Arterial-Phase Three-Dimensional Gadolinium Magnetic Resonance Angiography of the Renal Arteries

Abstract

The authors review different imaging and contrast-media infusion strategies for arterial-phase three-dimensional (3D) gadolinium-enhanced magnetic resonance angiography (Gd-MRA). The influence of physicochemical factors on the infusion of contrast media, including viscosity, flow rate, inline pressure, and cannula size, is assessed. The combination of manual or automated contrast-media administration with timing-dependent or -independent 3D Gd-MRA techniques is reviewed regarding the aspects of effectiveness, robustness, image quality, and costs. For effective bolus delivery with high flow rates, the type and temperature of the contrast media, the size of the cannula, and an immediate saline flush must be considered. Timing-dependent techniques based on a test bolus and using automated contrast-media infusion as well as timing independent techniques such as MR SmartPrep or multiphase 3D Gd-MRA by using a manual injection with a SmartSet tubing set, are all effective procedures for arterial phase 3D Gd-MRA. Manual contrast-media injection with a tubing set can be used for timing-independent MRA techniques. The multiphase 3D Gd-MRA approach seems to be favorable for different MR systems, robustness, and speed.