Three-dimensional gadolinium-enhanced MR angiography for aortoiliac inflow assessment plus renal artery screening in a single breath hold.
OBJECTIVE
To develop a magnetic resonance (MR) angiography protocol, with use of breath-hold techniques, for simultaneous aortoiliac inflow assessment and renal artery screening in patients with lower extremity ischemia or aortic aneurysm.


METHODS
Breath-hold three dimensional gadolinium-enhanced MR angiography was performed in 50 patients (conventional arteriography in 47 was the standard of reference). After multiple strategies were tested in the first 18 patients, a final protocol was formulated and tested in the subsequent 32 patients.


RESULTS
The final protocol comprised a single-slab (28 3-mm-thick partitions) coronal acquisition (repetition time, 7 msec; echo time, 2.8 msec; flip angle, 60 degrees) during a single breath hold, enhanced with 30 mL gadoteridol. In the final 32 patients, sensitivity and specificity, respectively, for obstructive lesions were 100% and 100% for the aorta, 100% and 98% for common iliac arteries, 100% and 89% for external iliac arteries, 100% and 89% for main renal arteries, and 100% and 62% for accessory renal arteries.


CONCLUSIONS
This breath-hold protocol improves the accuracy of aortoiliac inflow assessment, but low resolution limits evaluation of small renal arteries.
Snidow
J J
JJ
Department of Radiology, Indiana University Medical Center, Indianapolis 46202-5253, USA.
Johnson
M S
MS
Harris
V J
VJ
Margosian
P M
PM
Aisen
A M
AM
Lalka
S G
SG
Cikrit
D F
DF
Trerotola
S O
SO
D000328:Adult; D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology*; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000000981:diagnostic imaging; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D003287:Contrast Media; D005682:Gadolinium; D006571:Heterocyclic Compounds; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D007091:Image Processing, Computer-Assisted; D007511:Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging; D007866:Leg / Q000098:blood supply; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D012680:Sensitivity and Specificity
D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C062402:gadoteridol; D005682:Gadolinium