Prospective evaluation of high-resolution MRI using gadofosveset for stent-graft planning: comparison with CT angiography in 30 patients

AJR Am J Roentgenol. 2011 Nov;197(5):1251-7. doi: 10.2214/AJR.10.6268.

Abstract

Objective: The purpose of our study was to compare high-resolution gadofosveset-enhanced MR angiography (MRA) with the reference standard CT angiography (CTA) in planning endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms.

Subjects and methods: Thirty consecutive patients were included in this prospective study. CTA was performed routinely before EVAR for stent-graft implantation planning and selection. In addition, first-pass and, after a delay of 10 minutes, steady-state MRA were performed using the blood pool contrast agent gadofosveset for study purposes. Standard diameter and length parameters for stent-graft evaluation rendered from CTA and MRA were compared. According to the results of MRA measurements, stent-grafts were selected for each patient and compared with the device actually implanted. Image quality was assessed using subjective image quality parameters.

Results: Diameter and length measurements showed small but significant differences (p < 0.001) between MRA and CTA. Stent-graft selection according to these measurements showed 100% concordance between both modalities. Subjective imaging parameters showed significantly better results for CTA compared with MRA (p < 0.001).

Conclusion: In this study, MRA using a blood pool contrast agent has shown the ability to provide reliable and exact measurements before EVAR, allowing noninvasive planning of the intervention despite lower image-quality and without the disadvantages of ionizing radiation and nephrotoxicity.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiography / methods*
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / surgery*
  • Blood Vessel Prosthesis Implantation*
  • Contrast Media / administration & dosage*
  • Female
  • Gadolinium / administration & dosage*
  • Humans
  • Image Interpretation, Computer-Assisted
  • Iopamidol / administration & dosage
  • Iopamidol / analogs & derivatives
  • Magnetic Resonance Angiography / methods*
  • Male
  • Middle Aged
  • Organometallic Compounds / administration & dosage*
  • Patient Care Planning*
  • Prospective Studies
  • Statistics, Nonparametric
  • Stents*
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome

Substances

  • Contrast Media
  • Organometallic Compounds
  • iomeprol
  • Gadolinium
  • Iopamidol
  • gadofosveset trisodium