[Contrast media-enhanced 3D MR angiography before endovascular treatment of aneurysm in the abdominal aorta, iliac artery and peripheral vessels].
OBJECTIVE
The value of DSA for the measurement of aortic and peripheral arterial aneurysm dimensions before endovascular treatment is limited by projection effects. It was evaluated if additional gadolinium-enhanced three-dimensional MR angiography (3D-CEMRA) could compensate for the disadvantages of DSA.


METHODS
21 patients with 35 aneurysms in the abdominal aorta (14), iliac (9) and femoropopliteal vessels (12) were assessed with DSA (7 with calibrated catheter, 14 with yardstick) and 3D-CEMRA (TR/TE 7.8/2.1 ms, flip-angle 40 degrees, Matrix 512 x 224, FOV 500 mm, eff. slice 1.8 mm). We measured and compared aneurysm dimensions on both modalities. 3D-CEMRA was regarded as the reference method to evaluate the dimension of DSA-projection effects.


RESULTS
Diameter and length of aneurysms were underestimated on DSA with the yardstick as reference. The deviation ranged from 15% (+/- 5%) in the aorta to 21% (+/- 10%) in the iliac vessels. Only with calibrated catheters as reference (7/21 DSA), were the distances on DSA correlated well with MRA. In 2/35 aneurysms 3D-CEMRA detected thrombosis with difference between length of inner lumen dilatation on DSA and whole aneurysm length. 2/5 accessory renal arteries found on DSA were not detected on 3D-CEMRA.


CONCLUSIONS
3D-CEMRA is a valuable adjunct to DSA for pre-interventional diagnostics of aortic and peripheral arterial aneurysms. It provides exact evaluation of aneurysm dimensions and information about partial thrombosis.
Biederer
J
J
Klinik für Diagnostische Radiologie der Christian-Albrechts-Universität zu Kiel. juergen.biederer@rad.uni-kiel.de
Link
J
J
Steffens
J C
JC
Fronius
M
M
Heller
M
M
D000783:Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D000792:Angiography; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D002138:Calibration; D003287:Contrast Media; D005263:Femoral Artery; D006801:Humans; D017543:Iliac Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D018810:Magnetic Resonance Angiography / Q000379:methods*; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D011150:Popliteal Artery; D012077:Renal Artery; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media
Kontrastmittelverstärkte 3D-MR-Angiographie vor endoluminaler Therapie von Aneurysmen der Aorta abdominalis und der Becken-Bein-Strombahn.