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Two-Station Bolus-Chase MR Angiography with a Stationary Table: A Simple Alternative to Automated-Table Techniques

Pari V. Pandharipande1, Vivian S. Lee1, Peter M. Reuss1, Hearns W. Charles1, Robert J. Rosen1, Glenn A. Krinsky1, Jeffrey C. Weinreb1 and Neil M. Rofsky1,2

1 Department of Radiology, NYU Medical Center, 530 First Ave., New York, NY 10016.
2 Present address: Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215.



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  		Fig. 1A. —43-year-old woman referred for MR imaging with suspected embolic disease. Coronal oblique MR image of subtracted, volume-rendered, contrast-enhanced three-dimensional MR angiographic data (TR/TE, 4.0/1.6; flip angle, 25°) shows high-grade superficial femoral artery stenosis (arrow) and nonvisualization of right profunda femoral artery.

 


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  		Fig. 1B. —43-year-old woman referred for MR imaging with suspected embolic disease. Correlative digital subtraction angiogram shows high-grade superficial femoral artery stenosis (arrow) and nonvisualization of right profunda femoral artery, in confirmation of MR angiographic findings (A).

 


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  		Fig. 2A. —74-year-old woman referred for MR imaging with suspected embolic disease. Coronal oblique MR image of unsubtracted, volume-rendered, contrast-enhanced three-dimensional MR angiographic data (TR/TE, 4.6/1.8; flip angle, 40°) shows high-grade disease in distal right popliteal artery (short straight arrow), right anterior tibial artery (long straight arrow), and right peroneal artery (curved arrow).

 


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  		Fig. 2B. —74-year-old woman referred for MR imaging with suspected embolic disease. Correlative digital subtraction angiogram shows high-grade disease in distal right popliteal artery (short straight arrow), right anterior tibial artery (long straight arrow), and right peroneal artery (curved arrow), in confirmation of MR angiographic findings (A).

 


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  		Fig. 3A. —80-year-old woman referred for MR imaging with claudication. Coronal MR image of subtracted, volume-rendered, contrast-enhanced three-dimensional (3D) MR angiographic data (TR/TE, 4.6/1.8; flip angle, 25°) shows nearly 50% stenotic lesion of infrarenal aorta (arrow). MR angiography reviewers initially disagreed when scoring this borderline lesion.

 


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  		Fig. 3B. —80-year-old woman referred for MR imaging with claudication. Correlative digital subtraction angiogram shows borderline lesion of infrarenal aorta (arrow) with nearly identical appearance to A. Digital subtraction angiography reviewers also initially disagreed when scoring this lesion, but lesion was thought to produce less than 50% stenosis in consensus interpretations from both modalities.

 


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  		Fig. 3C. —80-year-old woman referred for MR imaging with claudication. Sagittal curved reconstruction of subtracted, volume-rendered, contrast-enhanced 3D MR angiographic data (4.6/1.8, 25° flip angle) obtained through level of borderline lesion of interest (straight arrow) shows second plaque in posterior aorta (curved arrow), just inferior to origin of superior mesenteric artery (s), that is not seen on frontal views on MR angiography or digital subtraction angiography. Multiplanar reformatting capabilities of 3D MR imaging methods can improve detection of aortic plaques in anterior or posterior wall that can easily be overlooked on digital subtraction angiography.

 

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