Combined arterial and venous whole-body MR angiography with cardiac MR imaging in patients with thromboembolic disease-initial experience

The objective was to assess the feasibility of a combined arterial and venous whole-body three-dimensional magnetic resonance (MR) angiography, together with a cardiac MR examination, in patients with arterial thromboembolism. Ten patients with arterial thromboembolism underwent a contrast-enhanced whole-body MR examination of the arterial and venous vessels, followed by a cardiac MR examination on a separate occasion within 24 h. All examinations were performed on a 1.5-T MR scanner. For both arterial and venous MR angiography only one injection of contrast agent was necessary. The cardiac imaging protocol included dark-blood-prepared half-Fourier acquisition single-shot turbo-spin-echo sequences, fast steady-state free precession cine sequences, T2-weighted turbo-spin-echo sequences and inversion recovery gradient-echo fast low-angle-shot sequences after injection of contrast agent. MR imaging revealed additional clinically unknown arterial thromboembolisms in four patients. The thoracic aorta was depicted as embolic source in four patients, while deep vein thrombosis (DVT) was found in one patient as the underlying disease. Unsuspected infarction of parenchymal organs was detected by MRI in two patients. An unknown additional DVT was found in one patient. Four patients were considered to have arterial emboli of cardiac origin. In conclusion, acquisition of arterial and venous MR angiograms of the entire vascular system combined with cardiac MR imaging is a most comprehensive and valuable strategy in patients with arterial thromboembolism.