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Vascular and Interventional Radiology |
1 From the Department of Radiology–MRI, New York University Medical Center, 530 First Ave, HCC Basement, New York, NY 10016. Received August 26, 1998; revision requested October 22; final revision received February 8, 1999; accepted June 8. Supported in part by an RSNA Research and Education Foundation Medical Student Departmental Grant. Address reprint requests to V.S.L. (e-mail: lee@mri.med .nyu.edu).
PURPOSE: To assess the usefulness of three-dimensional (3D) gadolinium-enhanced magnetic resonance (MR) venography for evaluation of thoracic central veins.
MATERIALS AND METHODS: A retrospective study included 15 patients who underwent 3D gadolinium-enhanced subtraction MR venography with a spoiled gradient-echo sequence before and at multiple times after intravenous administration of 30-40 mL of contrast material. Maximum intensity projection and multiplanar reconstruction images were used to categorize central veins as patent, occluded, or narrowed. Results were compared with findings (in 12 patients) at conventional venography (n = 3), attempted central venous catheter placement (n = 3), or surgery (n = 6). Medical records were retrospectively reviewed to determine if patient care was affected by MR venographic findings.
RESULTS: By using MR venograms, an appropriate vessel could be identified for successful placement of a catheter, indwelling venous access device, or arteriovenous hemodialysis graft in all nine patients in whom placement was attempted. MR venography also was predictive of unsuccessful hemodialysis catheter placement in one patient. Conventional venographic findings confirmed MR venographic findings in three patients; in a fourth patient, conventional venography was unsuccessful due to inadequate access. MR venographic findings influenced treatment in 14 patients.
CONCLUSION: On the basis of these initial results, 3D gadolinium-enhanced MR venography may facilitate comprehensive evaluation of abnormalities of the central veins in the thorax, particularly with regard to selection of venous access sites.
Index terms: Gadolinium • Magnetic resonance (MR), vascular studies, 94.129412, 94.12942, 94.12943 • Veins, access, 94.1269 • Veins, MR, 94.129412, 94.12942, 94.12943 • Veins, stenosis or obstruction, 94.75 • Veins, thrombosis, 94.75
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