By Martin R. Prince MD, PhD, Thomas M. Grist M.D., Jörg F. Debatin M.D., MBA (auth.)
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Extra info for 3D Contrast MR Angiography
Subtraction of the MIP images is not useful. If subtraction of successive breath-held scans is performed, it is important to coach the patient before the study so that the degree of inspiration for each 3D data acquisition is similar. As in all subtractions, motion between the mask and the enhanced image can lead to artifacts. Therefore, it is desirable to obtain the mask immediately before inject- Maximum Intensity Projection 31 ing the contrast. This is best accomplished with techniques that acquire sequential data sets, like the time-resolved method.
Equilibrium phase MIP (b) shows multiple enhancing lung nodules (arrows). Diagnosis: Lung metastases. Submitted by Martin R. , Ann Arbor, MI. Motion Artifacts The presence of respiratory motion may cause blurring, wh ich can easily obscure the subtle findings of a segmental or sub-segmental embolus. When the data is corrupted by respiratory motion, it is better to make no effort to interpret the study rather than provide false assurances that no embolus is identified. Partial Voluming When emboli are only partially obstructing flow, they may be missed on thick MIP images.
These advantages may be tempered by problems associated with venous overlap and safety related dose limitations. Nevertheless, a number of applications are likely to benefit from the introduction of blood pool contrast agents. Among them, pulmonary and coronary 3D MRA may feature prominently. Other uses relate to venous imaging and "road map" imaging for monitoring vascular interventions. Can Stents Be Imaged With 3D Contrast MRA 37 Clearly, however, 3D contrast MRA can be performed weIl without blood pool agents.
3D Contrast MR Angiography by Martin R. Prince MD, PhD, Thomas M. Grist M.D., Jörg F. Debatin M.D., MBA (auth.)