Comparison of non-contrast ECG-triggered 3D FSE MRA
with table stepping CE MRA for peripheral run off using total
imaging matrix coil system
Poster No.:
C-3127
Congress:
ECR 2010
Type:
Scientific Exhibit
Topic:
Vascular
Authors:
S. Kitano, N. Marugami, J. Takahama, A. Takahashi, S. Hirohashi,
K. Kichikawa; nara/JP
Keywords:
MRA, contrasr enhancement MRA, non contrast MRA
DOI:
10.1594/ecr2010/C-3127
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Purpose
Nephrogenic Systemic Fibrosis (NSF) is a serious, life-threatening skin disorder. Recent
reports have strongly correlated the development of NSF with exposure to gadoliniumcontaining MRI contrast agents. Non contrast MRA may provide an alternative imaging
approach for patients who risk developing NSF and other contrast material related
complications.
Assessment of the three stepping non-contrast MRA on the patients with suspected
arterial diseases as compared to four stepping CE MRA.
Methods and Materials
Twelve consecutive patients with peripheral artery occlusive disease underwent both
non-contrast MRA in a three step and CE body MRA in a four step table feed technique.
Ischemic leg was classified 3-grade scale (normal =0, mild =10 and severe =2). The
MRI unit used was MAGNETOM avanto 1.5T (SIEMENS) with total imaging matrix coil
system.
MRA protocol
1st Non-contrast MRA
2nd test bolus
3rd table stepping CE MRA
Non-contrast MRA (space MRA)
Non-contrast MRA was obtained by ECG-triggered 3D valuable flip angle TSE (SPACE)
using parallel acquisition technique. 2 sets of pelvic, femoral and popliteal MRA were
obtained at systolic and diastolic phase. Imaging parameter were TR 500 msec, TE 50
msec, matrix 256 x 256, FOV 400 mm, iPAT: GRAPPA, factor=2, with fat saturation. Non
contrasted MRA were reconstructed from the images obtained by subtracting the systolic
images from the diastolic images using the maximum intensity projection algorithm.
Whole body MRA
Page 2 of 15
Whole body MRA was obtained by turbo MRA using parallel acquisition technique; Upper
part of MRA was obtained using 3D time resolved MRA. Imaging parameter were TR 3.0
msec, TE 1.2 msec, matrix 205 x 256, partition 20, FOV 400 mm, PAT factor 2, acquisition
time 3.6 sec. Oblique sagital, 4 independent data sets were obtained consecutively.
Abdominal, femoral and popliteal MRA were obtained 3D high resolution MRA. Imaging
parameter (abdomen / femoral / popliteal) were TR (4.0/ 3.4/ 3.5) msec, TE (1.5/ 1.8/
1.6) msec, matrix 256 x 512, partition (32/ 56/ 72), FOV 400 mm, PAT factor 2. Threedimensional MRA were reconstructed from the images obtained by subtracting the precontrast images from the post contrast images using the maximum intensity projection
algorithm.
Image analysis
Non-contrast MRA (space MRA) vs CE MRA
To compare of non-contrast MRA with CE MRA in the abdomen, femoral, and popliteal
using a five grading system (5: space MRA >> CE MRA, 4: space MRA > CE MRA, 3:
space MRA =CE MRA, 2: space MRA < CE MRA, and 1: space MRA << CE MRA) on
each ischemic leg group.
Images for this section:
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Fig. 1: Total imaging matrix coil
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Fig. 2: Non contrast MRA
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Fig. 3: Non contrast MRA
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Fig. 4: Non contrast MRA
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Fig. 5: Table stepping CE-MRA
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Results
Non-contrast MRA (space MRA) vs CE MRA
image score was pelvic; 2.9#femoral; 2.7, popliteal; 2.3
On pelvic and femoral station, image score of space MRA was equal to CE-MRA. But on
popliteal station, image score of space MRA was lower than CE-MRA.
All stenosis and occlusion were overestimated on Non-contrast MRA.
mild ischemic group vs severe ischemic group
On mild ischemia group,
image score was pelvic; 3.1, femoral; 3.3, popliteal; 2.4.
On severe ischemia group,
image score was pelvic; 2.0, femoral; 1.5, popliteal; 1.5.
On severe ischemic group, image score of Non-contrast MRA was lower than CE-MRA .
Images for this section:
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Fig. 1
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Fig. 2
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Fig. 3: mild ischemic group
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Fig. 4: mild ischemic group
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Fig. 5: severe ischemic group
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Conclusion
ECG-triggered 3D valuable flip angle FSE (space) MRA with Tim coil system is a
promising technique in the diagnosis of the peripheral arterial vascular system on
abdominal and femoral station. On popliteal station or severe ischemic group, Space
MRA is inferior to CE-MRA.
References
1. Thomsen HS. ESUR guideline: gadolinium-based contrast media and nephrogenic
systemic fibrosis. Eur Radiol 2007; 17: 2692-2696.
2. Thomsen HS, Marckmann P, Logager VB. Update on nephrogenic systemic fibrosis.
Magn Reson Imaging Clin N Am 2008; 16: 551-560, vii.
3. Miyazaki M, Takai H, Sugiura S et al. Peripheral MR angiography: separation of
arteries from veins with flow-spoiled gradient pulses in electrocardiography-triggered
three-dimensional half-Fourier fast spin-echo imaging. Radiology 2003; 227: 890-896.
4. Miyazaki M, Lee VS. Nonenhanced MR angiography. Radiology 2008; 248: 20-43.
5. Lim RP, Storey P, Atanasova IP et al. Three-dimensional electrocardiographically
gated variable flip angle FSE imaging for MR angiography of the hands at 3.0 T: initial
experience. Radiology 2009; 252: 874-881.
Personal Information
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