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1
Department of Radiology, Hôpital Huriez, Centre
Hospitalier Universitaire de Lille, 1 rue Polonovski, F-59037 Lille,
France.
2
Department of Radiology, Hôpital Calmette,
Centre Hospitalier Universitaire de Lille, Blvd. du Professeur Leclerc,
F-59037 Lille, France.
3
Department of Gastroenterology, Hôpital Huriez,
Centre Hospitalier Universitaire de Lille, F-59037 Lille, France.
4
Siemens SAS, 39 Blvd. Ornano, F-93527 Saint-Denis, France.
OBJECTIVE. Our aim was to compare the results of gadolinium-enhanced breath-hold MRangiographywiththoseofconventionalangiographyforthestudyofmesentericcirculation.
SUBJECTS AND METHODS. MR angiography and digital subtraction angiography were prospectively performed in 33 patients referred for hepatic, pancreatic, or mesenteric disease. MR angiography was performed with four three-dimensional acquisitions at 0, 30, 60, and 90 sec after injection of 0.1 mmol/kg of gadolinium. Selective conventional angiography was used as the standard of reference.
RESULTS. A pure arterial angiogram (one on which veins could not be
visualized) was obtainedin 27 patients during the second or third acquisition.
By subtracting the arterial phase from an arteriovenous phase (third or fourth
acquisition) we obtained a pure venous angiogram (one on which arteries could
not be visualized) in 28 patients. Agreement was good or excellent for the
hepatic artery (
= 0.78), the superior mesenteric artery ( =
0.65), the splenic artery ( = 0.70), the portal vein ( = 1.0),
the superior mesenteric vein ( = 0.88), and the splenic vein ( =
0.75). Agreement was poor, and vessels were better shown by conventional
angiography, for the intrahepatic arteries ( = 0.006) and the branches
of the superior mesenteric artery ( = 0.14). MR angiography and
conventional angiography revealed 29 and 27 portosystemic collaterals,
respectively.
CONCLUSION. Dynamic breath-hold contrast-enhanced MR angiography compared favorably with conventional angiography in preoperative assessment of the proximal mesenteric arteries and in the evaluation of portal hypertension; however, conventional angiography is still necessary to evaluate distal arteries.
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