Inflammatory abdominal aortic aneurysms: Diagnosis with gadolinium enhanced T1-weighted imaging

AIM: Inflammatory abdominal aortic aneurysms (IAAA) are a variant of abdomi nal aortic aneurysms, which are associated with an increased morbidity, The diagnosis of IAAA has traditionally been established with a combination of clinical and laboratory findings together with contrast enhanced CT. There is a high incidence of renal impairment in this group, and therefore contr ast enhanced CT may be harmful, PATIENTS AND METHODS: Five patients with IAAA underwent T1-weighted spin ec ho and gradient echo gadolinium enhanced abdominal MRI. A total of eight ex aminations were performed, including three patients who underwent repeat MR I following steroid therapy, RESULTS: The inflammatory cuff was clearly identified following gadolinium administration in all eight examinations, The cuff enhanced homogeneously i n all patients with no alteration in appearance following steroid therapy. The intravenous administration of gadolinium DTPA enabled clearer definitio n of locally involved structures, CONCLUSION: Gadolinium enhanced MRI readily demonstrates features of IAAA. In view of potential renal impairment in this patient group, we recommend t his technique in preference to contrast enhanced CT in the initial investig ation of inflammatory abdominal aortic aneurysms. (C) 2000 The Royal CoIleg e of Radiologists.