Systolically gated 3D phase contrast MRA of mesenteric arteries in suspected mesenteric ischemia.
OBJECTIVE
Our goal was to assess the value of MRA for detecting stenoses in the celiac (CA) and superior mesenteric (SMA) arteries in patients suspected of having chronic mesenteric ischemia, using an optimized systolically gated 3D phase contrast technique.


METHODS
In an initial study in 24 patients who underwent conventional angiography of the abdominal vessels for different clinical indications, a 3D phase contrast MRA technique (3D-PCA) was evaluated and optimized to image the CAs and SMAs. Subsequently, a prospective study was performed to assess the value of systolically gated 3D-PCA in evaluation of the mesenteric arteries in 10 patients with signs and symptoms of chronic mesenteric ischemia. Intraarterial digital subtraction angiography and surgical findings were used as the reference standard.


RESULTS
In the initial study, systolic gating appeared to be essential in imaging the SMA on 3D-PCA. In 10 patients suspected of mesenteric ischemia, systolically gated 3D-PCA identified significant proximal disease in the two mesenteric vessels in 4 patients. These patients underwent sucessful reconstruction of their stenotic vessels.


CONCLUSIONS
Cardiac-gated MRA may become a useful tool in selection of patients suspected of having mesenteric ischemia who may benefit from surgery.
Wasser
M N
MN
Department of Diagnostic Radiology, Leiden University Hospital, the Netherlands.
Geelkerken
R H
RH
Kouwenhoven
M
M
van Bockel
J H
JH
Hermans
J
J
Schultze Kool
L J
LJ
de Roos
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002445:Celiac Artery; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000601:surgery; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008638:Mesenteric Arteries; D008643:Mesentery / Q000098:blood supply*; D008875:Middle Aged; D011446:Prospective Studies