Tariq Arshad Hameed MD, Presenter: Research Grant, Koninklijke Philips NV

Radya GamalEldin Osman MBBS, MD, Abstract Co-Author: Nothing to Disclose

Aashish A. Patel MD, Abstract Co-Author: Nothing to Disclose

To assess if magnetic resonance (MR) imaging using albumin binding gadolinium based blood pool agent is superior to standard contrast agent or non-contrast techniques in the assessment of deep veins of the abdomens and pelvis.

Retrospective review of MR venography of abdomen and pelvis with gadofosveset and equal number of consecutive cases utilizing gadobenate dimeglumine was performed. These examinations also included pre-contrast Axial 2-D Time of flight (ToF) and TrueFISP (True fast imaging with steady state free precession) techniques. Post contrast examination included time resolved multiphase coronal T1W examination to optimize timing for maximum enhancement of deep veins with subtraction and axial thin section T1 weighted post contrast images. Quantitative analysis was performed by measuring signal intensity in the IVC or iliac veins. Contrast to noise ratio (CNR) was calculated by obtaining signal intensity in muscle and standard deviation in air. Qualitative evaluation of image quality was performed by two radiologists on a 4 point Likert scale. Presence or absence of suspected low signal artifacts or thrombus was recorded.  

24 MR examinations with Gadofosveset (15 females, 9 males, mean age 47 years) compared with 24 examinations with gadobenate meglumine (16 females, 8 males, mean age 50 years). ToF and TrueFISP sequences for all 48 examinations were compared. The CNR for TrueFISP (469) and ToF (313 ) was significantly higher compared to CNR of gadofosveset (90) as well as CNR of gadobenate meglumine (66.8) with P value < 0.001. CNR of gadofosveset was higher compared to gadobenate (P 0.472). On qualitative evaluation mean score was 3. 5 for TrueFISP, 3.3 for ToF, 3.5 and 3.6 for gadofosveset on time-resolved non subtracted and subtraction images respectively compared with 2.7 and 3.7 for gadobenate meglumine. Low signal artifacts were noted in TrueFISP and ToF (Tof >TrueFISP).

A combination of non contrast techniques provides diagnostic quality comparable to contrast enhanced studies. Contrast enhanced examinations with blood pool agents provide better image quality compared to standard contrast agents.

Diagnostic quality MR venography can be performed without intravenous contrast. Contrast  enhanced examination may be obtained as problem solving in case of suspected artifacts or to evaluate for collateral flow pattern in case of occlusion.

Hameed, T, Osman, R, Patel, A, Magnetic Resonance Venography of Abdomen and Pelvis Using Albumin Binding Blood-pool Gadolinium Contrast Agent: Comparison with Standard Contrast Agent and Non-contrast Time of Flight and Gradient Echo Techniques.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009187.html