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Contrast-enhanced Three-dimensional MR Portography¹

¹ From the Department of Radiology, Kurashiki Central Hospital, Miwa 1-1-1, Kurashiki 710-8602, Japan. Presented as a scientific exhibit at the 1997 RSNA scientific assembly. Received April 16, 1998; revision requested May 22 and received September 14; accepted September 16. Address reprint requests to Y.W.

Three-dimensional (3D) magnetic resonance (MR) portography with contrast material enhancement is a fast means of evaluating the portal venous system that has some advantages over currently used modalities, such as digital subtraction angiography, helical computed tomography, ultrasonography, and nonenhanced MR angiography with time-of-flight and phase-contrast techniques. With contrast-enhanced 3D MR portography, a first-pass study of the mesenteric vasculature is performed after rapid bolus injection of gadopentetate dimeglumine; a 3D fast field echo sequence is used, which can demonstrate the intrahepatic and extrahepatic portal venous system clearly. Repeated sequences after administration of gadopentetate dimeglumine allow separate demonstration of the splanchnic arteries and portomesenteric veins. The images are reconstructed by means of maximum-intensity projection postprocessing, and a subtraction technique can be used to eliminate arterial enhancement and demonstrate portosystemic shunts. The coronal source images simultaneously demonstrate parenchymal lesions of the liver, pancreas, biliary tract, and spleen. This technique is clinically indicated in portosystemic shunt, portal vein thrombosis, hepatocellular carcinoma, pancreatobiliary tumor, hepatic vein obstruction, differentiation of splanchnic arterial from portal venous disease, and gastrointestinal hemorrhage. Its limitations include allergic reactions to contrast media, inappropriate positioning of the 3D acquisition slab, respiratory motion artifacts, and pseudodissection.

Index Terms: Magnetic resonance (MR), maximum intensity projection, 957.12949 • Magnetic resonance (MR), three-dimensional, 957.12917 • Magnetic resonance (MR), vascular studies, 957.12942 • Portal vein, MR, 957.12942 • Portal vein, stenosis or obstruction, 957.75

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