Pulmonary magnetic resonance angiography

Hoffmann, Udo; Schima, Wolfgang; Herold, Christian

doi:10.1007/s003300050918

Cited by 15 publications

(7 citation statements)

References 74 publications

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“…MRA is a better choice than T1-weighted spin-echo MR for identifying PV [7] and generally requires less time because ECG-gating is not necessary on most scanners. New technical implementations have allowed routine use of MRA for imaging of the pulmonary vasculature [8]: the method can be safely applied to a very high percentage of patients, and absolute contraindications are rare.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance angiography virtual endoscopy in the assessment of pulmonary veins before radiofrequency ablation procedures for atrial fibrillation

Cirillo

Bonamini

Gaïta³

et al. 2004

Eur Radiol

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Magnetic resonance angiography (MRA) is a safe and non-invasive imaging method that can readily depict the pulmonary veins (PV), whose imaging has acquired momentum with the advent of new techniques for radiofrequency ablation of atrial fibrillation (AF). We evaluated whether virtual endoscopy from 3D MRA images (MRA-VE) is feasible in studying the morphology of PV. Fifty patients with AF underwent pre-ablative MRA (1.5 T). Images were acquired with axial T-2 weighted and 3D-SPGR sequences after intravenous administration of Gd-DTPA and automatic triggering. Postprocessing was performed by an experienced radiologist with maximum intensity projection (MIP) and virtual endoscopy software (Navigator, GEMS). The venoatrial junction was visualized with MRA-VE in 49 of 50 patients (98.0%). Twenty-seven patients (55.1%) had two ostia on both sides, 13 patients (26.5%) had two ostia on the right and a single common ostium on the left, 5 patients (10.2%) had accessory PV and 4 patients (8.2%) had both an accessory right PV and a single common ostium on the left. Flythrough navigation showed the number and spatial disposition of second-order PV branches in 48 out of 49 patients (98.0%). MRA-VE is an excellent tool for at-a-glance visualization of ostia morphology, navigation of second-generation PV branches and easy endoluminal assessment of left atrial structures in pre-ablative imaging.

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Section: Introductionmentioning

confidence: 99%

Magnetic resonance angiography virtual endoscopy in the assessment of pulmonary veins before radiofrequency ablation procedures for atrial fibrillation

Cirillo

Bonamini

Gaïta³

et al. 2004

Eur Radiol

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“…Newer advances of second generation multi-slice spiral computed tomography with more than four detector rows and rotation times below 500 ms, as well as the recently presented time-resolved and contrast enhanced MR techniques requiring a breath-hold of only 8 s [11,12] with the additional advantage that arteries can be separated from veins, might supersede further investigations based on MR imaging of pulmonary arteries using contrast-enhanced navigator-echo angiography.…”

Section: Discussionmentioning

confidence: 96%

Gadomer-17-enhanced 3D navigator-echo MR angiography of the pulmonary arteries in pigs

et al. 2002

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The goal of this study was visualisation and quality assessment of the pulmonary arteries in pigs with modified navigator-echo magnetic resonance angiography using an intravascular contrast agent. Five sedated pigs were examined in a clinical 1.5-T system with modified three-dimensional navigator-echo magnetic resonance angiography (slice thickness 3 mm, pixel size 2.4x1.8 mm2) to evaluate the pulmonary arteries. Using a phased-array four-element thorax coil the entire thorax was scanned before and after intravenous infusion of a gadolinium-based intravascular contrast agent. Assessment of image quality, enhancement-related contrast-to-noise ratio (CNR) measurements and improvement of visibility of peripheral pulmonary vessels was performed. Improvement of quality using Gadomer-17 was found for smaller vessels; pulmonary trunks and the main pulmonary arteries were sufficiently imaged without enhancement. Mean rise of CNR measured in the pulmonary trunks was 28.64% ( P=0.0002), mean rise of CNR in the main pulmonary arteries and the segmental arteries were 79.6% and 148.2%, respectively. Mean distance between the visible peripheral end of 60 sub-segmental arteries and the inner thoracic wall was 12.2 +/- 0.4 mm, and was significantly ( P=0.00002) reduced after contrast infusion to 8.0 +/- 0.4 mm. The combination of inherent flow sensitivity of navigator-echo angiography and Gadomer-17 proved effective for imaging of the pulmonary arteries. In contrast to standard contrast-enhanced pulmonary MRA studies, breath holding is not required. Further studies and the evaluation of findings of patients suffering from pulmonary embolism are needed to evaluate the possible benefits of a higher spatial resolution which is achievable using navigator-echo techniques in contrast to the higher temporal resolution of ultra-fast pulmonary MRA.

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“…[148][149][150][151] The diagnostic accuracy of MR pulmonary angiography is comparable to that of spiral CT, with limited sensitivity for emboli in subsegmental vessels. 152 Advantages of MR particularly relevant to children are the absence of radiation exposure and the possibility of combining MR pulmonary angiography with MR venography of the central venous system. MR pulmonary angiography is still undergoing rapid technical improvement and is not yet established in clinical routine.…”

Section: Magnetic Resonance Pulmonary Angiographymentioning

confidence: 99%

Diagnosis of Venous Thromboembolism in Children

Male

Kuhle²,

Mitchell³

2003

Semin Thromb Hemost

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Venous thromboembolic events (VTE) in children are mostly related to central venous lines (CVL), and are located in the central upper venous system. The incidence of VTE in children with CVL is significant. However, the majority of CVL-related VTE do not present with typical symptoms or are not recognized due to underlying disease. Asymptomatic VTE still cause significant venous obstruction and are associated with short-term and long-term clinical complications. Because the clinical diagnosis of CVL-related VTE is unreliable, screening by objective radiographic testing is required. In the upper venous system, ultrasound is insensitive for the VTE in the central venous system and venography is not sensitive for jugular VTE. Therefore, a combination of ultrasound and venography is required for accurate diagnosis of CVL-related VTE in the upper venous system. Whether ultrasound alone is accurate for CVL-related VTE in the lower venous system is uncertain. Magnetic resonance venography will likely prove a valid alternative for diagnosis of VTE both in the upper and lower central venous system, and may be combined with magnetic resonance pulmonary angiography to screen for pulmonary embolism.

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Pulmonary magnetic resonance angiography

Cited by 15 publications

References 74 publications

Magnetic resonance angiography virtual endoscopy in the assessment of pulmonary veins before radiofrequency ablation procedures for atrial fibrillation

Magnetic resonance angiography virtual endoscopy in the assessment of pulmonary veins before radiofrequency ablation procedures for atrial fibrillation

Gadomer-17-enhanced 3D navigator-echo MR angiography of the pulmonary arteries in pigs

Diagnosis of Venous Thromboembolism in Children

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