Comparison of three-dimensional rotational angiography and digital subtraction angiography for the evaluation of the liver transplants

Accuracy of Inflow Inversion Recovery (IFIR) for Upper Abdominal Arteries Evaluation: Comparison with Contrast-Enhanced MR and CTA

Background: Inflow-sensitive inversion recovery (IFIR) is a recently introduced technique to perform unenhanced magnetic resonance angiography (MRA). The purpose of our study is to determine the accuracy of IFIR-MRA in the evaluation of upper abdominal arteries, compared to standard MRA and computed tomography angiography (CTA). Materials and Methods: Seventy patients undergoing upper abdomen Magnetic Resonance Imaging (MRI) in different clinical settings were enrolled. The MRI protocol included an IFIR-MRA sequence that was intra-individually compared by using a qualitative 4-point scale in the same patients who underwent concomitant or close MRA (n = 65) and/or CTA (n = 44). Celiac trunk (CA), common-proper-left-right hepatic artery (C-P-L-R-HA), left gastric artery (LGA), gastroduodenal artery (GDA), splenic artery (SA), renal arteries (RA) and superior mesenteric artery (SMA) were assessed. Results: IFIR-MRA images were better rated in comparison with MRA. Particularly, all arteries obtained a statistically significant higher qualitative rating value (all p < 0.05). IFIR-MRA and MRA exhibited acceptable intraclass correlation coefficients (ICC) values for CA, C-L-R-HA, and SMA (ICC 0.507, 0.591, 0.615, 0.570, 0.525). IFIR-MRA and CTA showed significant correlations in C-P-L-R-HA (τ = 0.362, 0.261, 0.308, 0.307, respectively; p < 0.05), and in RA (τ = 0.279, p < 0.05). Conclusions: Compared to MRA, IFIR-MRA demonstrated a higher image quality in the majority of upper abdomen arterial vessels assessment. LHA and RHA branches could be better visualized with IFIR sequences, when visualizable. Based on these findings, we suggest to routinely integrate IFIR sequences in upper abdomen MRI studies.

2D versus 3D roadmap for uterine artery catheterization: impact on several angiographic parameters

BACKGROUND

Three-dimensional (3D) roadmap is a recently developed imaging technique used to guide diagnostic and interventional catheter-directed procedures and mainly evaluated for neurovascular procedures. Few data with regard to efficacy and radiation dose are currently available in literature.

PURPOSE

To evaluate the use of 3D roadmap technique as compared with the conventional two-dimensional (2D) roadmap for uterine artery catheterization and embolization during uterine fibroid embolization and assess the potential impact on radiation dose, contrast load, and total procedure time.

MATERIAL AND METHODS

In this prospective study, 40 patients were randomly assigned to the 2D or 3D roadmap technique for uterine artery catheterization. Demographic data, specifically the patient's age, weight, height, pelvic circumference, and total uterine and fibroid volume were recorded. Exposure parameters, contrast load, and procedure time were recorded and organ doses for ovaries and uterus were calculated.

RESULTS

Demographic data did not differ between the groups. Catheterization and embolization of both uterine arteries were feasible in all patients, although in one patient in the 3D group, a focal dissection of the proximal uterine artery occurred. No significant difference in estimated ovarian dose was found in the 3D versus 2D group (P = 0.07). Total procedure time was shorter in the 2D group (P = 0.01) and no difference in total contrast load was seen (P = 0.17).

CONCLUSION

Both roadmap techniques are effective imaging-guided tools for uterine artery catheterization, without difference in terms of radiation exposure or contrast load. The total procedure time is shorter in the 2D group.

Endovascular treatment for large and giant fusiform aneurysms of the vertebrobasilar arteries

Fusiform aneurysms of vertebrobasilar arteries pose great challenge to surgical and endovascular treatment, especially large and giant aneurysms. We retrospectively reviewed our experiences and results of endovascular treatments for a series of 10 consecutive patients with large and giant fusiform aneurysms. Eight patients underwent stents placement (5 patients) or stent-assisted coiling (3 patients), and 2 patients underwent proximal occlusion of the parent arteries. Retreatment was needed in 2 patients. With the exception of 1 patient who died of rebleeding after sole stenting, the remaining 9 patients had good outcome. Reconstructive strategies using stents is a useful alternative for large and giant fusiform aneurysms of the vertebrobasilar arteries.