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MR Angiography for Abdominal and Thoracic Aortic Aneurysms: Assessment Before Endovascular Repair in Patients with Impaired Renal Function

Eli Atar1,2, Alexander Belenky1,2, Menashe Hadad2,3, Ehud Ranany2,4, Shlomo Baytner1,2 and Gil N. Bachar1,2

1 Department of Radiology, Interventional Radiology Unit, Rabin Medical Center, Beilinson Campus, Petah-Tiqva 49100, Israel.
2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
3 Department of Vascular Surgery, Rabin Medical Center, Petah-Tiqva 49100, Israel.
4 Department of Thoracic Surgery, Rabin Medical Center, Petah-Tiqva 49100, Israel.


Figure 1
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  		Fig. 1 —Schematic drawing showing points at which diameter and length were measured by both MR angiography and digital subtraction angiography in patients with infrarenal aortic aneurysm. (1) Diameter of aorta at renal artery ostium, (2) diameter of aorta at extent of aneurysm, (3) diameter of aorta 10 mm above aortic bifurcation, (4) maximum diameter of right common iliac artery, (5) proximal diameter of left common iliac artery, (6) proximal diameter of right external iliac artery, (7) maximum diameter of left external iliac artery, (8) length of proximal neck, (9) length of infrarenal aorta, (10) maximum diameter of right common iliac artery, and (11) maximum diameter of left external iliac artery.

 

Figure 2
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  		Fig. 2 —Plot of difference against mean for diameter of aorta at proximal extent of aneurysm by digital subtraction angiography and MR angiography.

 

Figure 3
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  		Fig. 3 —Plot of difference against mean for diameter of aorta at renal artery ostium by digital subtraction angiography and MR angiography.

 

Figure 4
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  		Fig. 4 —Schematic drawing showing points at which diameter and length were measured by both MR angiography and digital subtraction angiography in patients with thoracic aortic aneurysm. (1) Diameter of aorta at proximal extent of aneurysm, (2) diameter of aorta at distal part of aneurysm, (3) diameter of aorta at level of left subclavian artery, (4) length of thoracic aneurysm, (5) proximal caudal neck of aneurysm, (6) maximum diameter of left external iliac artery, (7) distance between left common carotid artery and left subclavian artery, and (8) diameter of aorta at level of left common carotid artery.

 

Figure 5
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  		Fig. 5 —Analysis of diameter of abdominal aortic aneurysm as measured by MR angiography compared with digital subtraction angiography. Regression plot shows excellent correlation (R = 0.968; R2 = 0.917).

 

Figure 6
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  		Fig. 6A —79-year-old man with infrarenal aortic abdominal aneurysm. Digital subtraction angiographic image shows aortic abdominal aneurysm.

 

Figure 7
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  		Fig. 6B —79-year-old man with infrarenal aortic abdominal aneurysm. Contrast-enhanced 3D maximum-intensity-projection MR angiographic image shows abdominal aorta and its major branches.

 

Figure 8
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  		Fig. 6C —79-year-old man with infrarenal aortic abdominal aneurysm. Digital subtraction angiographic image of abdominal aorta shows successful stent-graft deployment.

 

Figure 9
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  		Fig. 7A —73-year-old man with thoracic aortic aneurysm. Digital subtraction angiographic image shows thoracic aortic aneurysm.

 

Figure 10
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  		Fig. 7B —73-year-old man with thoracic aortic aneurysm. Contrast-enhanced 3D maximum-intensity-projection MR angiographic image of thoracic aorta and its major branches.

 

Figure 11
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  		Fig. 7C —73-year-old man with thoracic aortic aneurysm. Digital subtraction angiographic image of thoracic aorta shows successful stent-graft deployment.

 

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