Vivek Kalra MD, Presenter: Nothing to Disclose

John Gilbert BS, Abstract Co-Author: Nothing to Disclose

Saravanan Kokila Krishnamoorthy MD, Abstract Co-Author: Nothing to Disclose

Daniel Cornfeld MD, Abstract Co-Author: Nothing to Disclose

To evaluate the use of a non-contrast MRA sequence (In-Flow Inversion Recovery [IFIR]) to identify the hepatic arterial vasculature and compare this to a standard contrast-enhanced sequence (Liver Acquisition with Volume Acquisition [LAVA]).

Liver MRI was performed in 30 patients (mean age, 53.2 years ± 17.2 [SD]) with known or suspected liver masses. The protocol included a non-contrast MRA sequence (IFIR) in addition to the standard contrast-enhanced hepatic arterial phase sequence (LAVA). Individual vessels on non-contrast and contrast-enhanced sequences were retrospectively evaluated by a blinded reader using a four-point scale (1 = not seen, 2 = seen but non-diagnostic, 3 = sub-optimal but diagnostic, 4 = well seen). McNemar test was used to determine which sequence diagnostically imaged the vessels more frequently. Wilcoxan signed-rank test was used to determine which sequence better imaged the vessels.  

In 20% of patients, the anterior right hepatic artery was only diagnostically seen on the non-contrast sequences. Similarly, this occurred with the posterior right hepatic artery, lateral left hepatic artery, and hepatic artery to segment 4 in 10% of patients; gastroduodenal artery in 13% of patients; proper hepatic artery in 7% of patients; and celiac artery, common hepatic artery, and left hepatic artery in 3% of patients. Contrast sequences (LAVA) diagnostically imaged the left hepatic artery, posterior right hepatic artery, left lateral hepatic artery, hepatic artery to segment 4, and the superior mesenteric artery with statistically significant (p<0.05) greater frequency compared to non-contrast sequences (IFIR). Contrast sequences also demonstrated statistically significant (p<0.05) better visualization of the left hepatic artery, posterior right hepatic artery, lateral left hepatic artery, hepatic artery to segment 4, and superior mesenteric artery. 

Non-contrast sequences were able to diagnostically demonstrate hepatic arterial vasculature not seen on contrast-enhanced sequences in a substantial number of patients. Although non-contrast sequences (IFIR) alone are statistically inferior to contrast-enhanced sequences (LAVA), they do not add considerably to the scan time, and may be useful adjunct. 

Non-contrast sequences (IRIF) may be a useful adjunct to standard contrast-enhanced sequences (LAVA) in evaluation of hepatic arterial vasculature. 

Kalra, V, Gilbert, J, Krishnamoorthy, S, Cornfeld, D, Value of Noncontrast Sequences in Magnetic Resonance Angiography of Hepatic Arterial Vasculature.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034562.html