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Title: Vena Cava 3D Contrast-Enhanced MR Venography: A Pictorial Review

Abstract

Three-dimensional contrast-enhanced magnetic resonance venography (CE MRV) is a sensitive and accurate method for diagnosing vena cava pathologies. The commonly used indirect approach involves a nondiluted gadolinium contrast agent injected into an upper limb vein or, occasionally, a pedal vein for assessment of the superior or inferior vena cava. In our studies, a coronal 3D fast multi-planar spoiled gradient-echo acquisition was used. A pre-contrast scan was obtained to ensure correct coverage of the region of interest. We initiated contrast-enhanced acquisition 15 sec after the start of contrast agent injection and performed the procedure twice. The image sets were obtained during two 20-30-sec breath hold, with a breathing rest of 5-6 sec, to obtain the first-pass and delayed arteriovenous phases. For patients with Budd-Chiari syndrome, a third acquisition coinciding with late venous phase was collected to visualize the hepatic veins, which was carried out by one additional acquisition after a 5-6-sec breathing time. This review describes the clinical application of 3D CE MRV in vena cava congenital anomalies, superior and inferior vena cava syndrome, Budd-Chiari syndrome, peripheral vein thrombosis extending to the vena cava, pre-operational evaluation in portosystemic shunting and post-surgical follow-up, and road-mapping for the placement and evaluation of complicationsmore » of central venous devices.« less

Authors:
; ; ; ;  [1];  [2]
  1. Zhongshan Hospital, Fudan University, Department of Radiology (China)
  2. Current with Astrazeneca Pharmaceuticals (United Kingdom), E-mail: yi-xiang.wang@astrazeneca.com
Publication Date:
OSTI Identifier:
21091311
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 28; Journal Issue: 6; Other Information: DOI: 10.1007/s00270-004-0054-0; Copyright (c) 2005 Springer Science+Business Media, Inc.; www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CONTRAST MEDIA; EVALUATION; GADOLINIUM; INJECTION; LIMBS; LIVER; MAGNETIC RESONANCE; PATHOLOGY; RESPIRATION; REVIEWS; SURGERY; THROMBOSIS; VEINS

Citation Formats

Lin Jiang, Zhou Kangrong, Chen Zuwang, Wang Jianhua, Yan Ziping, and Wang, Yi-Xiang J. Vena Cava 3D Contrast-Enhanced MR Venography: A Pictorial Review. United States: N. p., 2005. Web. doi:10.1007/S00270-004-0054-0.
Lin Jiang, Zhou Kangrong, Chen Zuwang, Wang Jianhua, Yan Ziping, & Wang, Yi-Xiang J. Vena Cava 3D Contrast-Enhanced MR Venography: A Pictorial Review. United States. doi:10.1007/S00270-004-0054-0.
Lin Jiang, Zhou Kangrong, Chen Zuwang, Wang Jianhua, Yan Ziping, and Wang, Yi-Xiang J. Thu . "Vena Cava 3D Contrast-Enhanced MR Venography: A Pictorial Review". United States. doi:10.1007/S00270-004-0054-0.
@article{osti_21091311,
title = {Vena Cava 3D Contrast-Enhanced MR Venography: A Pictorial Review},
author = {Lin Jiang and Zhou Kangrong and Chen Zuwang and Wang Jianhua and Yan Ziping and Wang, Yi-Xiang J.},
abstractNote = {Three-dimensional contrast-enhanced magnetic resonance venography (CE MRV) is a sensitive and accurate method for diagnosing vena cava pathologies. The commonly used indirect approach involves a nondiluted gadolinium contrast agent injected into an upper limb vein or, occasionally, a pedal vein for assessment of the superior or inferior vena cava. In our studies, a coronal 3D fast multi-planar spoiled gradient-echo acquisition was used. A pre-contrast scan was obtained to ensure correct coverage of the region of interest. We initiated contrast-enhanced acquisition 15 sec after the start of contrast agent injection and performed the procedure twice. The image sets were obtained during two 20-30-sec breath hold, with a breathing rest of 5-6 sec, to obtain the first-pass and delayed arteriovenous phases. For patients with Budd-Chiari syndrome, a third acquisition coinciding with late venous phase was collected to visualize the hepatic veins, which was carried out by one additional acquisition after a 5-6-sec breathing time. This review describes the clinical application of 3D CE MRV in vena cava congenital anomalies, superior and inferior vena cava syndrome, Budd-Chiari syndrome, peripheral vein thrombosis extending to the vena cava, pre-operational evaluation in portosystemic shunting and post-surgical follow-up, and road-mapping for the placement and evaluation of complications of central venous devices.},
doi = {10.1007/S00270-004-0054-0},
journal = {Cardiovascular and Interventional Radiology},
number = 6,
volume = 28,
place = {United States},
year = {Thu Dec 15 00:00:00 EST 2005},
month = {Thu Dec 15 00:00:00 EST 2005}
}
  • We report the complication of hemopericardium following superior vena cava (SVC) stenting with an uncovered Wallstent in a patient with malignant SVC obstruction. The patient collapsed acutely 15 min following stent placement with hypoxemia and hypotension. A CT scan demonstrated a hemopericardium which was successfully treated with a pericardial drain. The possible complications of SVC stenting, including hemopericardium, pulmonary embolism, mediastinal hematoma, and pulmonary edema from increased venous return resulting from improved hemodynamics, ensure a wide differential diagnosis in the post procedural collapsed patient and this case emphasizes the important role of contrast-enhanced CT in the peri-resuscitation assessment of thesemore » patients.« less
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  • Isotopic phlebography with Tc-99m-labeled microspheres was performed in 55 patients, 22 of whom presented with superior vena cava syndrome. The localization of the venous obstruction was visualized in each case, along with associated collateral views. Moreover, the transit times at different levels were markedly increased. In 11 patients, isotopic phlebography was repeated following treatment. Improvement, when it occurred, was largely due to diminished obstruction of the superior vena cava rather than to increased collateral supply. Therefore, isotopic phlebography of the upper extremities is a useful tool for the diagnosis of superior vena cava syndrome and for the evaluation of responsemore » to treatment.« less
  • Isotopic phlebography with Tc-99m-labeled microspheres was performed in 55 patients, 22 of whom presented with superior vena cava syndrome. The localization of the venous obstruction was visualized in each case, along with associated collateral views. Moreover, the transit times at different levels were markedly increased. In 11 patients, isotopic phlebography was repeated following treatment. Improvement, when it occurred, was largely due to diminished obstruction of the superior vena cava rather than to increased collateral supply. Therefore, isotopic phlebography of the upper extremities is a useful tool for the diagnosis of superior vena cava syndrome and for the evaluation or responsemore » to treatment.« less
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