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Arterial Pseudostenosis on First-Pass Gadolinium-Enhanced Three-Dimensional MR Angiography

New Observation of a Potential Pitfall

¹ Department of Radiologic Sciences, Medical College of Pennsylvania, 3300 Henry Ave., 5th Level, Philadelphia, PA 19129.
² Department of Radiology, Thomas Jefferson University Hospital, 132 S. 10th St., Ste. 1096 Main, Philadelphia, PA 19107.

OBJECTIVE. The purpose of this study was to determine the frequency of apparent stenosis of normal aortic branches in patients on first-pass gadolinium-enhanced three-dimensional (3D) MR angiography and to reproduce the same phenomenon in a pulsatile flow phantom model.

CONCLUSION. Apparent stenosis of normal vessels on gadolinium-enhanced 3D MR angiography seen on the first-pass acquisition was observed in only a small proportion (approximately 2%) of our patients. The pseudostenosis was reproducible in the phantom model using rapid injection. A stenosis on first-pass images should be interpreted with caution. Confirmation of the findings on other sequences, such as the second-pass gadolinium-enhanced 3D MR angiography or 3D phase-contrast MR angiography, prevented overdiagnosis of significant stenoses.

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