Noncontrast Magnetic Resonance Angiography Using Inflow Sensitive Inversion Recovery Technique for Vascular Evaluation in Pre–liver Transplantation Recipients

Chen, W.-T.; Liang, Jiun Lung; Chen, Ming Hong; Liao, Chien-Chang; Huang, Tung‐Liang; Chen, T.-Y.; Tsang, Leo Leung-Chit; Ou, Hsin‐You; Hsu, Hsien‐Wen; Lazo, M.; Chen, C.-L.; Cheng, Yu‐Fan

doi:10.1016/j.transproceed.2015.12.083

Cited by 7 publications

(7 citation statements)

References 18 publications

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“…A recent study using IFIR MRA for vascular evaluation in pre‐LT recipients also revealed satisfactory vascular architecture image quality compared with contrast‐enhanced MRA . One of our previous studies even revealed that IFIR MRA provided better contrast‐to‐noise ratios and imaging quality in larger‐sized vessels, such as the IVC and PV, compared with contrast‐enhanced MRA . To the best of our knowledge, our study is the first study of the practical application of IFIR MRA in LT recipients as a substitute imaging modality for contrast‐enhanced CTA or MRA, and the first comparison of vascular architecture with intraoperative findings.…”

Section: Discussionsupporting

confidence: 56%

“…In recent publications, the inflow‐sensitive inversion recovery (IFIR) technique in MRA without the use of contrast medium and without the necessity for breath holding showed reproducible and promising results for the evaluation of renal, hepatic, and upper and lower extremity vessels . Prior study using IFIR MRA for pre‐LT vascular evaluation showed an even better contrast‐to‐noise ratio and imaging quality in larger‐sized vessels, such as the inferior vena cava (IVC) and portal veins (PVs), using IFIR MRA compared with using contrast‐enhanced MRA …”

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confidence: 99%

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Noncontrast Magnetic Resonance Angiography Clinical Application in Pre–Liver Transplant Recipients With Impaired Renal Function

Huang¹,

Liao²,

Chen³

et al. 2020

Liver Transpl

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Image evaluation of the vascular architecture is essential before living donor liver transplantation (LDLT). However, the use of contrast-enhanced study in recipients with impaired renal function is limited due to the risk of acute kidney injury and nephrogenic systemic fibrosis. Therefore, a contrast medium-free method is both valuable and necessary for preoperative vascular evaluation. Recent literature reported inflow-sensitive inversion recovery (IFIR) magnetic resonance angiography (MRA) without the use of a contrast medium to be a reproducible and noninvasive tool to assess hepatic vasculature with adequate-to-good image quality. The purpose of this study is to clinically apply IFIR MRA preoperatively in LDLT recipients. We retrospectively reviewed 31 LDLT recipients with renal function impairment from March 2013 to August 2018 who received IFIR MRA as a pretransplant vascular architecture evaluation and who underwent a subsequent LDLT. The image findings were assessed for subjective image quality and were compared with intraoperative findings. Our results showed that the pretransplant vascular anatomy was well correlated with intraoperative findings in all recipients. Successful ratings with image quality scores ≥2 for proper hepatic arteries (PHAs), portal veins, and inferior vena cavas (IVCs) were 100.0%, 96.8%, and 93.5%, respectively. Readable ratings with imaging quality score ≥1 for left and right hepatic arteries and gastroepiploic arteries were 83.9%, 96.7%, and 22.6%, respectively. We also found that recipients with higher Model for End-Stage Liver Disease scores (>23) had lower image quality scores for PHAs (P = 0.003) and IVCs (P = 0.046). However, images were still satisfactory for pre-liver transplantation (LT) vascular evaluation. In conclusion, in pre-LT recipients with impaired renal function, IFIR MRA is a feasible and reproducible image modality.Liver Transplantation 26 196-202 2020 AASLD.

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Section: Discussionsupporting

confidence: 56%

mentioning

confidence: 99%

Noncontrast Magnetic Resonance Angiography Clinical Application in Pre–Liver Transplant Recipients With Impaired Renal Function

Huang¹,

Liao²,

Chen³

et al. 2020

Liver Transpl

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“…The unenhanced respiratory-gated magnetization-prepared three-dimensional (3D) steady-state-free-precession (SSFP) inflow-sensitive inversion recovery (IFIR) technique in MRA has recently showed reproducible and promising results in the evaluation of upper abdomen arteries. It uses a preparatory inversion pulse to reduce signals from static tissue, while leaving inflow arterial blood unaffected, resulting in sparse arterial vasculature on modest tissue background [8,9].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Inflow Inversion Recovery (IFIR) for Upper Abdominal Arteries Evaluation: Comparison with Contrast-Enhanced MR and CTA

et al. 2022

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Background: Inflow-sensitive inversion recovery (IFIR) is a recently introduced technique to perform unenhanced magnetic resonance angiography (MRA). The purpose of our study is to determine the accuracy of IFIR-MRA in the evaluation of upper abdominal arteries, compared to standard MRA and computed tomography angiography (CTA). Materials and Methods: Seventy patients undergoing upper abdomen Magnetic Resonance Imaging (MRI) in different clinical settings were enrolled. The MRI protocol included an IFIR-MRA sequence that was intra-individually compared by using a qualitative 4-point scale in the same patients who underwent concomitant or close MRA (n = 65) and/or CTA (n = 44). Celiac trunk (CA), common-proper-left-right hepatic artery (C-P-L-R-HA), left gastric artery (LGA), gastroduodenal artery (GDA), splenic artery (SA), renal arteries (RA) and superior mesenteric artery (SMA) were assessed. Results: IFIR-MRA images were better rated in comparison with MRA. Particularly, all arteries obtained a statistically significant higher qualitative rating value (all p < 0.05). IFIR-MRA and MRA exhibited acceptable intraclass correlation coefficients (ICC) values for CA, C-L-R-HA, and SMA (ICC 0.507, 0.591, 0.615, 0.570, 0.525). IFIR-MRA and CTA showed significant correlations in C-P-L-R-HA (τ = 0.362, 0.261, 0.308, 0.307, respectively; p < 0.05), and in RA (τ = 0.279, p < 0.05). Conclusions: Compared to MRA, IFIR-MRA demonstrated a higher image quality in the majority of upper abdomen arterial vessels assessment. LHA and RHA branches could be better visualized with IFIR sequences, when visualizable. Based on these findings, we suggest to routinely integrate IFIR sequences in upper abdomen MRI studies.

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“…The three-dimensional (3D) non-CE MRA is acquired by IFIR (inflow-sensitive inversion recovery) by choosing an optimal inversion time and proper positioning of the tagging pulse to suppress unwanted blood flow signal; as such, this sequence delineates the hepatic arteries, portal veins, and hepatic veins separately without overlapping, which allows clearer interpretation of each vessel [ 16 ]. In addition, by using the non-CE MRA technique, particularly when other imaging studies have failed to provide detailed vascular anatomy, the technique can even be repeated and will still reduce contrast medium injections.…”

Section: Introductionmentioning

confidence: 99%

Non-Contrast-Enhanced and Contrast-Enhanced Magnetic Resonance Angiography in Living Donor Liver Vascular Anatomy

Liao

Chen

et al. 2022

Diagnostics

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Background: Since the advent of a new generation of inflow-sensitive inversion recovery (IFIR) technology, three-dimensional non-contrast-enhanced magnetic resonance angiography is being used to obtain hepatic vessel images without applying gadolinium contrast agent. The purpose of this study was to explore the diagnostic efficacy of non-contrast-enhanced magnetic resonance angiography (non-CE MRA), contrast-enhanced magnetic resonance angiography (CMRA), and computed tomography angiography (CTA) in the preoperative evaluation of living liver donors. Methods: A total of 43 liver donor candidates who were evaluated for living donor liver transplantation completed examinations. Donors’ age, gender, renal function (eGFR), and previous CTA and imaging were recorded before non-CE MRA and CMRA. CTA images were used as the standard. Results: Five different classifications of hepatic artery patterns (types I, III, V, VI, VIII) and three different classifications of portal vein patterns (types I, II, and III) were identified among 43 candidates. The pretransplant vascular anatomy was well identified using combined non-CE MRA and CMRA of hepatic arteries (100%), PVs (98%), and hepatic veins (100%) compared with CTA images. Non-CE MRA images had significantly stronger contrast signal intensity of portal veins (p < 0.01) and hepatic veins (p < 0.01) than CMRA. No differences were found in signal intensity of the hepatic artery between non-CE MRA and CMRA. Conclusion: Combined non-CE MRA and CMRA demonstrate comparable diagnostic ability to CTA and provide enhanced biliary anatomy information that assures optimum donor safety.

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Noncontrast Magnetic Resonance Angiography Using Inflow Sensitive Inversion Recovery Technique for Vascular Evaluation in Pre–liver Transplantation Recipients

Cited by 7 publications

References 18 publications

Noncontrast Magnetic Resonance Angiography Clinical Application in Pre–Liver Transplant Recipients With Impaired Renal Function

Noncontrast Magnetic Resonance Angiography Clinical Application in Pre–Liver Transplant Recipients With Impaired Renal Function

Accuracy of Inflow Inversion Recovery (IFIR) for Upper Abdominal Arteries Evaluation: Comparison with Contrast-Enhanced MR and CTA

Non-Contrast-Enhanced and Contrast-Enhanced Magnetic Resonance Angiography in Living Donor Liver Vascular Anatomy

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