Hepatic blood supply: Comparison of optimized dual phase contrast-enhancedthree-dimensional MR angiography and digital subtraction angiography

PURPOSE: To optimize and determine the value of dual-phase contrast materia l-enhanced three-dimensional (3D) magnetic resonance (MR) angiography for p reoperative evaluation of the blood supply to the liver. MATERIALS AND METHODS: Dual phase 3D MR angiography of the hepatic arteries and portal vein was performed in 140 patients. In 80 patients, the value o f fat saturation, digital image subtraction, an anticholinergic agent, and a high-caloric meal were evaluated. In the next 60 patients, MR angiographi c and digital subtraction angiographic (DSA) image quality and diagnostic v alue were compared. RESULTS: Fat-saturated images were of significantly better quality (P < .01 ) than non-fat-saturated images. Digital image subtraction was useful in on ly 23 of 40 patients. The injection of an anticholinergic agent was superfl uous, whereas administration of a high-caloric meal helped in demonstration of the superior mesenteric artery and portal vein. Classification on MR an giograms of the arterial blood supply was correct in 57 of 60 patients. All arterial and portal venous lesions were seen on MR angiograms, and MR angi ograms had a significantly higher subjective image-quality ranking than did DSA images in the evaluation of the portal vein (P < .05). CONCLUSION: Fat saturation and use of a high-caloric meal improve the resul ts of MR angiography of hepatic vessels. MR angiography was comparable to D SA for evaluation of the arterial system and was superior for demonstration of the portal vein; therefore, MR angiography could replace intraarterial DSA.