Hubbard Logan, Mathevosian Sipan, Yoshida Takegawa, Hassani Cameron, Jalili Mohammad H, Finn J Paul, Bedayat Arash
Department of Radiological Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA.
Department of Radiological Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA.
Clin Imaging. 2025 Feb;118:110383. doi: 10.1016/j.clinimag.2024.110383. Epub 2024 Dec 5.
To evaluate ferumoxytol-enhanced magnetic resonance angiography (FE-MRA) for assessment of endoleaks in patients with abdominal aortic aneurysms (AAA) and chronic kidney disease (CKD) status post endovascular aneurysm repair (EVAR).
Of 1854 patients who underwent FE-MRA at a single institution between 03/21/2014 and 08/21/2023, 21 patients with a history of AAA and CKD status post EVAR were retrospectively identified (IRB #13-001341). Multiplanar pre- and post-contrast HASTE, T1-VIBE, and high-resolution breath-held 3D MRA sequences were obtained, where a dose of 4 mg/kg of Ferumoxytol was infused over six minutes. All examinations were performed on either a Siemens 3.0 T Prisma Fit, a Siemens 3.0 T TIM Trio, or a Siemens 1.5 T Avanto MRI scanner. Image post-processing was performed using OsiriX and Vitrea software for endoleak identification and display.
Twenty-six FE-MRA examinations were completed, where 24 were fully diagnostic and 2 were limited by metal artifact. Three patients underwent one follow-up examination, while one patient underwent two follow-up examinations. Endoleaks were identified in seven patients: one Type Ia, two Type Ib, and four Type II. The Type Ia endoleak patient received follow-up imaging two years after initial imaging. A Type II endoleak patient received follow-up imaging six months and one year after initial imaging. In both cases, the Type I and Type II endoleaks were reproducibly visualized. No contrast reactions occurred.
For patients with a history of AAA and CKD status post EVAR, FE-MRA is a safe, practical and effective imaging solution for evaluation of Type I and Type II endoleaks.
评估铁羧麦芽糖增强磁共振血管造影（FE-MRA）在评估腹主动脉瘤（AAA）和慢性肾脏病（CKD）患者血管内动脉瘤修复术（EVAR）后内漏情况中的应用。
在2014年3月21日至2023年8月21日期间于单一机构接受FE-MRA检查的1854例患者中，回顾性确定了21例有AAA病史且处于EVAR术后CKD状态的患者（机构审查委员会编号#13-001341）。获得了多平面对比剂注射前后的HASTE、T1-VIBE和高分辨率屏气3D MRA序列，其中在6分钟内静脉注射4mg/kg的铁羧麦芽糖。所有检查均在西门子3.0T Prisma Fit、西门子3.0T TIM Trio或西门子1.5T Avanto MRI扫描仪上进行。使用OsiriX和Vitrea软件进行图像后处理以识别和显示内漏。
共完成26次FE-MRA检查，其中24次诊断充分，2次受金属伪影限制。3例患者接受了1次随访检查，1例患者接受了2次随访检查。7例患者发现内漏：1例Ia型、2例Ib型和4例II型。Ia型内漏患者在初次成像后两年接受了随访成像。1例II型内漏患者在初次成像后6个月和1年接受了随访成像。在这两种情况下，I型和II型内漏均能被重复显示。未发生造影剂反应。
对于有AAA病史且处于EVAR术后CKD状态的患者，FE-MRA是评估I型和II型内漏的一种安全、实用且有效的成像方法。
