Gadolinium-enhanced elliptically reordered three-dimensional MR angiography in the assessment of hand vascularization before radial artery harvest for coronary artery bypass grafting: first experience.
OBJECTIVE
To assess the suitability of contrast-enhanced magnetic resonance angiography (MRA) in the preoperative evaluation of hand vasculature in potential candidates for radial artery bypass grafting.


METHODS
In 21 patients, gadobenate dimeglumine-enhanced, three-dimensional gradient-echo sequences of both hands were performed, as well as a Doppler ultrasound study with radial artery compression. Doppler findings were correlated with MRA, focusing on the assessment of anastomoses between the vascular bed of the ulnar and radial arteries.


RESULTS
One individual had to be excluded because of accidentally disclosed metal foreign bodies. Sufficient depiction of the hand vasculature was achieved in the remainder. Seventeen patients had evidence of adequate collateral flow between the ulnar and radial artery supply on Doppler ultrasound. Three patients exhibited inadequate collateral flow, with angiographic signs of vessel occlusion or missing collaterals between the palmar arches. Two patients presented with stenosis or occlusion of the radial artery. Magnetic resonance angiograms displayed great variations in hand vasculature and collateral formation, with no mismatch compared with Doppler ultrasound results.


CONCLUSIONS
Contrast-enhanced MRA displays vascularization of the hand in detail and supplies ultrasound flow measurements for radial artery harvest, with high-resolution angiographic data about possible vessel variations and the presence of anastomoses between the radial or ulnar artery supply.
Winterer
J T
JT
Department of Diagnostic Radiology, University of Freiburg, Freiburg, Germany. winterja@ruf.uni-freiburg.de
Ennker
J
J
Scheffler
K
K
Rosendahl
U
U
Schäfer
O
O
Wanner
M
M
Laubenberger
J
J
Langer
M
M
D000328:Adult; D000368:Aged; D003097:Collateral Circulation; D003287:Contrast Media; D001026:Coronary Artery Bypass; D005260:Female; D006225:Hand / Q000098:blood supply*; D006801:Humans; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000502:physiology / Q000637:transplantation*; D013382:Subtraction Technique; D020858:Tissue and Organ Harvesting; D018608:Ultrasonography, Doppler
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine