Kontrastmittelverstärkte 3D-MR-venographie der oberen thoraxapertur: Erste erfahrungen

Purpose: To evaluate the usefulness of three-dimensional (3D) gadolinium-enhanced magnetic resonance (MR) venography for evaluation of thoracic central veins. Materials and Methods: Over a 4-month period, 14 patients with suspected central venous abnormalities were examined on a 1.5 T scanner (Magnetom Sonata®, SIEMENS, Germany) by means of MR venography. A FLASH-3D sequence using the following parameters was employed: TR 1,6 ms, TE 0.6 ms, TA 3.74 s, flip: 15°, slab thickness 110 mm, effective slice thickness: 2.75 mm, 40 partitions, FOV 360 mm, matrix 140 × 256. 10 s prior to imaging 20 ml of Gd-DOPTA (Multihance®, BRACCO, Italy) were automatically injected (MEDRAD®, Pittsburgh, USA) flushed by 20 ml of normal saline (flow 4 ml/s). Six 3D data sets were acquired in immediate succession in under 24 s. Results were corroborated with findings from duplex sonography. Results: MR venograms were of diagnostic quality for all 14 patients. Compared to duplex sonography thromboses, post-thrombotic changes as well as functional compressions were reliably detected. Unsuspected findings were found in two patients. Conclusion: The outlined strategy allows for dynamic diagnostic imaging of central thoracic veins. Gadolinium-enhanced breath-hold 3D MR venography is easy to perform, well tolerated and highly accurate in assessing central venous pathology.