Arterial visualization by contrast-enhanced moving-table MR angiography: crossover comparison of 0.1 and 0.2 mmol/kg doses of meglumine gadopentetate in normal volunteers.

PURPOSE: To determine the appropriate dose of contrast medium for moving-table MR angiography (MT-MRA) from the abdominal aorta to the ankle by comparing visualization with different doses of meglumine gadopentetate (Gd-DTPA) administered in crossover fashion to normal volunteers. MATERIALS AND METHODS: Twelve healthy adults underwent imaging after crossover administration of 0.1 and 0.2 mmol/kg of Gd-DTPA in random order. Continuous MT-MRA was performed with a fast 3D spoiled gradient echo sequence without parallel imaging technique. Visualization was evaluated in a total of 252 arteries by three blinded readers who independently rated arterial visualization using a 5-grade scale. Signal intensity was determined and the blood concentration of Gd-DTPA was estimated. RESULTS: Arterial visualization in the lower leg region was significantly better with a dose of 0.2 mmol/kg than with 0.1 mmol/kg (P<0.001). For all regions assessed the estimated blood Gd-DTPA level was significantly higher with 0.2 mmol/kg than with 0.1 mmol/kg (abdominal aorta, P=0.030; superficial femoral artery, P<0.001; posterior tibial artery, P=0.039). The vascular signal enhancement ratio and artery-to-muscle signal ratio were significantly higher in the upper leg and lower leg regions at 0.2 mmol/kg. CONCLUSION: With continuous MT-MRA imaging from the abdomen to the ankle in normal volunteers, better arterial visualization and superior contrast were achieved with 0.2 mmol/kg of Gd-DTPA.

Can selective CT angiography reduce the incidence of severe complications during transcatheter arterial embolization or infusion chemotherapy for thoracic diseases?

PURPOSE: To evaluate the usefulness of selective computed tomography (CT) angiography in preventing severe complications, such as spinal cord injury and broncho- esophageal fistula, during the transcatheter arterial embolization or infusion chemotherapy for thoracic diseases. MATERIALS AND METHODS: Data from 28 patients with thoracic diseases were retrospectively analyzed in terms of selective CT angiography procedures carried out before transcatheter arterial embolization or transcatheter arterial infusion chemotherapy. RESULTS: There were no spinal cord injuries (0/13 and 0/15) or broncho-esophageal fistula developments (0/13 and 0/15) during transcatheter arterial embolization and transcatheter arterial infusion chemotherapy, respectively. CONCLUSION: We conclude that selective CT angiography is potentially useful for reducing the incidence of severe complications during transcatheter arterial embolization or infusion chemotherapy for thoracic diseases.

[Clinical study of porous gelatin sphere (YM 670) in transcatheter arterial embolization].

A clinical study on the use of porous gelatin particles(sterile gelatin embolization material, YM 670, Gelpart) in transcatheter arterial embolization (TAE) was performed in patients with hepatocellular carcinoma, and the efficacy (embolization,anti-tumor effect, recanalization and operationality) and safety (tolerability) were studied. An additive agent comprising porous gelatin particles and low osmolarity contrast media was administered peripherally through a catheter into the hepatic artery proper of 63 patients with hepatocellular carcinoma. Good hepatic arterial embolization was confirmed in all cases (embolization: 100%), and a tumor necrosis effect was obtained in most cases (35/62 patients, 56.5%). Moreover, operationality was assessed as "highly easy to use" or "easy to use" in all cases. Frequencies of adverse events in which a relationship to TAE was not excluded and abnormalities of clinical laboratory data were high at 71.4% and 9 8.4%, respectively. The most common adverse reactions were pyrexia, abdominal pain, queasiness and blood pressure increase;abnormalities in clinical laboratory data included hepatic function with increased AST (GOT), increased ALT (GPT), decreased cholinesterase, increased LDH and increased total bilirubin. These adverse reactions and abnormalities in clinical laboratory data, however, were transient and attributed to the TAE procedure itself, and no adverse reactions related to YM 670 as an embolic material were observed. In addition, with regard to tolerability (safety), the treatment was assessed as suitable for use in all the present cases.