Purpose. To evaluate the feasibility of a contrast enhanced MR angiography (MRA) technique, using the latest 1.5 T MR tomoscan, to obtain optimal imaging of the portal system and compare the angiographic images with those obtained by color-Doppler and DSA. Material and methods. Thirty patients (9 women and 21 men: average 53 years old) underwent contrast MRA of the portal vein, after portal hypertension had been diagnosed on the basis of clinical and chemical data and by color-Doppler. We used a dynamic 3D FFE T1-weighted breath - hold sequence during the arterial and venous phase after administering. 0.2 mmol/Kg of gadolinium-DTPA were at the rate of 2 ml/s. The contrast bolus was monitored using a 2D FFE T1-weighted sequence on a coronal plane. A FFE T1-weighted sequence was performed on axial plane before and after the dynamic sequence to obtain evaluate the a hepatic parenchyma. In the post processing phase MIP (maximum intensity projection) were reconstructed. We considered the patency of the portal venous system and the presence of cavernomatous and collateral circles; portal thrombosis was classified as partial or complete and as proximal or distal. Results. Good quality MR angiographic images were obtained in 28 of the 30 cases examined; in 2 patients movement artefacts compramised the image quality. We observed a concardance between MRA and Doppler ultrasound in 79 vessels out of 84(94%). A 97.5% concordance was found between MRA and DSA (82 vessels out of 84) with a sensitivity of 100% and a specificity of 97.3%. MRA was superior to DSA aad Doppler ultrasound for evaluating large collateral shunts, above all gastro-esophageal and paraumbilical shunts, and complex anatomical conditions. Conclusions. Where available, advanced MRA technology with contrast enhancement should be used as a routine modality to study the anatomy and pathology and the portal system in all patients in whom Doppler ultrasound has yielded doubtful information. MRA is well-suited to obtain good vascular imaging before surgical or interventional procedures.

Squillaci, E., Mazzoleni, C., Sodani, G., Fanucci, E., Masala, S., Romagnoli, A., et al. (2001). Portal system evaluation with 3D dynamic contrast enhanced Magnetic Resonance angiography: technique and results = Angiografia con Risonanza Magnetica con tecnica tridimensionale dinamica dopo mezzo di contrasto nello studio del sistema portale: tecnica e risultati. LA RADIOLOGIA MEDICA, 102(4), 238-244.

Portal system evaluation with 3D dynamic contrast enhanced Magnetic Resonance angiography: technique and results = Angiografia con Risonanza Magnetica con tecnica tridimensionale dinamica dopo mezzo di contrasto nello studio del sistema portale: tecnica e risultati

SQUILLACI, ETTORE;FANUCCI, EZIO;MASALA, SALVATORE;ROMAGNOLI, ANDREA;SERGIACOMI, GIANLUIGI;SIMONETTI, GIOVANNI MARIA EGISTO
2001

Abstract

Purpose. To evaluate the feasibility of a contrast enhanced MR angiography (MRA) technique, using the latest 1.5 T MR tomoscan, to obtain optimal imaging of the portal system and compare the angiographic images with those obtained by color-Doppler and DSA. Material and methods. Thirty patients (9 women and 21 men: average 53 years old) underwent contrast MRA of the portal vein, after portal hypertension had been diagnosed on the basis of clinical and chemical data and by color-Doppler. We used a dynamic 3D FFE T1-weighted breath - hold sequence during the arterial and venous phase after administering. 0.2 mmol/Kg of gadolinium-DTPA were at the rate of 2 ml/s. The contrast bolus was monitored using a 2D FFE T1-weighted sequence on a coronal plane. A FFE T1-weighted sequence was performed on axial plane before and after the dynamic sequence to obtain evaluate the a hepatic parenchyma. In the post processing phase MIP (maximum intensity projection) were reconstructed. We considered the patency of the portal venous system and the presence of cavernomatous and collateral circles; portal thrombosis was classified as partial or complete and as proximal or distal. Results. Good quality MR angiographic images were obtained in 28 of the 30 cases examined; in 2 patients movement artefacts compramised the image quality. We observed a concardance between MRA and Doppler ultrasound in 79 vessels out of 84(94%). A 97.5% concordance was found between MRA and DSA (82 vessels out of 84) with a sensitivity of 100% and a specificity of 97.3%. MRA was superior to DSA aad Doppler ultrasound for evaluating large collateral shunts, above all gastro-esophageal and paraumbilical shunts, and complex anatomical conditions. Conclusions. Where available, advanced MRA technology with contrast enhancement should be used as a routine modality to study the anatomy and pathology and the portal system in all patients in whom Doppler ultrasound has yielded doubtful information. MRA is well-suited to obtain good vascular imaging before surgical or interventional procedures.
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/36 - Diagnostica per Immagini e Radioterapia
Italian
Con Impact Factor ISI
Portal Hypertension, diagnosis; Portal Hypertension, MRA; Portal van, thrombosis; Portal vein, MRA
Squillaci, E., Mazzoleni, C., Sodani, G., Fanucci, E., Masala, S., Romagnoli, A., et al. (2001). Portal system evaluation with 3D dynamic contrast enhanced Magnetic Resonance angiography: technique and results = Angiografia con Risonanza Magnetica con tecnica tridimensionale dinamica dopo mezzo di contrasto nello studio del sistema portale: tecnica e risultati. LA RADIOLOGIA MEDICA, 102(4), 238-244.
Squillaci, E; Mazzoleni, C; Sodani, G; Fanucci, E; Masala, S; Romagnoli, A; Sergiacomi, G; Simonetti, Gme
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/51780
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