The value of true-FISP sequence added to conventional gadolinium-enhanced MRA of abdominal aorta and its major branches

Abstract

To test true-fast imaging with steady-state precession (true-FISP) added to gadolinium-based MR angiography (Gd-MRA) for imaging abdominal aorta and major abdominal vessels, 35 consecutive patients (age 67 ± 11 years) with known or suspected abdominal and/or peripheral vascular disease were studied with sagittal and axial 2D true-FISP during free breathing and coronal 3D fast low-angle shot (FLASH) Gd-MRA (breath-holding, 0.2 mmol/kg of Gd-DOTA at 2 ml/s). We evaluated: suprarenal aorta, celiac trunk, superior mesenteric artery, right renal artery, left renal artery, infrarenal aorta, inferior mesenteric artery, aortic bifurcation/common iliac arteries, lumbar arteries and aortic atheromasia. The possible presence of accessory renal arteries, collateral vasculature and vascular prosthesis/stent was evaluated. A quality four-point score was assigned to each item on both sequences, from 0 (not visible) to 3 (good-to-excellent image quality) and Wilcoxon test was used. Main diagnoses resulted: normal or atheromasic aorta ( n = 25); aortic aneurysm ( n = 2); patent aorto-iliac surgical prosthesis ( n = 2); patent vascular iliac stent ( n = 2); aneurysm of iliac artery ( n = 1); patent aortic endovascular prosthesis ( n = 1); patent aorto-femural bypass ( n = 1) and aorto-iliac surgical prosthesis endoleak ( n = 1). We also found three patients with accessory renal arteries, two with collateral circulation, and three with surgical aorto-iliac prosthesis. The score of true-FISP (25.9 ± 4.1, median 27) was significantly higher ( p = 0.003) than that of Gd-MRA (23.9 ± 3.6, median 24). True-FISP was superior for visualizing inferior mesenteric artery (score 2.5 ± 1.1 vs. 1.0 ± 1.4; p < 0.001) and atheromasic plaques (2.5 ± 1.1 vs. 1.2 ± 1.1; p < 0.001). One collateral vasculature was demonstrated only with Gd-MRA. Summarizing, true-FISP is a power and fast non-breath-hold sequence to be added to Gd-MRA, obtaining an information increase.