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Equilibrium-Phase MR Angiography of the Aortoiliac and Renal Arteries Using a Blood Pool Contrast Agent

Dominik Weishaupt1, Stefan G. Rühm1,2, Christoph A. Binkert1, Michaela Schmidt1, Michael A. Patak1, Felix Steybe3, Steven McGill4 and Jörg F. Debatin1,2

1 Institute of Diagnostic Radiology, University Hospital Zurich, Ramistr. 100, CH8091 Zurich, Switzerland.
2 Department of Diagnostic Radiology, University Hospital Essen, Hufelandstr. 55, D-45122 Essen, Germany.
3 Nycomed Amersham, Nycomed Arzneimittel, COMET, Fraunhoferstr. 7, 0-85737 Ismaning, Germany.
4 Nycomed Amersham Imaging, Sandakerveien 100, 1-0401 Oslo, Norway.



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  		Fig. 1. —Graph depicts serum iron concentration after administration of NC100150 (Clariscan; Nycomed Amersham, Wayne, PA). Serum iron values were highest 2 hr after injection. Within 72 hr after administration of contrast agent, serum iron levels returned to normal in 15 of 20 patients. Line intersecting y-axis at 30 mmol/ml indicates upper limit of normal concentration for serum iron.

 


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  		Fig. 2A. —56-year-old woman with severe stenosis of right common iliac artery. Digital subtraction angiogram shows stenosis of right common iliac artery.

 


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  		Fig. 2B. —56-year-old woman with severe stenosis of right common iliac artery. MR angiogram with targeted maximum-intensity-projection image reconstructed from NC100150 (Clariscan; Nycomed Amersham, Wayne, PA)-enhanced three-dimensional gradient-recalled echo sequence (TR/TE, 5.6/1.7; flip angle, 30°) clearly depicts stenosis.

 


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  		Fig. 3A. —72-year-old man with infrarenal aortic aneurysm. Digital subtraction angiogram reveals infrarenal aortic aneurysm (arrow).

 


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  		Fig. 3B. —72-year-old man with infrarenal aortic aneurysm. Coronal source MR image after administration of NC100150 (Clariscan; Nycomed Amersham, Wayne, PA) clearly depicts aortic aneurysm.

 


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  		Fig. 3C. —72-year-old man with infrarenal aortic aneurysm. Surface rendered-display image reconstructed from three-dimensional MR image sets shows extent of aneurysm identical to A. Note left-sided stenosis of common iliac artery, which has been graded as mild (<50% luminal narrowing) on both digital subtraction angiography and MR angiography (arrow).

 


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  		Fig. 4A. —49-year-old man with fibromuscular dysplasia of both renal arteries. Digital subtraction angiogram shows typical changes of fibromuscular dysplasia affecting mid and distal segments of both renal arteries.

 


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  		Fig. 4B. —49-year-old man with fibromuscular dysplasia of both renal arteries. On NC100150 (Clariscan; Nycomed Amersham, Wayne, PA)-enhanced MR angiogram with targeted maximum-intensity-projection images, characteristic changes are displayed in left renal artery. Fibromuscular dysplasia changes in mid and distal segments of right renal artery are less well seen than in A but were interpreted correctly during prospective evaluation.

 


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  		Fig. 5A. —69-year-old man with occlusion of left internal iliac artery. Digital subtraction angiogram shows occlusion (arrow) of left internal iliac artery.

 


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  		Fig. 5B. —69-year-old man with occlusion of left internal iliac artery. Targeted maximum-intensity-projection image of equilibrium-phase MR angiogram after administration of NC100150 (Clariscan; Nycomed Amersham, Wayne, PA) is hampered by venous overlap. Assessment of this arterial segment was rated as "not possible" during prospective imaging analysis of source data and of targeted maximum-intensity-projection images because of venous overlap.

 

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