3D Dynamic Contrast-enhanced MR Portography

Objective To evaluate the method and the value of the clinical application of 3D dynamic contrast-enhanced MR portography(3D DCE-MRP). Methods Thirty-five patients suspected of having hepatic diseases underwent 3D DCE-MRP. A separate timing bolus sequence(TEST-BOLUS) was used to measure transit time of the contrast bolus. For timing of acquisition, we used the formula: T(scan delay) =T(transit)-1/4T(acquisition). 0.2 mmol/kg of Gd-DTPA was injected rapidly by hand from an antecubital vein. A breath-hold 3D FLASH sequence(TR/TE 4.6 ms/1.8 ms)was performed in the coronal plane to obtain three groups of source images. Then, the source images were postprocessed with MIP, and how 3D DCE-MRP revealed the normal and abnormal portal veins were evaluated. Results Of 35 patients, normal portal veins were revealed in 10 patients.25 patients appeared abnormal, including primary carcinoma of liver(n=14),portal hypertension(n=8),hepatic cavernous hemangioma(n=3). 3D DCE-MRP clearly showed normal anatomic structure of portal veins. It could reveal 4～6 grade intrahepatic sub-branching of portal vein. Also, it satisfactorily revealed tumor emboli within portal veins and collaterals in patients with portal hypertension. The anatomic relationship of portal vein, hepatic vein and inferior vena cava was well demonstrated. 3D DCE-MRP provided complete hepatic blood vessel structure for clinic. Conclusion 3D DCE-MRP is a useful, simple to perform and noninvasive technique in visualizing portal veins. It is an accurate method in the assessment of the portal venous lesions.