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PubMed1985

Non-selective intra-arterial digital subtraction angiography for the assessment of coronary artery bypass grafts.

Non-selective intra-arterial digital subtraction angiography (DSA) was performed immediately before selective coronary and bypass angiography in 33 consecutive symptomatic patients 48 +/- 30 months after coronary surgery, for the assessment of 75 coronary bypass grafts. Forty ml of non-ionic, low-iodine content contrast medium (iohexol) were injected into the ascending aorta at 10-20 ml/sec through a 7 or 8 F femoral pigtail catheter. Electrocardiogram-triggered images were acquired on a Siemens Digitron II apparatus in multiple projections in 24 patients and in a single projection in 9 patients. The results of this technique were compared by two independent angiographers with those of selective graft angiography in the same patients. Patency was shown by DSA in 45 of 54 grafts confirmed to be open by selective angiography (sensitivity 83%). Of 21 occluded grafts, stumps were clearly visible at selective angiography in 18 and at DSA in 9 (sensitivity for graft stumps = 50%, p less than 0.01). Of 54 patent grafts with selective angiography, the distal anastomosis could be visualized by DSA in 28 (52%), but the resolution was comparable to selective angiography in 20 grafts (37%) only. A non-significant difference in the sensitivity of DSA was observed between patent saphenous grafts to the left anterior descending coronary artery versus all other coronary arteries (95 vs 85%, respectively), while only 1 of 5 patent left internal mammary artery grafts to the left anterior descending coronary artery was visualized. In 16 of 50 grafts (32%) visualized in a second projection substantial additional diagnostic information was obtained. In conclusion, non-selective intra-arterial electrocardiogram-triggered DSA can visualize patent saphenous grafts with a high sensitivity and may be a useful screening tool for bypass grafts patency; false negatives, however, and poor visualization of distal anastomoses limit its routine clinical use.

Adult↗
PubMed2000

Three-dimensional magnetic resonance angiography of vascular lesions in children.

We applied three-dimensional (3D) magnetic resonance (MR) angiography to vascular lesions in children and evaluated the clinical usefulness of this technique. Ten patients, whose ages ranged from 1 month to 16 years, underwent 3D MR angiography for 12 vascular lesions, including lesions in seven pulmonary arteries, two thoracic aortae, a pair of renal arteries, and one iliac artery. Three-dimensional MR angiography was performed with body-or pelvic-phased array coils on a 1.5-T scanner using fast spoiled gradient echo sequence. Data were acquired with the following parameters: TE, 1.9 ms; TR, 10.1 ms; flip angle, 20-60 degrees ; 1 or 2 NEX; field of view, 24-48 x 18-40 cm; matrix, 256 or 512 x 128 or 256; slice thickness, 1.2-7.5 mm; and 12, 28, or 60 partitions. Vascular imaging was enhanced with 20% gadolinium-diethylenetriaminepentaacetic acid. The examination was performed under breath-holding in six patients and with shallow breathing in four patients. In a comparative study with other noninvasive methods, 3D MR angiography was superior in seven of nine cases to other noninvasive examinations and in two cases, all methods evaluated the lesions. Furthermore, six cases were compared with conventional angiography. In five of the six cases, both methods depicted the lesions similarly, and in one case, MR angiography was more effective. A quantitative comparison of vascular diameter in the MR image was made with that in the conventional angiographic image. The correlation between them was excellent: y = 1.145x-2.090 (r = 0.987; P < 0.0001), where x is the diameter in the conventional angiographic images, y is the diameter in the MR images, and r is the correlation coefficient. In conclusion, 3D MR angiography is useful for depicting peripheral vascular lesions in children.

Adolescent↗
PubMed1999

The value of pulmonary angiography for the differential diagnosis of pulmonary embolism.

The aim this study was to evaluate potential additional information of pulmonary angiography in patients with suspected pulmonary embolism and non-diagnostic lung scan findings. In a series of 150 patients who underwent pulmonary angiography for suspected venous thromboembolism, the images for potential alternative diagnoses other than pulmonary embolism were evaluated. All patients had non-diagnostic lung scan findings. Angiography was performed both by conventional and by digital subtraction angiography techniques. Images were evaluated by at least two experienced readers. Angiograms were scored for both presence or absence of pulmonary embolism, as well as other diagnoses. Pulmonary embolism was proven in 40 patients (27 %) and excluded in 105 patients (70 %), whereas non-interpretable images were obtained in 5 patients (3 %). A range of alternative diagnoses were detected by angiography: atelectasis (n = 24), pleural effusion (n = 15), pneumonia (n = 11), emphysematous bullae (n = 8), neoplasm (n = 3), atrial septum defect (n = 2), chronic thromboembolism (n = 1), and other diagnoses (n = 3). Overall, only 54 patients (36 %) had completely normal angiograms. Although pulmonary angiography remains the reference method for the diagnosis of pulmonary embolism, one has to be aware of other, often unexpected, but equally important findings which could influence the management of the patient. This aspect of pulmonary angiography has been insufficiently emphasized in the literature.

Adult↗
PubMed2000

Contrast-enhanced magnetic resonance angiography in the evaluation of peripheral bypass grafts.

The aim of this study was to determine the potential of contrast-enhanced magnetic resonance (MR) angiography in the evaluation of peripheral bypass grafts. Digital subtraction angiography (DSA) served as a standard of reference. Thirty-five patients with previous bypass graft surgery underwent DSA and contrast-enhanced MR angiography within 2 weeks. MR angiography was performed using a three-dimensional fast gradient-echo sequence after administration of gadopentetate dimeglumine. Every leg was divided into 11 segments and scored in five categories of stenosis. MR angiography findings were compared with those of DSA. A total of 38 bypass grafts and 454 segments in 27 patients were included in the evaluation. In 33 (87%) bypass grafts stenosis grading with both methods corresponded, and in 5 (13%) cases stenosis was overestimated on MR angiography. Agreement in detection of hemodynamically significant stenosis (stenosis =50%) was 94.7% with a sensitivity of 100% and a specificity of 91.3%. In 340 (83.0%) vascular segments there was conformity in graduation, in 69 (16.88%), there was a difference of one or more grades on MR angiograms. Forty-four segments (9.6%) were not assessable due to technical limitations. Contrast-enhanced MR angiography is an useful noninvasive tool in the detection of failing peripheral vascular bypass grafts.

Adult↗
PubMed2006

Multidetector-row CT angiography of renal artery stenosis in 50 consecutive patients: prospective interobserver comparison with DSA.

PURPOSE: The purpose of this study was to establish the diagnostic value of multidetector-row computed tomography (MDCT) angiography compared with digital subtraction angiography (DSA) for detection and quantification of both main and accessory renal artery stenosis in patients with secondary hypertension. MATERIALS AND METHODS: Fifty consecutive patients scheduled for DSA were considered candidates for MDCT angiography. In all patients, MDCT angiography of the abdominal aorta was performed before DSA. For the purpose of interpretation, the arteries were separately interpreted either with DSA or MDCT angiography in order to provide qualitative and quantitative information. For qualitative evaluation, one experienced reader graded the opacification of renal arteries as excellent, good or poor; for quantitative evaluation, MDCT and DSA were independently evaluated for the number of renal arteries and the presence, location and degree of stenosis in random order by three readers. On the basis of consensus readings, calculations of sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for detection of degree of stenosis were made by using DSA findings as the standard of reference. Interobserver variability was also assessed. RESULTS: With regard to qualitative analysis, arterial enhancement was considered excellent in 39 patients and good in 11. For quantitative analysis, 73 arteries were classified as normal with DSA. Although 72 of these were also classified as normal with CT angiography, one was overestimated by one grade; at DSA, 16 arteries were classified as moderately stenotic; in two arteries, there was an overestimation of one grade. Perfect correlation was achieved for the diagnosis of occlusion. In two patients, all three readers detected multiple severe stenoses on both modalities, with a "string-of-beads" appearance typical of fibromuscular dysplasia. Accessory arteries were correctly identified as such by all three readers on either DSA or MDCT. Levels of sensitivity, specificity and accuracy regarding degree of stenosis were 100%, 98.6% and 96.9%, respectively, with PPV and NPV of 97.6% and 100%, respectively. When we considered significant arterial stenosis (50%-100% luminal narrowing), sensitivity, specificity and accuracy were 100%, 97.3% and 97.8%, respectively, with a PPV and NPV of 98.2% and 97.8%, respectively. For all observers, interobserver agreement was almost perfect (k=0.81-1) for both MDCT and DSA, with a k value between 0.82 and 0.95. CONCLUSIONS: MDCT angiography is very accurate and robust, even for the assessment of renal artery stenosis, and has the potential to become a viable substitute, in most cases, for diagnostic catheter-based DSA.

Adult↗
PubMed1997

Toxoplasmic retinochoroiditis: new insights provided by indocyanine green angiography.

PURPOSE: To analyze features of indocyanine green angiography associated with recurrent toxoplasmic retinochoroiditis. METHODS: Indocyanine green angiography was performed according to a standard protocol and correlated with clinical signs and fluorescein angiography in 12 eyes of 12 consecutive patients with recurrent toxoplasmic retinochoroiditis. RESULTS: In 10 of 12 eyes with recurrent toxoplasmic retinochoroiditis, indocyanine green angiography showed multiple satellite dark dots not seen on fluorescein angiography or clinical examination of the fundus. CONCLUSION: Indocyanine green angiography shows that recurrent toxoplasmic retinochoroiditis is more widespread than clinically visible lesions indicate. Indocyanine green angiography is useful in assessing the extent of involvement of recurrent toxoplasmic retinochoroiditis and the evolution of lesions and might also provide insights into the pathophysiology of the disease.

Angiography↗
PubMed2006

Magnetic resonance coronary angiography to evaluate coronary arterial lesions in patients with Kawasaki disease.

We evaluated the efficiency of non-invasive magnetic resonance coronary angiography in detecting coronary arterial lesions in 106 patients, aged from 4 months to 37 years, with a median of 13 years, with Kawasaki disease. Non-contrast enhanced, free-breathing magnetic resonance coronary angiographic studies using both the steady-state free precession technique, namely bright blood imaging, and navigator-echo proton density weighted black blood imaging, so-called black blood imaging, were performed in all the patients. Conventional X-ray coronary angiography was performed in 70 patients with coronary arterial lesions. We observed 97 aneurysms, 17 dilatations, 17 occlusions, 18 localized stenoses and 10 recanalized vessels, and we clarified their unique pattern of images on magnetic resonance coronary angiography. The differences in size of the aneurysms as seen on X-ray coronary angiography and bright blood imaging was mean 0.0, and the 95% confidence interval was from -1.4 to 1.5 on the Bland-Altman plots. With bright blood imaging, the sensitivity of occlusion and localized stenosis based on X-ray angiography was 94.2% and 97.2%, specificity was 99.5% and 97.2%, and negative-predictive value was 99.5% and 97.2%, respectively. Black blood imaging provided remarkable visualization of the thickened intima of aneurysms, and/or thrombus, in 38 lesions. We conclude that magnetic resonance coronary angiography can visualize all types of lesions due to Kawasaki disease in patients of all ages, and that it is useful to reduce the number of times X-ray angiography needs to be performed in patients with Kawasaki disease.

Adolescent↗
PubMed2000

Assessment of renal artery stenosis: comparison of captopril renography and gadolinium-enhanced breath-hold MR angiography.

AIM: To determine the accuracy of captopril renography (CR) and gadolinium-enhanced breath-hold magnetic resonance (MR) angiography in the diagnosis of 50-99% renal artery stenosis (RAS). MATERIALS AND METHODS: Forty-three patients with possible RAS, of whom 53% had renal function impairment (creatinine >130 micromol/l), were included.(99m)Tc-mercaptoacetyl triglycine (MAG(3)) renography was performed after an oral dose of 25 mg captopril. Gadolinium-enhanced MR angiography was performed on a standard 1.5 Tesla system: TR 13.5, TE 3.5, flip angle 60 degrees, matrix 195 x 512. Intra-arterial digital subtraction angiography (DSA) was the standard of reference. RESULTS: Captropril renography accurately categorized 22 of 26 patients who had either uni- or bilateral RAS of 50-99%. The sensitivity and specificity of CR for the detection of 50-99% stenosis were 85 and 71%, respectively. With MR angiography one occluded artery was incorrectly diagnosed as a stenosis. Sensitivity and specificity were 100 and 94%, respectively. The difference between the accuracies of MR angiography and CR was statistically significant (P = 0.02). The accuracy of CR was lower in patients with renal impairment (70%) than in those with normal renal function (90%). CONCLUSION: MR angiography showed a high accuracy in diagnosing RAS of between 50 and 99%. CR was less accurate than MR angiography, especially in patients with renal function impairment. In patients with normal renal function, however, CR remains a useful diagnostic test.

Adult↗
PubMed2000

[Simultaneous ICG- and fluorescein-angiography for fundus examination].

BACKGROUND: An indocyanine-green (ICG) angiography is rarely used as the only diagnostic procedure. Almost always it is performed additionally to a fluorescein angiography. The use of simultaneous ICG and fluorescein (SIF) angiography therefore makes sense. Several examples for the application of SIF-angiography are presented. MATERIALS AND METHODS: SIF-angiography was performed using a 2-wavelength scanning laser ophthalmoscope (SLO). Images were digitally recorded in real time with a graphics workstation. The following cases will be presented: choroidal neovascularization in age-related macular degeneration, choroidal hemangioma, inflammatory fundus disease (APMPPE) and idiopathic polypoidal choroidal vasculopathy. RESULTS: ICG and fluorescein angiography can be simultaneously recorded with the 2-wavelenghth SLO. The quality of the combined pictures is comparable to single-channel recordings of separate ICG and fluorescein images. We show results of the above mentioned cases. CONCLUSIONS: SIF angiography is time efficient and allows precise comparison and analysis of the transit of both dyes through retinal and choroidal circulation. The topographic relation of pathologic findings in ICG angiograms with the critical retinal vascular landmarks is facilitated.

Adult↗
PubMed1998

[Contrast-enhanced MR angiography in Leriche's syndrome].

PURPOSE: To determine the usefulness of contrast-enhanced MR angiography for the diagnosis of Leriche's syndrome. MATERIAL AND METHODS: Leriche's syndrome was seen in 7 patients via DSA. In addition, contrast-enhanced MR angiography was performed (TR 7.8 ms/TE 2.1 ms, flip angle 30 degrees, slab thickness 116 mm, slice thickness 1.82 mm, 64 partitions, FOV 500 x 438 mm, matrix 224 x 512). RESULTS: Diagnosis of Leriche's syndrome was possible by contrast-enhanced MR angiography in each case. Visualisation of the femoral arteries was not possible in two patients by intraarterial DSA, in three other patients there was an insufficient contrast in the femoral arteries with DSA. Contrast-enhanced MR angiography revealed good visualisation of the femoral arteries in these patients. In addition, contrast-enhanced MR angiography allowed complete visualisation of the patent lower limb arteries. In intraarterial DSA visualisation of the lower limb arteries was achieved reached in only one patient, but was incomplete. CONCLUSION: Contrast-enhanced MR angiography yielded the correct diagnosis of Leriche's syndrome in all 7 patients. Contrast-enhanced MR angiography was superior to DSA in the assessment of the distal run-off vessels in five of seven patients.

Adult↗
PubMed1993

[Venous MR angiography for the primary diagnosis and follow-up of sinus venous thrombosis. The correlation with the clinical picture and DSA].

30 patients clinically suspected of suffering from venous sinus thrombosis were examined by MRT with venous MR angiography (FLASH 2-D). In 8 patients selective arterial angiography was also performed and 5 patients were followed up by MR angiography after an interval of three months. The MRT images and individual MR angiography images were analysed and 3-D reconstruction performed. In 11 patients MR angiography correctly demonstrated venous sinus thrombosis; the most frequently affected were the superior sagittal sinus, the ascending cerebral veins and the transverse sinus. Compared with DSA, magnetic resonance angiography achieved a high degree of accuracy in our patients. It was significantly better in evaluating the basal sinus system whereas thrombosis of individual ascending veins was better shown by DSA. In summary, primary use of MRT and MR angiography is recommended for the diagnosis of venous sinus thrombosis.

Adult↗
PubMed1999

Preoperative evaluation of living renal donors with gadolinium-enhanced magnetic resonance angiography.

BACKGROUND: Preoperative evaluation of living renal donors includes an intra-arterial digital subtraction angiography (DSA). Inasmuch as this technique is invasive, uses radiation and an iodine-containing contrast medium, an alternative technique would be preferable. The purpose of this study was to determine the accuracy of gadolinium-enhanced magnetic resonance (MR) angiography in the visualization of renovascular anatomy for the preoperative evaluation of renal donors. METHODS: Twenty-four consecutive potential renal donors underwent gadolinium-enhanced MR angiography before the standard of reference, intra-arterial DSA. Both modalities were evaluated in a blinded manner. The results were correlated with the surgical findings. RESULTS: Three MR angiograms were technically unacceptable because of inadequate breath-hold. The remaining 21 donors had 47 renal arteries, including 5 accessory renal arteries, which were all visualized by MR angiography. MR angiography failed to visualize one case of subtle fibromuscular dysplasia in the distal part of a renal artery. In one donor, a small accessory renal artery, which had not been visualized on DSA, was encountered during nephrectomy. CONCLUSION: Gadolinium-enhanced MR angiography is an accurate minimally invasive method for the detection of accessory renal arteries in the preoperative evaluation of potential renal donors. The accuracy for excluding stenosis in general is high; however, the depiction of stenosis that are located far distally, or in the branch vessels, is less accurate. Advantages of gadolinium-enhanced MR angiography over the currently used method, intra-arterial DSA, are the minimal invasive nature, lower costs, and superiority in detecting venous anomalies, renal cysts, and tumors.

Adult↗
PubMed2005

Magnetic resonance-guided percutaneous angioplasty of femoral and popliteal artery stenoses using real-time imaging and intra-arterial contrast-enhanced magnetic resonance angiography.

OBJECTIVE: The aim of this study was to demonstrate the possibility of performing magnetic resonance (MR)-guided interventional therapy for femoral and popliteal artery stenoses with commercially available materials supported by MR real-time imaging and intra-arterial MR angiography. MATERIALS AND METHODS: A total of 15 patients suffering from symptomatic arterial occlusive disease of the lower limbs with 19 stenoses were included. Interventional intra-arterial digital subtraction angiography was performed before and after angioplasty on each patient as standard of reference. MR images were acquired on a 1.5-T MR scanner. A fast-low-angle shot (FLASH) 3D sequence was applied for a contrast enhanced MR-angiography (ceMRA). A total of 5 mL of diluted gadodiamide was injected via the arterial access. Maximum intensity projections (MIPs) were used as roadmaps and localizers for the interactive positioning of a continuously running 2D-FLASH sequence with a temporal solution of 2 images/second. The lesion was crossed by a balloon-catheter, which was mounted on a guidewire. The visibility was provided by the radiopaque markers on the balloon and was improved by injection of 1 mL of gadolinium into the balloon. Postinterventional control was performed by intra-arterial MR angiography and catheter angiography. RESULTS: Stenoses were localized by intra-arterial MR angiography. The guidewire/balloon combination was visible, and the balloon was placed correctly to cover the entire stenoses. Balloon dilation reduced the degree of stenosis by approximately 57% on average. No complications were observed. CONCLUSION: MR-guided balloon dilation of femoral and popliteal artery stenoses supported by real-time MR imaging and intra-arterial MR angiography is feasible with commercially available materials.

Aged↗
PubMed1998

Magnetic resonance angiography in patients with brain infarction.

This study evaluated the role of magnetic resonance angiography (MRA) in detecting extra- or intracranial vascular disease in 118 patients with brain infarction and the accuracy of MRA diagnosis when compared with conventional angiography in patients who had both investigations. Magnetic resonance angiography ruled out extra- and intracranial large vessel disease in 36% of the patients. MRA also demonstrated extra- or intracranial disease in 56% (probably symptomatic in 31, possibly symptomatic in 18, and asymptomatic in 17 patients), and provided no information in 8% of the 118 patients. Among the 176 major vessels visualized by both MRA and conventional angiography, conventional angiography confirmed the presence of 9/10 extracranial and 32/40 intracranial large vessel abnormalities detected on MRA. There were two false-negative findings on MRA: occlusion of a distal branch of middle cerebral artery, and an asymptomatic posterior cerebral artery stenosis. Magnetic resonance angiography is a clinically useful method for screening extra- and intracranial disease in patients with brain infarction and selecting high-yield patients for conventional angiography.

Cerebral Angiography↗
PubMed2006

Intraarterial MR angiography and DSA in patients with peripheral arterial occlusive disease: prospective comparison.

PURPOSE: To prospectively evaluate the accuracy of intraarterial magnetic resonance (MR) angiography in the depiction of significant stenoses and occlusions, with intraarterial digital subtraction angiography (DSA) serving as the reference standard. MATERIALS AND METHODS: Approval of the local ethics committee and informed consent were obtained. Twenty patients (11 men; nine women; age range, 48-86 years; mean age, 69.5 years+/-11.2 [standard deviation]) with symptomatic peripheral arterial occlusive disease (PAOD) were prospectively enrolled. After percutaneous transluminal angioplasty (PTA), intraarterial MR angiography was performed in the thigh and the calf with a 1.5-T MR imager in two consecutive runs. Intraarterial MR angiography was performed with a low-dose injection protocol (ie, two 20-mL injections of a 50-mmol gadolinium-based contrast agent). Moderate stenoses (luminal narrowing 50%) or vessel occlusions; 95% confidence intervals (CIs) were calculated for sensitivity and specificity. RESULTS: Intraarterial DSA revealed 78 moderate stenoses, 57 significant stenoses, and 28 occlusions. Sensitivity, specificity, and accuracy of intraarterial MR angiography in the characterization of significant stenoses or occlusions were 92% (95% CI: 72%, 99%), 94% (95% CI: 82%, 98%), and 93%, respectively, in femoropopliteal arteries and 93% (95% CI: 83%, 98%), 71% (95% CI: 51%, 86%), and 86%, respectively, in infrapopliteal arteries. The main artifact observed with intraarterial MR angiography was venous contamination (12%). CONCLUSION: Intraarterial MR angiography is an accurate method used to depict significant stenoses and occlusions in lower extremity arteries with a low-dose injection protocol.

Aged↗
PubMed2006

Vessel wall calcifications at multi-detector row CT angiography in patients with peripheral arterial disease: effect on clinical utility and clinical predictors.

PURPOSE: To evaluate retrospectively the effect of vessel wall calcifications on the clinical utility of multi-detector row computed tomographic (CT) angiography performed in patients with peripheral arterial disease and to identify clinical predictors for the presence of vessel wall calcifications. MATERIALS AND METHODS: The study was approved by the hospital institutional review board, and informed consent was obtained from all patients. For this study the authors included patients from two randomized controlled trials that measured the costs and effects of diagnostic imaging in patients with peripheral arterial disease. All patients underwent CT angiography and were followed up for 6 months. Clinical utility was measured on the basis of therapeutic confidence (rated on a 10-point scale) in the results of initial CT angiography and the need for additional vascular imaging. Univariable and multivariable logistic and linear regression analysis and the area under the receiver operating characteristic curve were used to evaluate the effect of vessel wall calcifications on the clinical utility of CT angiography and the use of patient characteristics to predict the number of calcified segments at CT angiography. RESULTS: A total of 145 patients were included (mean age, 64 years; 70% men). The authors found that the number of calcified segments was a significant predictor of the need for additional imaging (P = .001) and of the confidence scores (P < .001). The number of calcified segments discriminated between patients who required additional imaging after CT angiography and those who did not (area under the receiver operating characteristic curve, 0.66; 95% confidence interval: 0.54, 0.77). Age, diabetes mellitus, and cardiac disease were significant predictors of the number of calcified segments in both the univariable and multivariable analyses (P < .05). CONCLUSION: Vessel wall calcifications decrease the clinical utility of CT angiography in patients with peripheral arterial disease. Diabetes mellitus, cardiac disease, and elderly age (older than 84 years) are independently predictive for the presence of vessel wall calcifications.

Angiography, Digital Subtraction↗
PubMed1994

Intracranial vertebrobasilar system: MR angiography.

PURPOSE: To determine the reliability of magnetic resonance (MR) angiography in depicting normal vascular anatomy and its usefulness in detecting vascular disease compared with those of digital subtraction angiography (DSA). MATERIALS AND METHODS: Sixty patients with symptoms referable to disease of the vertebrobasilar system were examined with MR angiography and DSA. RESULTS: In patients with normal DSA results, all vertebral arteries (VAs) and basilar arteries (BAs) were also visualized with MR angiography. MR angiography demonstrated 117 of 120 superior cerebellar arteries and 80 of 90 posterior inferior cerebellar arteries but only 30 of 58 anterior inferior cerebellar arteries. MR angiography demonstrated disease of the VAs and BAs with 100% sensitivity. Stenoses were differentiated from occlusions in all cases. However, the degree of stenosis was overestimated in 63% of patients. In six patients with occlusive disease, collateral flow was correctly analyzed with selective saturation. CONCLUSION: Despite its limitations, MR angiography is a clinically important noninvasive technique for screening patients for macroangiopathy of the posterior arterial supply to the brain.

Adolescent↗
PubMedDate not supplied

Preoperative hepatic vascular evaluation with CT and MR angiography: implications for surgery.

Partial liver resection for living donor transplantations and treatment of hepatic tumors is a major surgical undertaking, and detailed knowledge of the hepatic angioarchitecture is essential to ensure safe and successful liver surgery. Noninvasive imaging techniques such as computed tomographic (CT) and magnetic resonance (MR) angiography have begun to replace conventional catheter angiography for evaluation of the hepatic vascular anatomy. Multisection CT angiography and MR angiography are complementary modalities that permit comprehensive, accurate preoperative delineation of the hepatic vascular anatomy and evaluation of the parenchyma in patients undergoing liver surgery, thereby obviating multiple invasive studies including catheter angiography. Understanding a surgeon's perspective on liver surgery is critical so that the required information can be provided accurately with imaging. Both CT angiography and MR angiography have had a significant impact on the selection of candidates for liver surgery as well as on surgical technique.

Angiography↗