Value Of Magnetic Resonance Angiography Research Articles

Predictive value of the hemispheric magnetic resonance angiography score on the development of indirect pial synangiosis after combined revascularization surgery for adult moyamoya disease.

It is difficult to precisely predict indirect bypass development in the context of combined bypass procedures in moyamoya disease (MMD). We aimed to investigate the predictive value of magnetic resonance angiography (MRA) signal intensity in the peripheral portion of the major cerebral arteries for indirect bypass development in adult patients with MMD. We studied 93 hemispheres from 62 adult patients who underwent combined direct and indirect revascularization between 2005 and 2019 and genetic analysis for RNF213 p.R4810K. The signal intensity of the peripheral portion of the major intracranial arteries during preoperative MRA was graded as a hemispheric MRA score (0-3 in the middle cerebral artery and 0-2 in the anterior cerebral and posterior cerebral arteries, with a high score representing low visibility) according to each vessel's visibility. Postoperative bypass development was qualitatively evaluated using MRA, and we evaluated the correlation between preoperative factors, including the hemispheric MRA score and bypass development, using univariate and multivariate analyses. A good indirect bypass was observed in 70% of the hemispheres. Hemispheric MRA scores were significantly higher in hemispheres with good indirect bypass development than in those with poor indirect bypass development (median: 3 vs. 1; p < 0.0001). Multiple logistic regression analysis revealed hemispheric MRA score as an independent predictor of good indirect bypass development (odds ratio, 2.1; 95% confidence interval, 1.3-3.6; p < 0.01). The low hemispheric MRA score (< 2) and wild-type RNF213 predicted poor indirect bypass development with a specificity of 0.92. Hemispheric MRA score was a predictive factor for indirect bypass development in adult patients who underwent a combined bypass procedure for MMD. Predicting poor indirect bypass development may lead to future tailored bypass surgeries for MMD.

Value of magnetic resonance angiography before prostatic artery embolization for intervention planning

Knowledge about anatomical details seems to facilitate the procedure and planning of prostatic artery embolization (PAE) in patients with symptomatic benign prostatic hyperplasia (BPS). The aim of our study was the pre-interventional visualization of the prostatic artery (PA) with MRA and the correlation of iliac elongation and bifurcation angles with technical success of PAE and technical parameters. MRA data of patients with PAE were analysed retrospectively regarding PA visibility, PA type, vessel elongation, and defined angles were correlated with intervention time, fluoroscopy time, dose area product (DAP), cumulative air kerma (CAK), contrast media (CM) dose and technical success of embolization. T-test, ANOVA, Pearson correlation, and Kruskal–Wallis test was applied for statistical analysis. Between April 2018 and March 2021, a total of 78 patients were included. MRA identified the PA origin in 126 of 147 cases (accuracy 86%). Vessel elongation affected time for catheterization of right PA (p = 0.02), fluoroscopy time (p = 0.05), and CM dose (p = 0.02) significantly. Moderate correlation was observed for iliac bifurcation angles with DAP (r = 0.30 left; r = 0.34 right; p = 0.01) and CAK (r = 0.32 left; r = 0.36 right; p = 0.01) on both sides. Comparing the first half and second half of patients, median intervention time (125 vs. 105 min.) and number of iliac CBCT could be reduced (p < 0.001). We conclude that MRA could depict exact pelvic artery configuration, identify PA origin, and might obviate iliac CBCT. Vessel elongation of pelvic arteries increased intervention time and contrast media dose while the PA origin had no significant influence on intervention time and/or technical success.

Imaging investigation of cervicocranial artery dissection by using high resolution magnetic resonance VWI and MRA: qualitative and quantitative analysis at different stages

BackgroundTo explore the value of magnetic resonance angiography (MRA) and high resolution magnetic resonance vessel wall imaging (HRMR-VWI) in cervicocranial artery dissection (CCAD) for the disease diagnosis, course staging and treatment. On the basis of qualitative evaluation, this study also extract the changes of different stages in vessel wall in different vessel segments to identify imaging indicators for the quantitative evaluation of CCAD.MethodsWe retrospectively enrolled 34 patients with CCAD (38branches) with conventional MRA and HRMR-VWI examinations. Two radiologists independently analyzed imaging features of vessel wall and lumen in the different stages, and the typical sign detection of artery dissection were compared between MRA and HRMR-VWI. Then the parameters of vessel wall was quantitatively evaluated by the post-processing software (Vesselmass, Leiden University Medical Center, Leiden, The Netherlands.ResultsHRMR-VWI revealed typical sign detection of artery dissection in all patients in the acute and subacute stage. Among them, the intimal flap/double lumen sign ditection were more common than the MRA, there was significant difference (P = 0.012). MRA revealed typical sign detection of artery dissection in more than half the patients, and the detection was no significant difference at the chronic stage between MRA and HRMR-VWI (P = 1.000/1.000/0.761). In the acute and subacute stage, the typical sign detection of intramural hematoma and Grade II enhancement revealed by HR-MRI was higher than the observations in the chronic stage (P = 0.000/0.000/0.016), while there was no significant difference by MRA (P = 0.902). The values of wall thickness, relative signal intensity of vessel wall enhancement, relative signal intensity of intramural hematoma (IMH), and percentage of stenosis in CCAD decreased from acute to subacute and then to chronic stages. Each quantitative parameter in patients with CCAD in the early stages (i.e., acute and subacute stages) was significantly different from that in patients with CCAD in the recovered group at chronic stage (P < 0.05). Wall thickness and relative signal intensity of vessel wall enhancement in patients with CCAD in the early stages were not significantly different from those in patients with CCAD in the incompletely recovered group at chronic stage (P > 0.05).ConclusionsAs the only noninvasive imaging technology, HRMR-VWI displays the structure of the vessel wall in vivo, showing not only excellent performance in the early diagnosis of CCAD, but also describing the changes of different stages in the qualitative and quantitative characteristics of vessel wall. It also helps to guide the diseasediagnosis, course staging and treatment of CCAD. Although the diagnostic efficacy of MRA was not as good as HRMR-VWI, it should be the first choice of method for routine examination in evaluating CCAD, especially at the chronic stage of CCAD.

Clinical significance of MRA, TCD and electroencephalogram in the diagnosis of intracranial artery stenosis in ischemic cerebrovascular disease

ABSTRACT The clinical value of magnetic resonance angiography (MRA), transcranial Doppler ultrasound (TCD) and electroencephalogram (EEG) in the diagnosis of intracranial artery stenosis in ischemic cerebrovascular disease (ICVD) was explored. The clinical data of TCD, MRA and EEG in 98 patients with ICVD were retrospectively analyzed. The clinical value of TCD, MRA combined with EEG in the diagnosis of intracranial artery stenosis in ICVD was analyzed based on the results of digital subtraction angiography (DSA) as the gold standard. A total of 98 patients were diagnosed with 27 cases of normal intracranial artery, 32 cases of mild stenosis, 25 cases of moderate stenosis, and 14 cases of severe stenosis DSA examination. TCD was detected in 23 cases of normal, 25 cases of mild stenosis, 23 cases of moderate stenosis and 13 cases of severe stenosis. MRA showed 24 cases of normal, 28 cases of mild stenosis, 21 cases of moderate stenosis and 12 cases of severe stenosis. EEG examination detected that there were 25 cases of normal, 24 cases of mild stenosis, 22 cases of moderate stenosis, and 14 cases of severe stenosis. Sensitivity, accuracy and negative predictive value had significant differences between combined diagnosis and single diagnosis. The combined detection of TCD, MRA and EEG is consistent with DSA detection in the diagnosis of ICVD intracranial artery stenosis.

Clinical Diagnosis and Treatment Value of CT Three-Dimensional Imaging of Gynecological Pelvic Blood Vessels

For diseases of the abdominal and pelvic system, especially those of the blood duct system, the main examination methods of the transmission system are color Doppler ultrasound, enhanced CT angiography and digital subtraction angiography (DSA). Among them, DSA is the gold standard of angiography, but it is an invasive examination, which is complicated, time-consuming and laborious, and the skill of intubation is very high. Enhanced 3D-CT blood tube imaging has been gradually used in clinic because of its advantages such as fast imaging speed and wide imaging range. It has good vascular imaging conditions and satisfactory vascular imaging results in all parts of the human body, but this examination is radioactive and is not beneficial to young women of childbearing age, children and frail patients. The purpose of this paper is to further illustrate the value of magnetic resonance angiography (CTA) in displaying pelvic vessels by comparing the three-dimensional model of magnetic resonance angiography (CTA) and magnetic resonance angiography (MRA) in healthy young women. The results showed that for the venous system, CTA usually showed only the internal and external iliac vein, but not for the uterine vein and other branches of the internal and external iliac vein, and almost no imaging for the anterior sacral vein. CE-MRA can not only display 1-4 grade arteries to the same extent, but also show more branches of superior and inferior gluteal arteries, and show more abundant veins, especially presacral veins. For cases such as gynecological pelvic floor surgery, it is necessary to know the vascular network of presacral region before operation. In a word, for clinical diagnosis and treatment value, the 3D-CT imaging is the first choice.

Interrupted Aortic Arch in an Adult.

Interrupted aortic arch (IAA) is a rare congenital abnormality with only a few cases reported in adults. It is defined as complete loss of continuity between the ascending and descending portions of the aorta, and is usually associated with other cardiac defects. The diagnosis in adults should be suspected in the presence of refractory hypertension, a careful physical examination being crucial to early diagnosis. Magnetic resonance angiography (MRA) techniques can accurately characterize cardiovascular anatomy, and also provide information regarding heart chamber and valve function.LEARNING POINTSAlthough rare, interrupted aortic arch (IAA) must be considered in the differential diagnosis of adults with refractory hypertension. A careful physical examination, with evaluation of femoral pulses and blood pressure in the four limbs, is essential for the diagnosis and for ensuring that the correct diagnosis is made promptly.This case highlights the value of magnetic resonance angiography (MRA) in radiation-free non-invasive evaluation of adults with congenital aortic abnormalities, as it may provide clinically important haemodynamic information.Only a few cases have been reported in adults. We present an unusual case in which the diagnosis was not made until adulthood.

Acute Stroke Imaging: Feasibility and Value of MR Angiography with High Spatial and Temporal Resolution for Vessel Assessment and Perfusion Analysis in Patients with Wake-up Stroke

Magnetic resonance (MR) imaging (MRI) provides information that can be used to estimate the symptom onset in patients with wake-up stroke (WUS). Time-resolved MR angiography (MRA) is the fastest available MR sequence technique for vessel assessment, and the different phases acquired can provide information about cerebral perfusion. The aim of this study was to evaluate the diagnostic performance of time-resolved MRA both for the assessment of vessel morphology and for the feasibility of perfusion. Nineteen patients with WUS were included. Image quality and vessel pathologies were evaluated and correlated to time-of-flight-MRA (n = 14), computed tomography-angiography (n = 4), sonography (n = 12), and conventional angiography (n = 6). The temporal delay of signal enhancement in all pixels of the time-resolved MRA measurement after contrast injection was evaluated and compared to dynamic susceptibility contrast-enhanced (DSC) perfusion imaging (n = 13). Time-resolved MRA resulted in the diagnosis of large vessel disease in 14 of 19 patients, involving the internal carotids (n = 4), the vertebral arteries (n = 3), and the circle of Willis (n = 10). All severe vascular pathologies which influence patients' acute stroke therapy were obtained by time-resolved MRA. Overestimation of stenoses in two of 14 patients resulted in sensitivity and specificity of 100% and 71%, respectively. Time-to-peak (TTP) estimations were hampered by movement artifacts in four patients (31%). Compared to DSC, the area of TTP delay was comparable in size and localization without relevant overestimation or underestimation. Time-resolved MRA is a valuable technique in patients with WUS with high sensitivity and high negative predictive value. Cerebral perfusion estimation can be performed in selected cases for therapy decision but can be hampered by patient movement.

Role of MRA in the detection of intracranial aneurysm in the acute phase of subarachnoid hemorrhage

Magnetic resonance angiography (MRA) has been evaluated for the detection of unruptured intracranial aneurysms with favorable results at 3 Tesla (3T) and with similar diagnostic accuracy as both 3D time-of-flight (3D-TOF) and contrast-enhanced (CE-MRA) MRA. However, the diagnostic value and place of MRA in the detection of ruptured aneurysms has been little evaluated. Thus, the goal of this prospective single-center series was to assess the feasibility and diagnostic value of 3T 3D-TOF MRA and CE-MRA for aneurysm detection in acute non-traumatic subarachnoid hemorrhage (SAH). From March 2006 to December 2007, all consecutive patients admitted to our hospital with acute non-traumatic SAH (≤10 days) were prospectively included in this study evaluating MRA in the diagnostic workup of SAH. Feasibility of MRA and sensitivity/specificity of 3D-TOF and CE-MRA were assessed compared with gold standard DSA. In all, 84 consecutive patients (45 women, 39 men; age 23-86 years) were included. The feasibility of MRA was low (43/84, 51.2%). The reasons given for patients not undergoing magnetic resonance imaging (MRI) examination were clinical status (27 patients), potential delay in aneurysm treatment (11 patients) and contraindications to MRI (three patients). In patients explored by MRA, the sensitivity of CE-MRA (95%) was higher compared with 3D-TOF (86%) with similar specificity (80%). Also, 3D-TOF missed five aneurysms while CE-MRA missed two. The value of MRA in the diagnostic workup of ruptured aneurysms is limited due to its low feasibility during the acute phase of bleeding. Sensitivity for aneurysm detection was good for both MRA techniques, but tended to be better with CE-MRA.

Comparison of Ventilation-Perfusion Scintigraphy With MR Angiography in Patients With Swyer–James Syndrome

The aim of this study was to establish the value of magnetic resonance angiography (MRA) in diagnosing) Swyer-James syndrome (SJS) and to compare MRA and ventilation-perfusion (V/Q) scan results in patients with established SJS. The V/Q scans and the MRA findings of 22 lungs of 11 patients with SJS (6 males, 5 females; age range: 17-69 years, mean: 38.4 years) were retrospectively studied. The perfusion scan was performed after the injection of Tc macroaggregated albumin. After 2 days, the ventilation scan was performed by using Tc diethylene triamine penta-acetic acid aerosol. The MRA was performed with a 1.5 T magnetic resonance unit. We compared the MRA and V/Q scan findings of the lungs of the patients. The V/Q scans showed the characteristic pattern of a matched V/Q defect on the affected lungs. The MRA displayed a smaller pulmonary artery and markedly poor peripheral vasculature on the affected side in all patients. The MRA had a sensitivity of 84.6%, a specificity of 100% for the detection SJS. Interobserver variability was minimum as indicated by a weighted kappa statistic of 0.818. This study indicates that the MRA is a fast, accurate, without radiation, and noninvasive technique for supporting the diagnosis of SJS. But, V/Q scans showed additional segmental perfusion/ventilation abnormalities on contralateral lung to reveal the segmental involvement of SJS. As a result, the MRA has no more any extra advantages for patient management.

Detection of Type II Endoleak After Endovascular Aortic Repair: Comparison Between Magnetic Resonance Angiography and Blood-Pool Contrast Agent and Dual-Phase Computed Tomography Angiography

This prospective study was designed to assess the diagnostic value of magnetic resonance angiography (MRA) with blood-pool contrast agent (gadofosveset) in the detection of type-II endoleak after endovascular aortic repair (EVAR). Thirty-two patients with aortic aneurysms who had undergone EVAR were included in this study. All patients were examined by dual-phase computed tomography angiography (CTA) as well as MRA with gadofosveset in the first-pass and steady-state phases. Two independent readers evaluated the images of CTA and MRA in terms of endoleak type II, feeding vessel, and image quality. Median follow-up-time after EVAR was 22 months (range 4 to 59). Endoleak type II was detected by CTA in 12 of 32 patients (37.5%); MRA detected endoleak in all of these patients as well as in another 9 patients (n = 21, 65.6%), of whom the endoleaks in 6 patients showed an increasing diameter. Most endoleaks were detected in the steady-state phase (n = 14). The decrease in diameter of the aneurysmal sac was significantly greater in the patients without a visible endoleak that was visible on MRA (P = 0.004). In the overall estimation of diagnostic accuracy, MRA was judged superior to CTA in 66% of all examinations. MRA with gadofosveset appeared superior to CTA, and has higher diagnostic accuracy, in the detection of endoleak after EVAR.

A rare case of cerebral vasculitis in Henoch‐Schönlein purpura with emphasis on the diagnostic value of magnetic resonance angiography (MRA) and single‐photon emission computed tomography (SPECT) given normal magnetic resonance imaging (MRI)

A rare case of cerebral vasculitis in Henoch‐Schönlein purpura with emphasis on the diagnostic value of magnetic resonance angiography (MRA) and single‐photon emission computed tomography (SPECT) given normal magnetic resonance imaging (MRI)

A comparison of magnetic resonance angiography with conventional angiography in the diagnosis of tetralogy of Fallot

Our purpose was to assess the value of magnetic resonance angiography as a non-invasive alternative to catheterization in the evaluation of patients with tetralogy of Fallot, including those with pulmonary atresia. We evaluated prospectively, using magnetic resonance angiography, 30 patients, aged from 1 to 18 years, 15 with tetralogy of Fallot and pulmonary stenosis, and 15 with pulmonary atresia. The studies obtained using magnetic resonance provided adequate visualization of the aorta, and provided excellent imaging of the pulmonary trunk and its right and left branches. Compared with catheterization, magnetic resonance had 100 percent sensitivity, specificity and accuracy for defining the presence or absence of the pulmonary arteries. Magnetic resonance also had 93.9 percent sensitivity, 98.2 percent specificity, and 96.7 percent accuracy for detection of stenosis or hypoplasia of the pulmonary arteries. We detected 25 major aortopulmonary collateral arteries with magnetic resonance, but only 22 with conventional angiography. There was complete agreement between the two methods in detecting patency of the arterial duct in 6 patients, and of Blalock-Taussig shunts in 12 patients. Magnetic resonance angiography is a useful tool in the evaluation of patients with tetralogy of Fallot. It can be considered a non-invasive alternative to cardiac catheterization in the evaluation of the pulmonary vascular anatomy.

Value of magnetic resonance angiography combined with magnetic resonance cholangiopancreatography on diagnosis for patients with carcinoma of head of pancreas

To study the value of magnetic resonance imaging (MRI) combined with magnetic resonance angiography (MRA) and magnetic resonance cholangiopancreatography (MRCP) in the preoperative diagnosis of patients with carcinoma of head of pancreas. Forty-two patients were examined by MRI, MRCP and MRA. The results were compared with the intraoperative exploration findings and operative procedures. The MRCP and MRA results of 42 cases demonstrated that peripancreatic tissues and blood vessels were not invaded in 24 cases, while portal vein and superior mesenteric vein were invaded by the tumor in 5 cases, and peripancreatic vessels were infiltrated in 10 cases, and 3 cases were detected with organ metastasis. Thirty-five of forty-two cases were consistent with the intraoperative exploration findings, and the accurate rate was 89.7%. Pancraticoduodenectomy was performed in 28 patients, internal drainage in 11 and interventional therapy in 3 cases. The resection rate was 66.7%. The results of MRCP and MRA could definitely demonstrate the preoperative organ metastasis and peripancreatic organization invasion, especially blood vessel infiltration. So the imaging results played an important role in estimating the level of the process and guiding the treatment.

Magnetic resonance angiography of coronary arteries with a 3-dimensional magnetization-prepared true fast imaging with steady-state precession sequence compared with conventional coronary angiography

The aim of the study was to compare the detection of clinically significant coronary artery stenosis using a magnetic resonance 3-dimensional (3D) breath-hold true fast imaging with steady-state precession (trueFISP) sequence with conventional coronary angiography. Twenty-nine patients who were scheduled to undergo or had recently undergone diagnostic conventional coronary angiogram participated in this study. The left main, left anterior descending, left circumflex, and right coronary arteries were studied using the 3D breath-hold trueFISP technique. Each artery was imaged with 1 acquisition in 16 to 32 heartbeats. The image quality, vessel length, and presence or absence of stenosis were evaluated. A score of 1 to 3 (1 = noninterpretable, 2 = good, 3 = excellent) was used to assess image quality. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of magnetic resonance angiography in detecting significant coronary artery stenosis (> 50% luminal narrowing) on conventional coronary angiogram were calculated. Of 116 vessels, 108 were assessed in 29 patients. Twenty vessels that had image quality score of 1 were excluded from further evaluation. The mean lengths of vessels visualized were the following: left anterior descending 3.6 cm, left circumflex 3.4 cm, and right coronary 6.6 cm. The entire length of the left main coronary artery was visualized. For the visualized arterial segments, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for detecting significant coronary artery stenosis were 92.8%, 95.3%, 95.0%, 68.4%, and 99.2%, respectively. The 3D breath-hold trueFISP technique, which uses the endogenous contrast of blood, is potentially useful in ruling out significant coronary artery stenosis but not yet sensitive enough as a screening tool.

Value of MR Angiography before Percutaneous Transluminal Renal Artery Angioplasty and Stent Placement

To determine the benefit of preprocedural three-dimensional gadolinium (Gd)-enhanced magnetic resonance (MR) angiography before percutaneous transluminal renal artery angioplasty and stent placement (PTRA/S) in terms of procedural success, iodinated contrast material load, and procedure duration. Over an 18-month period, 39 patients underwent attempted percutaneous renal angioplasty with or without stent placement. A total of 48 renal arteries were treated (40 cases of atherosclerosis, one of stent restenosis, five of fibromuscular dysplasia, and two of transplant stenosis). Preprocedural Gd-enhanced MR angiography was available in 16 procedures (41%). Procedural outcome, complications, iodinated contrast material load, number of diagnostic angiographic runs, and total procedure duration were each compared between two subgroups: patients who had preprocedural Gd-enhanced MR angiography ("prior MR angiography group") and those who did not ("no MR angiography" group). All procedures were technically successful. The two groups were equivalent in terms of age and disease pattern. However, technical complexity of the procedure was judged to be high in five of 16 procedures in the prior MR angiography group compared to three of 23 procedures in the no MR angiography group (P =.16). Bilateral or dual interventions were performed in six of 16 procedures in the prior MR angiography group compared to three of 23 in the no MR angiography group (P =.075). Iodinated contrast material load was significantly lower in the prior MR angiography group than in the no MR angiography group (68.7 mL +/- 28.4 vs 119.1 mL +/- 49.2 mL;P <.0008). The number of diagnostic angiographic runs before interventions were also significantly lower in the prior MR angiography group (1.2 +/- 0.4 vs 2.6 +/- 0.7; P <.0001). Overall procedure duration was comparable between the two groups (91.9 +/- 47.8 vs 112.2 +/- 49.4;P =.2). Preprocedural planning with use of Gd-enhanced MR angiography significantly reduces the iodinated contrast material requirement during percutaneous renal artery interventions. It can also significantly shorten procedure duration.

The vasculopathy of autosomal dominant polycystic kidney disease: Insights from animal models

A 37-year-old white man with autosomal dominant polycystic kidney disease (ADPKD) was admitted to Boston's Beth Israel Hospital with sudden severe headache of two-hour duration. He was unconscious on admission. Emergency angiography revealed a ruptured 15 mm cerebral aneurysm. Emergency surgery to clip the aneurysm was unsuccessful, and the patient died 36 hours after admission. His serum creatinine was 3.2 mg/dL on admission; the rest of his laboratory values were within normal limits. A request for an autopsy was denied. At age 20, the patient and his then 15-year-old sister had abdominal ultrasound examinations that revealed bilateral renal cysts, consistent with the diagnosis of ADPKD. At age 32, the patient had a sudden, relatively severe, acute myocardial infarction (MI). Cardiac catheterization revealed three-vessel disease, and he subsequently underwent a triple coronary artery bypass operation. Throughout his medical course, the patient's blood pressure was in the 120/80 to 140/80 mm Hg range while he was taking lisinopril, 10 mg/day, which was started after his MI. The patient's mother has ADPKD and end-stage renal disease, and she is on hemodialysis. She recently underwent unsuccessful renal transplantation. There is no known family history of cerebral aneurysms. However, the mother had two cerebrovascular accidents and recovered from both. The patient's father had an MI at age 32, but he lived to age 64. A paternal uncle also died at an early age of an MI. The patient's younger sister was later screened for cerebral aneurysms and the test was negative. The patient's two young children have not been screened for ADPKD.

INTRACRANIAL ANEURYSMS AND AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE: FOLLOWUP STUDY BY MAGNETIC RESONANCE ANGIOGRAPHY

Intracranial aneurysms are known to complicate autosomal dominant polycystic kidney disease. We assess the value of magnetic resonance angiography to detect intracranial aneurysms early in patients with autosomal dominant polycystic kidney disease. We evaluated 15 patients with asymptomatic autosomal dominant polycystic kidney disease treated at our hospital between 1992 and 1998. Magnetic resonance angiography was performed at presentation and was repeated 18 to 72 months after treatment. On the initial magnetic resonance angiogram 3 intracranial aneurysms were detected in 3 patients. The intracranial aneurysms ranged from 4 to 8 mm. in diameter, and were in the anterior communicating artery in 1, in the vertebral artery in 1, and at the bifurcation of the internal carotid artery and ophthalmic artery in 1 case. Repeat magnetic resonance angiography 18 to 72 months after treatment revealed new intracranial aneurysms in 2 patients. In 1 case the lesion was 7 mm. in diameter, in the internal carotid artery and posterior communicating artery, and detected 69 months after the initial angiogram. In the other patient the lesion was 4 mm. in diameter, in the anterior communicating artery and detected 71 months after treatment. Since new intracranial aneurysms were demonstrated in patients followed for a long time periodic repeat magnetic resonance angiography is important.

Value of Fast Gradient Echo Magnetic Resonance Angiography as an Adjunct to Coronary Arteriography in Detecting and Confirming the Course of Clinically Significant Coronary Artery Anomalies

We investigated the additional value of magnetic resonance (MR) angiography in 12 patients with clinically significant coronary anomalies. In 5 patients, the referring cardiologist requested additional evaluation because coronary arteriography was inconclusive about the course of the anomaly. For comparison, 7 patients with known anomalous coronary arteries were collected from our database. In these patients, there had been no doubt about the course of the anomalous coronary arteries. MR angiography provided the diagnosis in all 5 patients in whom the diagnosis was inconclusive beforehand. From the 7 patients in whom diagnosis had been established previously by contrast arteriography, the anomaly was confirmed in 5 by MR angiography. In 1 patient, the initial diagnosis at contrast arteriography had to be changed as a result of MR angiography. In 1 patient, the MR image was of insufficient quality to be conclusive.In conclusion, in patients with angiographically suspected coronary anomalies, fast gradient echo MR angiography is a helpful adjunct to coronary arteriography in identifying and confirming the origin and course of clinically significant coronary anomalies. The additional value of fast gradient echo MR coronary angiography is the visualization of both the artery and its surrounding structures.In 12 patients with angiographically suspected clinically significant coronary anomalies, we investigated the additional value of magnetic resonance angiography to delineate the course of the coronary artery. Fast gradient echo magnetic resonance angiography appeared to be a helpful adjunct to coronary arteriography in identifying and confirming the course of the clinically significant coronary anomalies.

Follow-up of intracranial aneurysms in autosomal dominant polycystic kidney disease by magnetic resonance angiography.

The purpose of this study was to assess the value of magnetic resonance angiography (MRA) in the follow-up of patients with autosomal dominant polycystic kidney disease (ADPKD) and saccular intracranial aneurysms (ICA), the risk of MRA-defined growth of asymptomatic incidental ICA, and the rate of development of MRA-defined de novo ICA in these patients. Between 1989 and 1995, 15 asymptomatic incidental ICA measuring 1.5 to 6.5 mm in diameter, three symptomatic aneurysms, and one asymptomatic concurrent aneurysm were detected by MRA in this study in 18 patients from 15 families. Four-vessel cerebral angiography in the three patients with symptomatic ICA and autopsy in one patient with an asymptomatic incidental ICA did not reveal additional aneurysms undetected by MRA. Thirty MRA studies were obtained in 10 of the 15 patients with incidental ICA during a cumulative clinical follow-up of 500 months (mean, 33.3; range, 0 to 65 months). The cumulative interval between the initial and the last MRA was 306 months (mean, 30.6; range, 14 to 51 months). No change in aneurysmal size or development of de novo aneurysms was detected. Eight MRA studies were obtained in the three patients with symptomatic ICA during a cumulative clinical follow-up of 130 months (mean, 43.3; range, 23 to 64 months). The cumulative interval between the first and the last MRA was 95 months (mean, 31.7; range, 15 to 49 months). Development of de novo aneurysms was not detected. These results indicate that MRA is an appropriate technique to follow small asymptomatic incidental ICA in patients with ADPKD and that the risk for rapid growth of these aneurysms is low. Although the results of this study should be viewed as preliminary, they do not suggest a higher rate of development of de novo aneurysms or a higher frequency of multiple aneurysms in patients with ADPKD and ICA as compared with patients with sporadic ICA in the general population.

Value of magnetic resonance angiography in the evaluation of head and neck neoplasms

Value of magnetic resonance angiography in the evaluation of head and neck neoplasms