Three-dimensional reconstructed contrast-enhanced MR angiography for internal iliac artery branch visualization before uterine artery embolization.
OBJECTIVE
To evaluate the feasibility of three-dimensional (3D) reconstructed contrast-enhanced (CE) magnetic resonance (MR) angiography in mapping the pelvic arteries in women before uterine artery embolization (UAE).


METHODS
CE MR angiography studies before UAE in 49 women (age range, 38-57 years; mean, 47.04 y +/- 4.7 [SD]) who underwent UAE for uterine leiomyomas between February 2005 and February 2007 were retrospectively evaluated by two radiologists in consensus. Studies were performed on a 1.5-T MR unit with a 3D fast low-angle shot sequence in the coronal direction. Reconstruction was performed with 3D computed tomographic angiography reconstruction software.


RESULTS
In the current study, 98 internal iliac arteries (IIAs) from 49 women were studied. The superior and inferior gluteal arteries were visualized in all cases (N = 98; 100%), the lateral sacral artery in 86 cases (88%), the iliolumbar artery in 84 (86%), the obturator artery in 81 (83%), the internal pudendal artery in 96 (98%), and the uterine artery in 95 (97%). The superior vesical and middle rectal arteries were seen in 21 (21%) and 11 (11%) cases, respectively. The mean length of the uterine artery was 12.56 cm (range, 4.6-22.2 cm), and it showed the longest traceable length among all branches. The uterine artery showed five patterns of origin. The superior gluteal artery showed constant origin from the posterior division of the IIA, whereas the iliolumbar and obturator arteries showed the most variations in origin.


CONCLUSIONS
Three-dimensional reconstructed CE MR angiography can detect most branches of the IIA in addition to their point of origin. Therefore, it can be used as a mapping tool of the pelvic arterial tree before UAE.
Naguib
Nagy N N
NN
Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. nagynnn@yahoo.com
Nour-Eldin
Nour-Eldin A
NE
Hammerstingl
Renate M
RM
Lehnert
Thomas
T
Floeter
Julius
J
Zangos
Stefan
S
Vogl
Thomas J
TJ
D000328:Adult; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007083:Iliac Artery / Q000473:pathology*; D007089:Image Enhancement / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055357:Uterine Artery Embolization / Q000379:methods*
D003287:Contrast Media; D019786:Gadolinium DTPA