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MRI for Interventions and Surgery

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PanVascular Medicine

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Abstract

Magnetic resonance imaging (MRI) is a major modality for the imaging of vascular disease. Improvements in magnetic resonance angiography (MRA) techniques have provided an important complimentary technology to computed tomography angiography (CTA) for vascular imaging. In this chapter, we review the basic principles of MRI and MRA, including the pulse sequences used to generate MRA images. Next we introduce the clinical applications of MRA to evaluation of vascular disease and to planning and postoperative surveillance of vascular interventions. Common artifacts with MRA are reviewed, and side effects of gadolinium-based contrast agents are examined. Evaluation of patients with pacemakers and implanted devices including endovascular devices is discussed. Finally a comparison of CTA to MRA and the appropriateness of each modality in various clinical scenarios are presented.

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Abbreviations

Artery of Adamkiewicz:

An artery present in some patients which is thought to provide a dominant source of perfusion to the spinal cord.

Electrocardiogram (ECG)-gated MRA:

A method which times image acquisition to the cardiac cycle.

Endovascular aortic repair:

Deployment of an endovascular stent-graft in the aorta to repair various aortic pathologies.

Fat saturation:

A method which suppresses the signal from fat with an RF pulse that utilizes the small difference in resonance frequency between fat and water.

Gadolinium:

Contrast material used for magnetic resonance imaging.

Gradient-echo sequences:

A method which uses RF and field gradients to produce images, particularly T1-weighted images.

Implantable cardioverter-defibrillator:

An implantable device capable of cardioversion and defibrillation.

Implanted devices:

Devices which are indwelling in the patient and can be a contraindication to magnetic resonance imaging.

IVC filters:

A device placed in the inferior vena cava to prevent pulmonary embolism.

Magnetic field gradients:

Magnetic fields which vary in space, used to generate spatial resolution in MRI.

Magnetic resonance angiography:

Technique of MRI used to image blood vessels, either with or without contrast material.

Magnetic resonance imaging:

Technique of imaging using magnetic fields and radiofrequency field.

Methemoglobin:

A component of clotted blood which can mimic contrast material on magnetic resonance imaging.

Nephrogenic systemic fibrosis:

A severe reaction to gadolinium-containing contrast material, seen in patients with renal failure.

Nitinol:

A material contained in many stent-grafts.

Pacemakers:

A device used to provide pacing impulses to the heart.

Pulse sequence:

Particular combination of radiofrequency and magnetic field gradients that are used to create the image.

Radiofrequency field:

Oscillating magnetic field used to generate magnetic resonance images.

Steady-state free precession:

A method used to image the aorta and its branches without contrast material.

Susceptibility artifact:

An artifact arising from concentrated gadolinium which can create the appearance of vessel stenosis.

Thoracic endovascular aortic repair:

Deployment of an endovascular stent-graft in the thoracic aorta to repair various aortic pathologies.

Time-of-flight imaging:

⊓

Zenith AAA stent-graft system:

A stent-graft used for abdominal aortic aneurysm repair.

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Authors and Affiliations

  1. Division of Cardiothoracic and Vascular Surgery, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3306, Los Angeles, CA, 90048, USA

    Stephen D. Waterford & Margot Knight

  2. Division of Cardiothoracic Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd, HSP 3rd floor, Los Angeles, CA, 90048, USA

    Prof. Ali Khoynezhad M.D., Ph.D., FACS, FACC

Authors
  1. Stephen D. Waterford
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  2. Margot Knight
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  3. Prof. Ali Khoynezhad M.D., Ph.D., FACS, FACC
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Corresponding author

Correspondence to Stephen D. Waterford .

Editor information

Editors and Affiliations

  1. Akademisches Lehrkrankenhaus MLU, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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© 2014 Springer-Verlag Berlin Heidelberg

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Waterford, S.D., Knight, M., Khoynezhad, A. (2014). MRI for Interventions and Surgery. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37393-0_242-1

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  • DOI: https://doi.org/10.1007/978-3-642-37393-0_242-1

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  • Online ISBN: 978-3-642-37393-0

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