Contrast enhanced MR venography with gadofosveset trisodium: evaluation of the intracranial and extracranial venous system

J Magn Reson Imaging. 2014 Sep;40(3):630-40. doi: 10.1002/jmri.24409. Epub 2013 Nov 22.

Abstract

Purpose: To demonstrate the efficacy of contrast enhanced magnetic resonance venography (CEMRV) using gadofosveset trisodium in the comprehensive evaluation of the intracranial and extracranial venous system.

Materials and methods: Temporal signal decay, in-plane saturation and flow artifacts were assessed in an institutional review board approved, HIPAA compliant CEMRV study of 99 subjects. In a 39 subject subset, percent diameter narrowing of the internal jugular (IJ), brachiocephalic and azygous veins were coded according to the following ordinal grades for both catheter venography (CV) and CEMRV: grade 0 ≤ 50%, grade 1 >50% and ≤ 75%, grade 2 >75% and <100% and grade 3 = 100% and compared with pressure gradient measurements obtained during CV.

Results: There was no significant signal decay, in-plane saturation or flow artifacts identified on CEMRV or hemodynamically significant pressure gradients identified on CV. All brachiocephalic and azygous veins had matched grade 0 narrowing on both modalities. Discrepancy between modalities occurred in the IJ veins at the level of thyroid gland where 15% of IJ veins had CEMRV grade ≥ 1 narrowing compared with 4% for CV or below the thyroid gland where 5% of IJ veins had CEMRV grade ≥ 1 narrowing compared with 20% for CV. There was fair agreement (κ = 0.24) between modalities for grade of narrowing in the combined data set of all coded veins.

Conclusion: CEMRV using gadofosveset trisodium is accurate in the evaluation of the venous system.

Keywords: Gadolinium; MRV; contrast; gadofosveset trisodium; multiple sclerosis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Artifacts
  • Cerebrovascular Circulation
  • Contrast Media
  • Female
  • Gadolinium*
  • Humans
  • Magnetic Resonance Angiography / methods*
  • Male
  • Middle Aged
  • Multiple Sclerosis / pathology
  • Organometallic Compounds*
  • Prospective Studies
  • Sensitivity and Specificity
  • Veins / anatomy & histology*
  • Veins / pathology

Substances

  • Contrast Media
  • Organometallic Compounds
  • Gadolinium
  • gadofosveset trisodium