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DOI: 10.1148/radiol.2403050723
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Orthopedic Spinal and Hip Prostheses: Effects of Magnetic Susceptibility Artifacts during MR Arteriography and Venography of Abdomen and Pelvis1

Nicholas A. Fidelman, MD, Mark W. Wilson, MD, Allan I. Bloom, MD, Robert K. Kerlan, Jr, MD, Jeanne M. LaBerge, MD and Roy L. Gordon, MD

1 From the Department of Radiology, University of California, San Francisco, 505 Parnassus Ave, L-361, San Francisco, CA 94143. Received April 28, 2005; revision requested June 30; revision received July 18; accepted August 15; final version accepted October 17. Address correspondence to M.W.W. (e-mail: Mark.Wilson{at}radiology.ucsf.edu).


Figure 1
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  		Figure 1a: (a) Anterior-posterior radiograph of lumbosacral spine. Representative coronal contrast-enhanced MR images obtained at (b) MR arteriography and (c) MR venography (1.4/5; one signal acquired; section thickness, 1.5 mm; flip angle, 40°; breath-hold acquisition) demonstrate loss of signal intensity due to susceptibility artifact in left common iliac artery and bilateral common iliac veins, as well as in inferior vena cava.

 

Figure 1
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  		Figure 1b: (a) Anterior-posterior radiograph of lumbosacral spine. Representative coronal contrast-enhanced MR images obtained at (b) MR arteriography and (c) MR venography (1.4/5; one signal acquired; section thickness, 1.5 mm; flip angle, 40°; breath-hold acquisition) demonstrate loss of signal intensity due to susceptibility artifact in left common iliac artery and bilateral common iliac veins, as well as in inferior vena cava.

 

Figure 1
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  		Figure 1c: (a) Anterior-posterior radiograph of lumbosacral spine. Representative coronal contrast-enhanced MR images obtained at (b) MR arteriography and (c) MR venography (1.4/5; one signal acquired; section thickness, 1.5 mm; flip angle, 40°; breath-hold acquisition) demonstrate loss of signal intensity due to susceptibility artifact in left common iliac artery and bilateral common iliac veins, as well as in inferior vena cava.

 

Figure 2
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  		Figure 2a: (a) Representative radiograph of patient who underwent right total hip arthroplasty and posterior fusion from T6 through L4 with insertion of Harrington rods. (b) MIP obtained at coronal contrast-enhanced MR arteriography demonstrates mild right internal iliac artery stenosis (arrow) but no significant metallic artifact. (c) MIP obtained at MR venography shows no metallic artifact or deep venous thrombosis; however, mild narrowing is noted in right common iliac vein (arrows).

 

Figure 2
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  		Figure 2b: (a) Representative radiograph of patient who underwent right total hip arthroplasty and posterior fusion from T6 through L4 with insertion of Harrington rods. (b) MIP obtained at coronal contrast-enhanced MR arteriography demonstrates mild right internal iliac artery stenosis (arrow) but no significant metallic artifact. (c) MIP obtained at MR venography shows no metallic artifact or deep venous thrombosis; however, mild narrowing is noted in right common iliac vein (arrows).

 

Figure 2
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  		Figure 2c: (a) Representative radiograph of patient who underwent right total hip arthroplasty and posterior fusion from T6 through L4 with insertion of Harrington rods. (b) MIP obtained at coronal contrast-enhanced MR arteriography demonstrates mild right internal iliac artery stenosis (arrow) but no significant metallic artifact. (c) MIP obtained at MR venography shows no metallic artifact or deep venous thrombosis; however, mild narrowing is noted in right common iliac vein (arrows).

 

Figure 3
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  		Figure 3a: (a) Anterior-posterior spine radiograph and MIP images obtained at (b) coronal contrast-enhanced MR arteriography and (c) MR venography. (a) Posterior spinal fusion with Harrington rods is shown extending from T5 through S1 and diskectomy and interbody fusion in lumbar spine. (b) Image, which is free of artifacts, demonstrates severe narrowing of right internal iliac artery (short arrow) and mild disease in left common iliac artery (long arrow). (c) Image shows nonvisualization of left common iliac vein and narrowing of left external iliac vein (arrows). Review of source images did not demonstrate loss of signal intensity in soft tissues surrounding vessels. Signal void in venous structures extending far from location of hardware suggests diagnosis of deep venous thrombosis in left common and external iliac veins.

 

Figure 3
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  		Figure 3b: (a) Anterior-posterior spine radiograph and MIP images obtained at (b) coronal contrast-enhanced MR arteriography and (c) MR venography. (a) Posterior spinal fusion with Harrington rods is shown extending from T5 through S1 and diskectomy and interbody fusion in lumbar spine. (b) Image, which is free of artifacts, demonstrates severe narrowing of right internal iliac artery (short arrow) and mild disease in left common iliac artery (long arrow). (c) Image shows nonvisualization of left common iliac vein and narrowing of left external iliac vein (arrows). Review of source images did not demonstrate loss of signal intensity in soft tissues surrounding vessels. Signal void in venous structures extending far from location of hardware suggests diagnosis of deep venous thrombosis in left common and external iliac veins.

 

Figure 3
View larger version (135K):

[in a new window]
  		Figure 3c: (a) Anterior-posterior spine radiograph and MIP images obtained at (b) coronal contrast-enhanced MR arteriography and (c) MR venography. (a) Posterior spinal fusion with Harrington rods is shown extending from T5 through S1 and diskectomy and interbody fusion in lumbar spine. (b) Image, which is free of artifacts, demonstrates severe narrowing of right internal iliac artery (short arrow) and mild disease in left common iliac artery (long arrow). (c) Image shows nonvisualization of left common iliac vein and narrowing of left external iliac vein (arrows). Review of source images did not demonstrate loss of signal intensity in soft tissues surrounding vessels. Signal void in venous structures extending far from location of hardware suggests diagnosis of deep venous thrombosis in left common and external iliac veins.

 




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