Hepatic blood supply: comparison of optimized dual phase contrast-enhanced three-dimensional MR angiography and digital subtraction angiography

Abstract

Purpose: To optimize and determine the value of dual-phase contrast material-enhanced three-dimensional (3D) magnetic resonance (MR) angiography for preoperative evaluation of the blood supply to the liver.

Materials and methods: Dual phase 3D MR angiography of the hepatic arteries and portal vein was performed in 140 patients. In 80 patients, the value of fat saturation, digital image subtraction, an anticholinergic agent, and a high-caloric meal were evaluated. In the next 60 patients, MR angiographic and digital subtraction angiographic (DSA) image quality and diagnostic value were compared.

Results: Fat-saturated images were of significantly better quality (P < .01) than non-fat-saturated images. Digital image subtraction was useful in only 23 of 40 patients. The injection of an anticholinergic agent was superfluous, whereas administration of a high-caloric meal helped in demonstration of the superior mesenteric artery and portal vein. Classification on MR angiograms of the arterial blood supply was correct in 57 of 60 patients. All arterial and portal venous lesions were seen on MR angiograms, and MR angiograms had a significantly higher subjective image-quality ranking than did DSA images in the evaluation of the portal vein (P < .05).

Conclusion: Fat saturation and use of a high-caloric meal improve the results of MR angiography of hepatic vessels. MR angiography was comparable to DSA for evaluation of the arterial system and was superior for demonstration of the portal vein; therefore, MR angiography could replace intraarterial DSA.