Journal Article

Equilibrium-Phase High Spatial Resolution Contrast-Enhanced MR Angiography at 1.5T in Preoperative Imaging for Perforator Flap Breast Reconstruction

Versluis, Bas, Leiner, Tim, Tuinder, Stefania, Wildberger, Joachim, Boetes, Carla, Van Der Hulst, René, de Haan, Michiel, Van Mulken, Tom, Lataster, Arno

2013

Overview

The aim was (i) to evaluate the accuracy of equilibrium-phase high spatial resolution (EP) contrast-enhanced magnetic resonance angiography (CE-MRA) at 1.5T using a blood pool contrast agent for the preoperative evaluation of deep inferior epigastric artery perforator branches (DIEP), and (ii) to compare image quality with conventional first-pass CE-MRA. Twenty-three consecutive patients were included. All patients underwent preoperative CE-MRA to determine quality and location of DIEP. First-pass imaging after a single bolus injection of 10 mL gadofosveset trisodium was followed by EP imaging. MRA data were compared to intra-operative findings, which served as the reference standard. There was 100% agreement between EP CE-MRA and surgical findings in identifying the single best perforator branch. All EP acquisitions were of diagnostic quality, whereas in 10 patients the quality of the first-pass acquisition was qualified as non-diagnostic. Both signal- and contrast-to-noise ratios were significantly higher for EP imaging in comparison with first-pass acquisitions (p<0.01). EP CE-MRA of DIEP in the preoperative evaluation of patients undergoing a breast reconstruction procedure is highly accurate in identifying the single best perforator branch at 1.5Tesla (T). Besides accuracy, image quality of EP imaging proved superior to conventional first-pass CE-MRA.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Abdomen / Accuracy / Adult / Angiography / Cancer / Comparative analysis / Contrast agents / Contrast Media / Diagnostic systems / Drug delivery systems / Equilibrium / Evaluation / Female / Humans / Image Processing, Computer-Assisted / Image quality / Ionizing radiation / Magnetic resonance / Magnetic Resonance Angiography - methods / Magnetic Resonance Angiography - standards / Magnetic resonance imaging / Mammaplasty / Medical imaging / Medical imaging equipment / Medicine / Middle Aged / Noise / Patients / Perforator Flap - blood supply / Plastic surgery / Reconstruction / Spatial discrimination / Spatial resolution / Surgery / Ultrasonic imaging / Veins & arteries