title: Feasibility of non-contrast-enhanced magnetic resonance angiography for imaging upper extremity vasculature prior to vascular access creation.
abstract: OBJECTIVE
  Preoperative mapping of arterial and venous anatomy helps to prevent postoperative complications after vascular access creation. The use of gadolinium in contrast-enhanced (CE) magnetic resonance angiography (MRA) has been linked to nephrogenic systemic fibrosis in patients with end-stage renal disease (ESRD). The purpose of this study was to evaluate non-contrast-enhanced (NCE) MRA for assessment of upper extremity and central vasculature and to compare it with CE-MRA.
  
  
  METHODS
  NCE and CE-MRA images were acquired in 10 healthy volunteers and 15 patients with ESRD. In each data set, two observers analysed 11 arterial and 16 venous segments with regard to image quality (0-4), presence of artefacts (0-2) and vessel-to-background ratio.
  
  
  RESULTS
  More arterial segments were depicted using CE-MRA compared to NCE-MRA (99% vs. 96%, p = 0.001) with mean image quality of 3.80 vs. 2.68, (p < 0.001) and mean vessel-to-background ratio of 6.47 vs. 4.14 (p < 0.001). Ninety-one percent of the venous segments were portrayed using NCE-MRA vs. 80% using CE-MRA (p < 0.001). Mean image quality and vessel-to-background ratio were 2.41 vs. 2.21 (p = 0.140) and 5.13 vs. 3.88 (p < 0.001), respectively.
  
  
  CONCLUSIONS
  Although arterial image quality and vessel-to-background ratios were lower, NCE-MRA is considered a feasible alternative to CE-MRA in patients with ESRD who need imaging of the upper extremity and central vasculature prior to dialysis access creation.
authors: Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6202 AZ Maastricht, The Netherlands.
authors: A S
authors: AS
authors: Bode
authors: R N
authors: RN
authors: Planken
authors: M A G
authors: MA
authors: Merkx
authors: F M
authors: FM
authors: van der Sande
authors: L
authors: L
authors: Geerts
authors: J H M
authors: JH
authors: Tordoir
authors: T
authors: T
authors: Leiner
mesh_terms: D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D016477:Artifacts; D016022:Case-Control Studies; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011237:Predictive Value of Tests; D011300:Preoperative Care; D006435:Renal Dialysis; D034941:Upper Extremity / Q000098:blood supply*; D055815:Young Adult
chemical_list: D003287:Contrast Media