Direct contrast-enhanced 3D MR venography evaluation of upper extremity deep venous system.
OBJECTIVE
To investigate the diagnostic value of direct contrast-enhanced three dimensional magnetic resonance (3D MR) venography in mapping the deep venous system of the upper extremities and to plan potential interventional procedures.


METHODS
Nineteen cases with the diagnoses of end-stage renal disease with multiple hemodialysis catheter access were examined. Direct contrast-enhanced 3D MR venograms were obtained with 1.5 Tesla device with 3D-FSPGR pulse sequence and using body coil following the manual injection of gadolinium solution prepared by diluting 20 ml of contrast substance in 200 ml saline with a proportion of 1:10 through intravenous access opened symmetrically in antecubital fossa. In the workstation, evaluation was performed on three-dimensional images, two-dimensional multiplanar reformats and maximum-intensity projection method obtained from the source images. Intravenous DSA was performed on all the patients, and two radiologists evaluated MR venograms and conventional angiograms independently from each other. Results of MR venography and conventional angiography were then compared.


RESULTS
In all cases, the MR venograms obtained were capable of supporting the diagnoses. Venous pathologies were found in 16 cases. In three cases central veins were evaluated to be patent. Results of MR venography and conventional angiography were consistent with each other (100% sensitivity and 100% specificity).


CONCLUSIONS
Direct contrast-enhanced 3D MR venography is a well-tolerated sensitive technique in explaining the cause of the malfunctioning arterio-venous fistulas and in pre-surgical planning before placing new catheters or creating fistulas. It is possible to obtain high-quality images with this technique as an alternative to invasive angiography.
Tanju
Sumru
S
Department of Radiology, Ankara University School of Medicine, Ankara, Turkey. sumrutanju@yahoo.com
Sancak
Tanzer
T
Düşünceli
Ebru
E
Yağmurlu
Banu
B
Erden
Ilhan
I
Sanlidilek
Umman
U
D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007275:Injections, Intravenous; D007676:Kidney Failure, Chronic; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013923:Thromboembolism / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D034941:Upper Extremity / Q000098:blood supply*; D014680:Veins / Q000502:physiology
D003287:Contrast Media; D019786:Gadolinium DTPA