Hepatic blood supply: comparison of optimized dual phase contrast-enhanced three-dimensional MR angiography and digital subtraction angiography.
OBJECTIVE
To optimize and determine the value of dual-phase contrast material-enhanced three-dimensional (3D) magnetic resonance (MR) angiography for preoperative evaluation of the blood supply to the liver.


METHODS
Dual phase 3D MR angiography of the hepatic arteries and portal vein was performed in 140 patients. In 80 patients, the value of fat saturation, digital image subtraction, an anticholinergic agent, and a high-caloric meal were evaluated. In the next 60 patients, MR angiographic and digital subtraction angiographic (DSA) image quality and diagnostic value were compared.


RESULTS
Fat-saturated images were of significantly better quality (P < .01) than non-fat-saturated images. Digital image subtraction was useful in only 23 of 40 patients. The injection of an anticholinergic agent was superfluous, whereas administration of a high-caloric meal helped in demonstration of the superior mesenteric artery and portal vein. Classification on MR angiograms of the arterial blood supply was correct in 57 of 60 patients. All arterial and portal venous lesions were seen on MR angiograms, and MR angiograms had a significantly higher subjective image-quality ranking than did DSA images in the evaluation of the portal vein (P < .05).


CONCLUSIONS
Fat saturation and use of a high-caloric meal improve the results of MR angiography of hepatic vessels. MR angiography was comparable to DSA for evaluation of the arterial system and was superior for demonstration of the portal vein; therefore, MR angiography could replace intraarterial DSA.
Kopka
L
L
Department of Radiology, Georg-August-University Göttingen, Germany.
Rodenwaldt
J
J
Vosshenrich
R
R
Fischer
U
U
Renner
B
B
Lorf
T
T
Graessner
J
J
Ringe
B
B
Grabbe
E
E
D015901:Angiography, Digital Subtraction / Q000379:methods*; D018680:Cholinergic Antagonists; D003287:Contrast Media; D005526:Food, Formulated; D019786:Gadolinium DTPA; D006499:Hepatic Artery / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007472:Iohexol / Q000031:analogs & derivatives; D008099:Liver / Q000098:blood supply*; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D016031:Liver Transplantation; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology; D011446:Prospective Studies; D012601:Scopolamine
D018680:Cholinergic Antagonists; D003287:Contrast Media; D007472:Iohexol; C038192:iopromide; D012601:Scopolamine; D019786:Gadolinium DTPA