Non-contrast fresh-blood MRA for assessment of abdominal endovascular stent grafts
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KeywordsAbdominal Aortic Aneurysm Abdominal Aortic Aneurysm Abdominal Aortic Aneurysm Repair Black Blood Bright Blood
Serial imaging of abdominal aortic endovascular stent grafts (AA-ESG) is done in order to determine: 1) stent stability, 2) presence of endograft leak, and 3) residual abdominal aortic aneurysm (AAA) sac size. CT angiography (CTA) has traditionally been used for serial follow-up. Given the high incidence of renal dysfunction in patients with AAA and potential contraindications to both CT and MR contrast agents we development a non-contrast vascular imaging protocol for assessment of patients with AA-ESG.
Consecutive patients are reported on (n = 5): 73 ± 4 yo, 45 ± 16 months since AAA repair (mean ± SD). Aneurysm dimension at its greatest size as assessed by CTA (3.9 ± 0.1 cm) was similar to that for BB imaging (3.8 ± 0.1 cm) (p = 0.40). Endograft visualization as assessed by luminal dimensions was similar between FBI and CTA (r2 = 0.96, n = 15) with good visualization of the AA-ESG and surrounding arterial tree.
A combined approach of 2D BB and 3D FBI imaging of AA-ESG can accurately assess aneurysm sac size and endograft angiographic characteristics. Although this non-contrast technique cannot directly assess for endograft leak this approach may still be an acceptable alternative to contrast imaging for serial follow-up of patients with renal dysfunction. Further validation of this novel technique will need to be done in a larger cohort of patients.
This article is published under license to BioMed Central Ltd.