Guenther Karl Schneider PhD, Presenter: Nothing to Disclose

Roland Michael Seidel MD, Abstract Co-Author: Nothing to Disclose

Peter Fries MD, Abstract Co-Author: Nothing to Disclose

Vascular malformations in pediatric patients represent a widespread spectrum of different pathologies in different localizations of varying clinical significance reaching from esthetic alterations of the skin up to life threatening pathologies such as complex malformations of the aorta and great vessels and angiomatoid tumors manifesting with compression of the tracheobronchial system.This variation of pathologies implicates the need of an adequate noninvasive imaging modality to correctly diagnose and subsequently plan therapy. This study gives an overview of different congenital vascular malformations visualized by contrast enhanced MRA with the use of Gd-BOPTA, a high relaxivity contrast agent which gives the opportunity to even depict very small vascular structures.

MRA was performed on a 1.5 T Magnet (Sonata, Siemens, Germany) and a total of 38 patients with an age range from 2 days up to 8 years were examined. In order to avoid motion artifacts, MRA was performed in sedation or after intubation and controlled ventilation corresponding to the age of the patient and the vascular territory imaged. For MRA Gd-BOPTA was applied intravenously at a dose of 0.1-0.2 mmol/kg body weight resulting in total doses between 0.2 and 6 ml. Contrast agent was injected by hand during ongoing sequence acquisition without the use of a test bolus.

At the injected dose Gd-BOPTA shows an excellent and homogeneous delineation of for example the aorta and supra-aortic branches even in newborn babies in which vessel diameter of <3mm have to be considered. Long breath-hold intervals due to controlled ventilation allow for dynamic whole body imaging of the arterial and venous system in one imaging session and thus may give a complete overview about the vascular status.

Gd-BOPTA in contrast enhanced MRA of pediatric patients shows an excellent delineation of even very small vessels and thus allows a diagnostic workup of even newborn or premature babies. As known from other studies this better delineation of small vessels may be caused by the increased relaxivity as compared to other gadolinium chelates and thus, Gd-BOPTA may be favorable in contrast enhanced MRA of pediatric patients.

Schneider, G, Seidel, R, Fries, P, Pediatric MRA with Gd-BOPTA.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4417134.html