GADOLINIUM-ENHANCED MR-ANGIOGRAPHY OF VISCERAL ARTERIES IN PATIENTS WITH SUSPECTED CHRONIC MESENTERIC ISCHEMIA

The purpose of this study was to evaluate accuracy of dynamic gadolini um-enhanced MR angiography (MRA) of the celiac, superior, and inferior mesenteric arteries in patients with suspected mesenteric ischemia co mpared with catheter angiography or surgery, Sixty-dye patients with s uspected mesenteric ischemia underwent three-dimensional spoiled gradi ent-recalled acquisition in the steady state (GRASS) gadolinium-enhanc ed MRA. Correlative studies were performed on 14 patients, catheter an giography alone was performed on 12 patients, and surgery alone was pe rformed on two patients. Six patients had mesenteric ischemia, in all patients, the celiac artery (CA) and superior mesenteric artery (SMA) were seen well enough to evaluate; however, the inferior mesenteric ar tery (IMA) could be evaluated in only 9 of the 14 patients, MRA showed severe stenosis (>75%) or occlusion of the celiac axis In seven patie nts, of the SMA in six patients, and of the IMA in four patients, The overall sensitivity and specificity were 100% and 95%, respectively, c ompared with catheter angiography and surgery. The two errors were cau sed by overgrading the severity of IMA disease. Three-dimensional gado linium-enhanced MRA can accurately demonstrate the origins of the CA a nd SMA and is useful in evaluation of patients with suspected mesenter ic ischemia.