Artikel
Time-resolved contrast-enhanced 3D MR subtraction angiography (4D MRA) in the evaluation of meningiomas at 3 Tesla
Zeitaufgelöste Kontrastmittel-3D-MR-Subtraktionsangiographie in der präoperativen Diagnostik von Meningeomen bei 3 Tesla
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Veröffentlicht: | 8. Mai 2006 |
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Gliederung
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Objective: Advances in MR hardware performance and imaging techniques have enabled us to perform time-resolved contrast-enhanced 3D MR subtraction angiography (4D MRA). In this series we assess the value of 4D MRA in the preoperative diagnosis of meningiomas.
Methods: 15 patients with meningiomas underwent 3D dynamic contrast-enhanced MR subtraction angiography (4D MRA) using a 3 Tesla Philips Achieva system combining the keyhole technique with CENTRA (Contrast Enhanced Timing Robust Angiography) profile ordering and parallel imaging (SENSE). Using this approach it was possible to speed up the temporal resolution to 2.1 sec/3D volume while registering 110 slices with a submillimeter isotropic voxelsize, resulting in a true 3D volume block. A dose of 20 ml gadobenate dimeglumine was injected at a flow rate of 3 ml/sec beginning with the start of the dynamic acquisition. The acquired images were evaluated in terms of differentiation into early arterial, late arterial and venous phases, detection of normal vessels and tumor feeders, localization of bridging veins, and depiction of tumor vascularization.
Results: Excellent separation of early and late arterial, capillary and early and late venous phases was possible in all 15 investigated patients. The localization and displacement of cerebral arteries and the extent of tumor vascularization was similarly well-defined, as was the anatomy of the venous system including the tributaries to the large sinuses. Moreover, depiction of the tumor feeding vessels was possible in all cases.
Conclusions: 4D MRA is helpful for characterizing the degree of vascularization of meningiomas. The differentiation of the arterial and venous phases, the displacement of normal vessels and the localization of bridging veins as well as the evaluation of sinus patency can be achieved in a short period of time. The high spatial resolution even allows for the demonstration of the major feeding arteries, which will help in reducing the number of conventional angiographies carried out for tumor evaluation.