Abstract
BackgroundThe aim of this study was to compare non-contrast-enhanced 3D phase contrast magnetic resonance angiography (3D PC-MRA) and conventional intravenous administration of contrast media, i.e., contrast-enhanced MRA (CE-MRA), to evaluate the courses of facial arteries for the preparation of vascularized submental lymph node flap (VSLN flap) transfer.MethodsThe head and neck regions of 20 patients with limb lymphedema were imaged using a 3 T MRI scanner. To improve the evaluation of facial artery courses, MRA was fused with anatomical structures generated by high-resolution T1-weighted imaging. The diagnostic and image qualities of facial arteries for VSLN flap planning were independently rated by two radiologists. Interobserver agreement was evaluated using Cohen’s kappa. Differences between 3D PC-MRA and CE-MRA in terms of the diagnostic quality of facial arteries were evaluated using McNemar’s test.ResultsCohen’s kappa indicated fair to good interobserver agreement for the diagnostic and image qualities of the bilateral facial arteries. No significant difference in terms of the diagnostic quality of the left and right facial arteries between 3D PC-MRA and CE-MRA, respectively, was identified.ConclusionsNon-contrast 3D PC-MRA is a reliable method for the evaluation of facial artery courses prior to VSLN flap transfer and could serve as an alternative to CE-MRA for patients with renal insufficiency or severe adverse reactions to contrast media.
Highlights
The aim of this study was to compare non-contrast-enhanced 3D phase contrast magnetic resonance angiography (3D Three-dimensional phase contrast magnetic resonance angiography (PC-MRA)) and conventional intravenous administration of contrast media, i.e., contrast-enhanced MRA (CE-MRA), to evaluate the courses of facial arteries for the preparation of vascularized submental lymph node flap (VSLN flap) transfer
Because the enhancement of facial arteries is associated with contrast media (CM)-induced T1-shortening of the blood, it may be sometimes difficult to differentiate the small arteries from neighboring tissues due to CM contamination with CE-MRA compared with 3D PC-MRA (Fig. 3)
The radiologists rated vascular morphology by maximum intensity projection (MIP) of Volume-T1 fused with 3D PC-MRA or CE-MRA using a four-point scale
Summary
The aim of this study was to compare non-contrast-enhanced 3D phase contrast magnetic resonance angiography (3D PC-MRA) and conventional intravenous administration of contrast media, i.e., contrast-enhanced MRA (CE-MRA), to evaluate the courses of facial arteries for the preparation of vascularized submental lymph node flap (VSLN flap) transfer. CE four-dimensional MRA with modified true fast imaging and steady-state free precession as well as a flowsensitive alternating inversion recovery scheme for spin tagging of blood labeling sequences using a three Tesla (3 T) magnetic resonance imaging (MRI) system to evaluate 15 patients with head and neck tumors [15]. Unlike traditional PC-MRA, 3D PCMRA is compatible with parallel imaging and uses a timeefficient elliptical k-space-filling technique to reduce scan time and influence patient motions, especially in children and the elderly. The aim of present study was to compare the performances of non-CE 3D PC-MRA and CE-MRA in terms of visualization of the facial arteries
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