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Subtraction MR Venography Acquired from Time-Resolved Contrast-Enhanced MR Angiography: Comparison with Phase-Contrast MR Venography and Single-Phase Contrast-Enhanced MR Venography.

Jang J, Kim BS, Sung J, Kim BY, Choi HS, Jung SL, Ahn KJ - Korean J Radiol (2015)

Bottom Line: Image quality and the degree of arterial contamination of the three MRVs were compared.The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the three MRVs were also compared.The dural sinus score of SMRV (median and interquartile range [IQR] 48, 43-50 for reviewer 1, 47, 43-49 for reviewer 2) was significantly higher than for PCMRV (median and IQR 31, 25-34 for reviewer 1, 30, 23-32 for reviewer 2) (p < 0.01) and did not differ from that of CEMRV (median and IQR 50, 47-52 for reviewer 1, 49, 45-51 for reviewer 2) (p = 0.146 in reviewer 1 and 0.123 in reviewer 2).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.

ABSTRACT

Objective: To evaluate the image characteristics of subtraction magnetic resonance venography (SMRV) from time-resolved contrast-enhanced MR angiography (TRMRA) compared with phase-contrast MR venography (PCMRV) and single-phase contrast-enhanced MR venography (CEMRV).

Materials and methods: Twenty-one patients who underwent brain MR venography (MRV) using standard protocols (PCMRV, CEMRV, and TRMRA) were included. SMRV was made by subtracting the arterial phase data from the venous phase data in TRMRA. Co-registration and subtraction of the two volume data was done using commercially available software. Image quality and the degree of arterial contamination of the three MRVs were compared. In the three MRVs, 19 pre-defined venous structures (14 dural sinuses and 5 cerebral veins) were evaluated. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the three MRVs were also compared.

Results: Single-phase contrast-enhanced MR venography showed better image quality (median score 4 in both reviewers) than did the other two MRVs (p < 0.001), whereas SMRV (median score 3 in both reviewers) and PCMRV (median score 3 in both reviewers) had similar image quality (p ≥ 0.951). SMRV (median score 0 in both reviewers) suppressed arterial signal better than did the other MRVs (median score 1 in CEMRV, median score 2 in PCMRV, both reviewers) (p < 0.001). The dural sinus score of SMRV (median and interquartile range [IQR] 48, 43-50 for reviewer 1, 47, 43-49 for reviewer 2) was significantly higher than for PCMRV (median and IQR 31, 25-34 for reviewer 1, 30, 23-32 for reviewer 2) (p < 0.01) and did not differ from that of CEMRV (median and IQR 50, 47-52 for reviewer 1, 49, 45-51 for reviewer 2) (p = 0.146 in reviewer 1 and 0.123 in reviewer 2). The SNR and CNR of SMRV (median and IQR 104.5, 83.1-121.2 and 104.1, 74.9-120.5, respectively) were between those of CEMRV (median and IQR 150.3, 111-182.6 and 148.4, 108-178.2) and PCMRV (median and IQR 59.4, 49.2-74.9 and 53.6, 43.8-69.2).

Conclusion: Subtraction magnetic resonance venography is a promising MRV method, with acceptable image quality and good arterial suppression.

No MeSH data available.


Related in: MedlinePlus

47-year-old female underwent MRV as part of her preoperative workup for midline meningioma.PCMRV (A), CEMRV (B), and SMRV (C) reveal abrupt obliteration of superior sagittal sinus (arrowheads) and prominent collateral cortical vein (empty arrows). Note unsuppressed signal of internal carotid arteries in PCMRV and CEMRV (asterisks), whereas internal carotid arteries are not seen on SMRV. Internal cerebral veins (arrows) are not visualized on PCMRV. Degree of visualization of straight sinus (double arrows) and vein of Galen are different in three MRV images. CEMRV = single-phase contrast-enhanced MR venography, MRV = MR venography, PCMRV = phase-contrast MR venography, SMRV = subtraction MR venography
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Figure 3: 47-year-old female underwent MRV as part of her preoperative workup for midline meningioma.PCMRV (A), CEMRV (B), and SMRV (C) reveal abrupt obliteration of superior sagittal sinus (arrowheads) and prominent collateral cortical vein (empty arrows). Note unsuppressed signal of internal carotid arteries in PCMRV and CEMRV (asterisks), whereas internal carotid arteries are not seen on SMRV. Internal cerebral veins (arrows) are not visualized on PCMRV. Degree of visualization of straight sinus (double arrows) and vein of Galen are different in three MRV images. CEMRV = single-phase contrast-enhanced MR venography, MRV = MR venography, PCMRV = phase-contrast MR venography, SMRV = subtraction MR venography

Mentions: Representative cases are presented in Figures 3-5. A patient (Fig. 3) with a falx meningioma showed obliteration of the superior sagittal sinus on all three MRV images. Surgical findings confirmed the invasion of the meningioma into the superior sagittal sinus. Another patient (Fig. 4), who was undergoing follow-up after diagnosis of dural sinus thrombosis in the right transverse sinus, had a suspected persistent thrombosis on PCMRV. However, that segment was normal on both CEMRV and SMRV. There was also a case of a meningioma that had a feeding artery that mimicked a draining vein on conventional MRV (Fig. 5), but this structure was not seen on SMRV. After the review of dynamic TRMRA images, this vascular structure was confirmed to be a feeding artery to the meningioma and not a draining vein.


Subtraction MR Venography Acquired from Time-Resolved Contrast-Enhanced MR Angiography: Comparison with Phase-Contrast MR Venography and Single-Phase Contrast-Enhanced MR Venography.

Jang J, Kim BS, Sung J, Kim BY, Choi HS, Jung SL, Ahn KJ - Korean J Radiol (2015)

47-year-old female underwent MRV as part of her preoperative workup for midline meningioma.PCMRV (A), CEMRV (B), and SMRV (C) reveal abrupt obliteration of superior sagittal sinus (arrowheads) and prominent collateral cortical vein (empty arrows). Note unsuppressed signal of internal carotid arteries in PCMRV and CEMRV (asterisks), whereas internal carotid arteries are not seen on SMRV. Internal cerebral veins (arrows) are not visualized on PCMRV. Degree of visualization of straight sinus (double arrows) and vein of Galen are different in three MRV images. CEMRV = single-phase contrast-enhanced MR venography, MRV = MR venography, PCMRV = phase-contrast MR venography, SMRV = subtraction MR venography
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644759&req=5

Figure 3: 47-year-old female underwent MRV as part of her preoperative workup for midline meningioma.PCMRV (A), CEMRV (B), and SMRV (C) reveal abrupt obliteration of superior sagittal sinus (arrowheads) and prominent collateral cortical vein (empty arrows). Note unsuppressed signal of internal carotid arteries in PCMRV and CEMRV (asterisks), whereas internal carotid arteries are not seen on SMRV. Internal cerebral veins (arrows) are not visualized on PCMRV. Degree of visualization of straight sinus (double arrows) and vein of Galen are different in three MRV images. CEMRV = single-phase contrast-enhanced MR venography, MRV = MR venography, PCMRV = phase-contrast MR venography, SMRV = subtraction MR venography
Mentions: Representative cases are presented in Figures 3-5. A patient (Fig. 3) with a falx meningioma showed obliteration of the superior sagittal sinus on all three MRV images. Surgical findings confirmed the invasion of the meningioma into the superior sagittal sinus. Another patient (Fig. 4), who was undergoing follow-up after diagnosis of dural sinus thrombosis in the right transverse sinus, had a suspected persistent thrombosis on PCMRV. However, that segment was normal on both CEMRV and SMRV. There was also a case of a meningioma that had a feeding artery that mimicked a draining vein on conventional MRV (Fig. 5), but this structure was not seen on SMRV. After the review of dynamic TRMRA images, this vascular structure was confirmed to be a feeding artery to the meningioma and not a draining vein.

Bottom Line: Image quality and the degree of arterial contamination of the three MRVs were compared.The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the three MRVs were also compared.The dural sinus score of SMRV (median and interquartile range [IQR] 48, 43-50 for reviewer 1, 47, 43-49 for reviewer 2) was significantly higher than for PCMRV (median and IQR 31, 25-34 for reviewer 1, 30, 23-32 for reviewer 2) (p < 0.01) and did not differ from that of CEMRV (median and IQR 50, 47-52 for reviewer 1, 49, 45-51 for reviewer 2) (p = 0.146 in reviewer 1 and 0.123 in reviewer 2).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.

ABSTRACT

Objective: To evaluate the image characteristics of subtraction magnetic resonance venography (SMRV) from time-resolved contrast-enhanced MR angiography (TRMRA) compared with phase-contrast MR venography (PCMRV) and single-phase contrast-enhanced MR venography (CEMRV).

Materials and methods: Twenty-one patients who underwent brain MR venography (MRV) using standard protocols (PCMRV, CEMRV, and TRMRA) were included. SMRV was made by subtracting the arterial phase data from the venous phase data in TRMRA. Co-registration and subtraction of the two volume data was done using commercially available software. Image quality and the degree of arterial contamination of the three MRVs were compared. In the three MRVs, 19 pre-defined venous structures (14 dural sinuses and 5 cerebral veins) were evaluated. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the three MRVs were also compared.

Results: Single-phase contrast-enhanced MR venography showed better image quality (median score 4 in both reviewers) than did the other two MRVs (p < 0.001), whereas SMRV (median score 3 in both reviewers) and PCMRV (median score 3 in both reviewers) had similar image quality (p ≥ 0.951). SMRV (median score 0 in both reviewers) suppressed arterial signal better than did the other MRVs (median score 1 in CEMRV, median score 2 in PCMRV, both reviewers) (p < 0.001). The dural sinus score of SMRV (median and interquartile range [IQR] 48, 43-50 for reviewer 1, 47, 43-49 for reviewer 2) was significantly higher than for PCMRV (median and IQR 31, 25-34 for reviewer 1, 30, 23-32 for reviewer 2) (p < 0.01) and did not differ from that of CEMRV (median and IQR 50, 47-52 for reviewer 1, 49, 45-51 for reviewer 2) (p = 0.146 in reviewer 1 and 0.123 in reviewer 2). The SNR and CNR of SMRV (median and IQR 104.5, 83.1-121.2 and 104.1, 74.9-120.5, respectively) were between those of CEMRV (median and IQR 150.3, 111-182.6 and 148.4, 108-178.2) and PCMRV (median and IQR 59.4, 49.2-74.9 and 53.6, 43.8-69.2).

Conclusion: Subtraction magnetic resonance venography is a promising MRV method, with acceptable image quality and good arterial suppression.

No MeSH data available.


Related in: MedlinePlus