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Equilibrium-phase high spatial resolution contrast-enhanced MR angiography at 1.5T in preoperative imaging for perforator flap breast reconstruction.

Versluis B, Tuinder S, Boetes C, Van Der Hulst R, Lataster A, Van Mulken T, Wildberger J, de Haan M, Leiner T - PLoS ONE (2013)

Bottom Line: MRA data were compared to intra-operative findings, which served as the reference standard.Both signal- and contrast-to-noise ratios were significantly higher for EP imaging in comparison with first-pass acquisitions (p<0.01).Besides accuracy, image quality of EP imaging proved superior to conventional first-pass CE-MRA.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.

ABSTRACT

Objectives: The aim was (i) to evaluate the accuracy of equilibrium-phase high spatial resolution (EP) contrast-enhanced magnetic resonance angiography (CE-MRA) at 1.5T using a blood pool contrast agent for the preoperative evaluation of deep inferior epigastric artery perforator branches (DIEP), and (ii) to compare image quality with conventional first-pass CE-MRA.

Methods: Twenty-three consecutive patients were included. All patients underwent preoperative CE-MRA to determine quality and location of DIEP. First-pass imaging after a single bolus injection of 10 mL gadofosveset trisodium was followed by EP imaging. MRA data were compared to intra-operative findings, which served as the reference standard.

Results: There was 100% agreement between EP CE-MRA and surgical findings in identifying the single best perforator branch. All EP acquisitions were of diagnostic quality, whereas in 10 patients the quality of the first-pass acquisition was qualified as non-diagnostic. Both signal- and contrast-to-noise ratios were significantly higher for EP imaging in comparison with first-pass acquisitions (p<0.01).

Conclusions: EP CE-MRA of DIEP in the preoperative evaluation of patients undergoing a breast reconstruction procedure is highly accurate in identifying the single best perforator branch at 1.5Tesla (T). Besides accuracy, image quality of EP imaging proved superior to conventional first-pass CE-MRA.

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Related in: MedlinePlus

Transverse slices demonstrate the vascular bundle dorsal to the rectus muscle.Transverse source images of equilibrium-phase dataset in the same patient. Images are from caudal (top panel) to cranial (bottom panel), and clearly demonstrate the vascular bundle dorsal to the rectus muscle shortly after branching off the external iliac artery (asterisks in top three panels). The perforating branches can easily be followed when traversing the rectus muscle to the point where they arise in the subcutaneous fat (asterisks in lower 4 panels).
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pone-0071286-g003: Transverse slices demonstrate the vascular bundle dorsal to the rectus muscle.Transverse source images of equilibrium-phase dataset in the same patient. Images are from caudal (top panel) to cranial (bottom panel), and clearly demonstrate the vascular bundle dorsal to the rectus muscle shortly after branching off the external iliac artery (asterisks in top three panels). The perforating branches can easily be followed when traversing the rectus muscle to the point where they arise in the subcutaneous fat (asterisks in lower 4 panels).

Mentions: Equilibrium-phase high spatial resolution images were acquired in all patients, whereas because of a timing error first-pass acquisition failed in one patient. Figures 3 and 4 show examples of reconstructed MPR images of an equilibrium-phase acquisition. Image quality results of both equilibrium-phase and first pass acquisitions are presented in table 2. All equilibrium-phase acquisitions were of diagnostic quality, whereas in 10 out of 22 patients the quality of the first-pass images was qualified as non-diagnostic. In those patients it was not possible to identify any perforator branch using the first-pass acquisition. Excellent image quality was obtained in 13 out of 23 patients for equilibrium-phase imaging against only 7 out of 22 in first-pass imaging. Both the signal- and contrast-to-noise ratios were significantly higher for equilibrium-phase imaging in comparison with first-pass acquisitions (p<0.01).


Equilibrium-phase high spatial resolution contrast-enhanced MR angiography at 1.5T in preoperative imaging for perforator flap breast reconstruction.

Versluis B, Tuinder S, Boetes C, Van Der Hulst R, Lataster A, Van Mulken T, Wildberger J, de Haan M, Leiner T - PLoS ONE (2013)

Transverse slices demonstrate the vascular bundle dorsal to the rectus muscle.Transverse source images of equilibrium-phase dataset in the same patient. Images are from caudal (top panel) to cranial (bottom panel), and clearly demonstrate the vascular bundle dorsal to the rectus muscle shortly after branching off the external iliac artery (asterisks in top three panels). The perforating branches can easily be followed when traversing the rectus muscle to the point where they arise in the subcutaneous fat (asterisks in lower 4 panels).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3756980&req=5

pone-0071286-g003: Transverse slices demonstrate the vascular bundle dorsal to the rectus muscle.Transverse source images of equilibrium-phase dataset in the same patient. Images are from caudal (top panel) to cranial (bottom panel), and clearly demonstrate the vascular bundle dorsal to the rectus muscle shortly after branching off the external iliac artery (asterisks in top three panels). The perforating branches can easily be followed when traversing the rectus muscle to the point where they arise in the subcutaneous fat (asterisks in lower 4 panels).
Mentions: Equilibrium-phase high spatial resolution images were acquired in all patients, whereas because of a timing error first-pass acquisition failed in one patient. Figures 3 and 4 show examples of reconstructed MPR images of an equilibrium-phase acquisition. Image quality results of both equilibrium-phase and first pass acquisitions are presented in table 2. All equilibrium-phase acquisitions were of diagnostic quality, whereas in 10 out of 22 patients the quality of the first-pass images was qualified as non-diagnostic. In those patients it was not possible to identify any perforator branch using the first-pass acquisition. Excellent image quality was obtained in 13 out of 23 patients for equilibrium-phase imaging against only 7 out of 22 in first-pass imaging. Both the signal- and contrast-to-noise ratios were significantly higher for equilibrium-phase imaging in comparison with first-pass acquisitions (p<0.01).

Bottom Line: MRA data were compared to intra-operative findings, which served as the reference standard.Both signal- and contrast-to-noise ratios were significantly higher for EP imaging in comparison with first-pass acquisitions (p<0.01).Besides accuracy, image quality of EP imaging proved superior to conventional first-pass CE-MRA.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.

ABSTRACT

Objectives: The aim was (i) to evaluate the accuracy of equilibrium-phase high spatial resolution (EP) contrast-enhanced magnetic resonance angiography (CE-MRA) at 1.5T using a blood pool contrast agent for the preoperative evaluation of deep inferior epigastric artery perforator branches (DIEP), and (ii) to compare image quality with conventional first-pass CE-MRA.

Methods: Twenty-three consecutive patients were included. All patients underwent preoperative CE-MRA to determine quality and location of DIEP. First-pass imaging after a single bolus injection of 10 mL gadofosveset trisodium was followed by EP imaging. MRA data were compared to intra-operative findings, which served as the reference standard.

Results: There was 100% agreement between EP CE-MRA and surgical findings in identifying the single best perforator branch. All EP acquisitions were of diagnostic quality, whereas in 10 patients the quality of the first-pass acquisition was qualified as non-diagnostic. Both signal- and contrast-to-noise ratios were significantly higher for EP imaging in comparison with first-pass acquisitions (p<0.01).

Conclusions: EP CE-MRA of DIEP in the preoperative evaluation of patients undergoing a breast reconstruction procedure is highly accurate in identifying the single best perforator branch at 1.5Tesla (T). Besides accuracy, image quality of EP imaging proved superior to conventional first-pass CE-MRA.

Show MeSH
Related in: MedlinePlus