Purpose
To evaluate the ability of 3Tesla Contrast-Enhanced MR-Angiography (CE-MRA) in visualizing the Internal Iliac Artery (IIA) branches in females prior to UAE.
Methods and Materials
Pre-embolization contrast enhanced MR angiographic studiesfrom 22 females (Age range:30-53years) who underwent Uterine Artery Embolization for uterine fibroids were included.Evaluations were retrospectively done by two radiologists in consensus.All patients underwent MR imaging, including CE-MRA as a part of the pre-interventional work-up.MRA studies were performed on a 3 Tesla MRI system (Magnetom Trio; Siemens Medical Systems, Erlangen, Germany) using a body-array-coil.Anun-enhanced 3D-FLASH sequencein coronal slice orientation was performed during end inspiratory phase.The same sequence was repeated after contrast administration.Image subtraction(of the un-enhanced images from contrast-enhanced images)...
Results
Scores of the differentbranches of the internal iliac arteryassessed using 3D reconstructed contrast enhanced MRA performed in a 3 Tesla MRI unitBranchScore 2Score 1Score 0Overall SensitivitySuperior Gluteal Artery44001Inferior Gluteal Artery43101Lateral Sacral Artery291501Iliolumbar Artery331010.98Obturator Artery261620.95Internal Pudendal Artery43101Uterine Artery43101Superior Vesical Artery912230.48Middle Rectal Artery66320.27
Conclusion
3 Tesla CE-MRA is a helpful non invasive tool in detecting most of the branches of the internal iliac artery in females. Pre-procedural knowledge of the arterial tree can possibly decrease the number of contrast medium injections needed to map the arteries during the procedure, thus decreasing the overall dose of radiation and contrast material used but further work is required in this field.
References
Glockner JF. Three-dimensional Gadolinium-enhanced MR angiography: applications for abdominal imaging. Radiographics. 2001;21:357–370.Pelage JP, Le Dref O, Soyer P, et al. Arterial anatomy of the female genital tract: variations and relevance to transcatheter embolization of the uterus. AJR Am J Roentgenol. 1999;172:989–994Naguib NN, Nour-Eldin NE, Lehnert T, et al. Uterine artery embolization: optimization with preprocedural prediction of the best tube angle obliquity by using 3D-reconstructed contrast-enhanced MR angiography. Radiology. 2009 Jun;251(3):788-95.Naguib NN, Nour-Eldin NE, Hammerstingl RM, et al. Three-dimensional reconstructed contrast-enhanced MR angiography for internal iliac...
Personal Information
Nagy N.N. Naguib, MSCInstitute for Diagnostic and Interventional RadiologyJohann Wolfgang Goethe-University FrankfurtTheodor-Stern-Kai 760590 Frankfurt am Main (Germany)Tel. +49 (0) 69 6301 87200E-mail:
[email protected]