Gadolinium 3D MRA, intracranial pathology, case 1

Comparison of the three presently available MRA techniques applied to a normal patient.

This 33-year-old male suffered from chronic headaches and loss of balance. Moreover, several cases of intracranial aneurysms were reported in his family. Vascular study of the circle of Willis was requested in order to rule out the presence of an aneurysm or an AVM.

Images 1 - 2 - 3
Gd 3D MRA (3 dimensional Gadolinium-enhanced T1 images). Reconstructions made from the first arterial passage of contrast media administered by bolus injection.

Images 4 - 5
3DSET1. Same reconstructions obtained from the images acquired 18 sec after the first set of images: on those images, not only the arterial but also the venous structures are seen like the cavernous sinus, cortical veins and transverse sinus.

Image 6
Native axial images acquired every 18 seconds at one level during bolus injection of Gd 3D MRA technique.
a) purely arterial phase: only both carotids and the basilar arteries are well shown
b) image acquired 18 seconds after a): the cavernous sinus is now also visible surrounding both carotids arteries.
c) and d) On those later acquisitions, every 18 seconds, the venous structures are still better identified while the contrast within the arterial components has mainly faded and is inferior to what is seen on images a and b.

For comparison standard MIP reconstruction of the TOF image (images 7 - 8 - 9) and 3DPC (images 10 - 11 - 12) are shown in the same normal patient. No vascular abnormalities were found in this case.

Conclusion
Image 13: axial view of the circle of Willis as demonstrated by the three different MRI angiographic techniques: a) 3DTOF, b) 3DPC and c) Gd 3D MRA.

Search also:
- Gd 3D MRA: intracranial pathology

The ESNR CD-Rom Series