [3,7,25]. The results of this method in the study of the mesenteric, hepatic, and portal vessels have rarely been evaluated [9][10][11][12]14].…”

“…Breath-hold MR angiography limits motion artifacts [3] and has proven reliable for evaluation of the renal arteries [6][7][8]. With fast MR angiography it is possible to obtain angiograms during the arterial and venous phases of the contrast medium injection by using several acquisitions repeated at short intervals [9]. Gadolinium-enhanced breath-hold MR angiography has recently been used to evaluate the mesenteric circulation [9][10][11][12][13][14][15][16], but to our knowledge only a few studies have compared its results with those of conventional angiography [11,14].…”

Non-invasive evaluation of the visceral arteries with magnetic resonance angiography

“…Angiographically, the demonstration of significant stenoses ( > 50 %) in two or more of the three main mesenteric vessels in the appropriate clinical setting establishes the diagnosis; however, in practice the SMA is almost severely narrowed ( > 90 %) or occluded [1±8]. Catheter angiography, traditionally the only method by which the diagnosis could be established, has now been relegated to a secondary role in departments with access to high-quality MRA [12±16, 22,23].…”

“…Therefore, it appears that CE MRA is the most accurate method for evaluating visceral artery anatomy, and in many department CE MRA has completely supplanted conventional arteriography for the diagnosis of mesenteric ischaemia. Images acquired with CE MRA [22,23] or 3D PC MRA [12] provide anatomical information only and give no clue as to the functional significance of the lesions demonstrated. To assess visceral function Li et al evaluated a cine-2D PC technique to determine changes in baseline SMA flow 15, 30 and 45 min after ingestion of a standard meal [13].…”