Multistation Whole-Body High-Spatial-Resolution MR Angiography Using a 32-Channel MR System
Kambiz Nael1,
Stefan G. Ruehm1,
Henrik J. Michaely2,
Roya Saleh1,
Margaret Lee1,
Gerhard Laub3 and
J. Paul Finn1
1 Department of Radiological Sciences, David Geffen School of Medicine,
University of California at Los Angeles, 10945 Le Conte Ave., Ste. 3371, Los
Angeles, CA 90095-7206.
2 Department of Radiology, University Hospitals Grosshadem,
Ludwig-Maximilians-University Munich, Munich, Germany.
3 Siemens Medical Solutions, Malvern, PA.
View larger version (66K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 1 —Drawing shows coil positioning for whole-body contrast-enhanced MR
angiography. By activating up to 76 coil elements over the body, no coil
repositioning is required. (Courtesy of Siemens Medical Solutions)
|
|
View larger version (12K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 3 —Schematic shows MR angiography (MRA) and contrast injection
protocol. Phase-encoding order was linear for stations I (HN) and II (CA) and
centric for stations III (T) and IV (C). Preinjection "mask"
measurement was acquired at each station immediately before respective
contrast infusion and MRA. Drawings of syringes mark first and second contrast
injections. Subjects were instructed to hold their breath during acquisitions
of stations I (HN) and II (CA). HN = head-neck, CA = chest-abdomen, T =
thighs, C = calves.
|
|
View larger version (26K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 4A —Graphs show overall image quality scores. SMA = superior mesenteric
artery, IMA = inferior mesenteric artery. Overall image quality scores for all
arterial segments (A) and for arterial segments with > 10% narrowing
(B). Data are mean ± SD, with SDs being shown by horizontal tic
marks with each bar. Scoring scale was as follows: 1 = poor image quality and
blurring of arterial segment; 2 = fair image quality, inadequate for confident
diagnosis; 3 = good image quality and arterial enhancement, adequate for
confident diagnosis; and 4 = excellent image quality and arterial enhancement,
for highly confident diagnosis. Note that majority of arterial segments (82%)
scored for image quality were relatively healthy (no stenosis or < 10%
irregularities).
|
|
View larger version (23K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 4B —Graphs show overall image quality scores. SMA = superior mesenteric
artery, IMA = inferior mesenteric artery. Overall image quality scores for all
arterial segments (A) and for arterial segments with > 10% narrowing
(B). Data are mean ± SD, with SDs being shown by horizontal tic
marks with each bar. Scoring scale was as follows: 1 = poor image quality and
blurring of arterial segment; 2 = fair image quality, inadequate for confident
diagnosis; 3 = good image quality and arterial enhancement, adequate for
confident diagnosis; and 4 = excellent image quality and arterial enhancement,
for highly confident diagnosis. Note that majority of arterial segments (82%)
scored for image quality were relatively healthy (no stenosis or < 10%
irregularities).
|
|
View larger version (128K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 5 —Coronal maximum-intensity-projection image from whole-body
contrast-enhanced MR angiography (thigh station) of 58-year-old woman with
diabetes and peripheral vascular disease shows significant venous
contamination affecting diagnostic image quality.
|
|
View larger version (31K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 6A —63-year-old man with severe right lower extremity claudication.
Coronal maximum-intensity-projection (MIP) image from whole-body
contrast-enhanced MR angiography (CEMRA) depicts entire arterial tree with
good image quality. Note absence of venous contamination. There is mild
irregularity along course of abdominal aorta and severe stenosis of right
common iliac artery (arrow).
|
|
View larger version (95K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 6B —63-year-old man with severe right lower extremity claudication.
Coronal MIP image from whole-body CE-MRA (B) and conventional angiogram
(C) reveal mild irregularities of left common iliac artery with
ulcerative plaque (black arrows). Thread line (white arrows)
indicating minimal contrast flow through stenotic segments on both CE-MRA and
conventional angiogram is noted.
|
|
View larger version (75K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 6C —63-year-old man with severe right lower extremity claudication.
Coronal MIP image from whole-body CE-MRA (B) and conventional angiogram
(C) reveal mild irregularities of left common iliac artery with
ulcerative plaque (black arrows). Thread line (white arrows)
indicating minimal contrast flow through stenotic segments on both CE-MRA and
conventional angiogram is noted.
|
|
View larger version (30K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 7A —67-year-old woman with lower extremity claudication, hypertension,
and history of transient ischemic attack. Coronal maximum-intensity-projection
(MIP) from whole-body contrast-enhanced MR angiography (A) shows
significant stenosis of innominate artery (arrow) and left common
carotid artery, which is confirmed by catheter angiography (B).
|
|
View larger version (64K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 7B —67-year-old woman with lower extremity claudication, hypertension,
and history of transient ischemic attack. Coronal maximum-intensity-projection
(MIP) from whole-body contrast-enhanced MR angiography (A) shows
significant stenosis of innominate artery (arrow) and left common
carotid artery, which is confirmed by catheter angiography (B).
|
|
View larger version (88K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 7C —67-year-old woman with lower extremity claudication, hypertension,
and history of transient ischemic attack. Magnified coronal MIP image from
abdominal station (C) shows significant stenosis at origin of renal
arteries (arrows) as well as distal narrowing of abdominal aorta with
significant stenosis just before common iliac bifurcation
(arrowhead). These findings were confirmed by catheter angiography
(D and E). Coronal MIP images of stations III and IV (A)
show patent runoff vasculatures, with no significant arterial disease.
|
|
View larger version (80K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 7D —67-year-old woman with lower extremity claudication, hypertension,
and history of transient ischemic attack. Magnified coronal MIP image from
abdominal station (C) shows significant stenosis at origin of renal
arteries (arrows) as well as distal narrowing of abdominal aorta with
significant stenosis just before common iliac bifurcation
(arrowhead). These findings were confirmed by catheter angiography
(D and E). Coronal MIP images of stations III and IV (A)
show patent runoff vasculatures, with no significant arterial disease.
|
|
View larger version (87K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 7E —67-year-old woman with lower extremity claudication, hypertension,
and history of transient ischemic attack. Magnified coronal MIP image from
abdominal station (C) shows significant stenosis at origin of renal
arteries (arrows) as well as distal narrowing of abdominal aorta with
significant stenosis just before common iliac bifurcation
(arrowhead). These findings were confirmed by catheter angiography
(D and E). Coronal MIP images of stations III and IV (A)
show patent runoff vasculatures, with no significant arterial disease.
|
|
View larger version (27K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 8A —70-year-old man with bilateral lower extremity claudication and
nonhealing ulcers of feet. Coronal maximum-intensity-projection (MIP) from
whole-body contrast-enhanced MR angiography (A) shows irregularities
along course of abdominal aorta and mild stenoses of right and left common
iliac arteries (arrows), which were confirmed by catheter angiography
(B). Coronal MIP image from station III (thigh) (A) shows
proximal occlusion of right superficial femoral artery, with reperfusion of
distal part by collaterals, and severe stenosis of left superficial femoral
artery (arrow). Coronal MIP image from station IV (calf) (A)
shows proximal occlusion of popliteal artery and anterior tibial artery at
right, and severe stenosis of tibioperoneal trunk (arrow) and
occlusion of anterior tibial artery at left (arrow).
|
|
View larger version (71K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 8B —70-year-old man with bilateral lower extremity claudication and
nonhealing ulcers of feet. Coronal maximum-intensity-projection (MIP) from
whole-body contrast-enhanced MR angiography (A) shows irregularities
along course of abdominal aorta and mild stenoses of right and left common
iliac arteries (arrows), which were confirmed by catheter angiography
(B). Coronal MIP image from station III (thigh) (A) shows
proximal occlusion of right superficial femoral artery, with reperfusion of
distal part by collaterals, and severe stenosis of left superficial femoral
artery (arrow). Coronal MIP image from station IV (calf) (A)
shows proximal occlusion of popliteal artery and anterior tibial artery at
right, and severe stenosis of tibioperoneal trunk (arrow) and
occlusion of anterior tibial artery at left (arrow).
|
|
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Copyright © 2007 by the American Roentgen Ray Society.
