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Pictorial essay


Blood Pool Contrast-enhanced Magnetic Resonance Angiography with Correlation to Digital Subtraction Angiography: A Pictorial Review.

Martha-Grace KnuttinenJillian KarowWinnie MarMargaret GoldenKaren L Xie
Department of Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois, United States
Date of Submission: 30-Jun-2014, Date of Acceptance: 23-Sep-2014, Date of Web Publication: 29-Nov-2014.
Corresponding Author:
Corresponding Author

Jillian Karow

Department of Radiology, University of Illinois at Chicago Medical Center (M/C 931), 1740 West Taylor Street, Room 2483, Chicago, IL 60612, United states.
E-mail: jkowal9@uic.edu

Corresponding Author:
Corresponding Author

Jillian Karow

Department of Radiology, University of Illinois at Chicago Medical Center (M/C 931), 1740 West Taylor Street, Room 2483, Chicago, IL 60612, United states.
E-mail: jkowal9@uic.edu

DOI: 10.4103/2156-7514.145860 Facebook Twitter Google Linkedin

ABSTRACT


Magnetic resonance angiography (MRA) provides noninvasive visualization of the vascular supply of soft tissue masses and vascular pathology, without harmful radiation. This is important for planning an endovascular intervention, and helps to evaluate the efficiency and effectiveness of the treatment. MRA with conventional extracellular contrast agents relies on accurate contrast bolus timing, limiting the imaging window to first-pass arterial phase. The recently introduced blood pool contrast agent (BPCA), gadofosveset trisodium, reversibly binds to human serum albumin, resulting in increased T1 relaxivity and prolonged intravascular retention time, permitting both first-pass and steady-state phase high-resolution imaging. In our practice, high-quality MRA serves as a detailed "roadmap" for the needed endovascular intervention. Cases of aortoiliac occlusive disease, inferior vena cava thrombus, pelvic congestion syndrome, and lower extremity arteriovenous malformation are discussed in this article. MRA was acquired at 1.5 T with an 8-channel phased array coil after intravenous administration of gadofosveset (0.03 mmol/kg body weight), at the first-pass phase. In the steady-state, serial T1-weighted 3D spoiled gradient echo images were obtained with high resolution. All patients underwent digital subtraction angiography (DSA) and endovascular treatment. MRA and DSA findings of vascular anatomy and pathology are discussed and correlated. BPCA-enhanced MRA provides high-quality first-pass and steady-state vascular imaging. This could increase the diagnostic accuracy and create a detailed map for pre-intervention planning. Understanding the pharmacokinetics of BPCA and being familiar with the indications and technique of MRA are important for diagnosis and endovascular intervention.
Keywords: Interventional Radiology, Pre-procedural Planning, Vascular

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