Contrast Enhanced Magnetic Resonance Angiography with Gadofosveset Used in Detection and Localization of Bleeding

D. Durant, G. Annamalai

Sunnybrook Health Sciences Centre, Toronto, Canada.

DOI: 10.4236/ojrad.2014.41004                

Abstract

It has been established that internal hemorrhage can be detected and localized with noninvasive and minimally invasive imaging methods such as CT angiography, conventional angiography and nuclear scintigraphy. The use of steady-state MRI with the relatively new intravascular contrast agent gadofosveset offers the possibility of accurate anatomic localization of bleeding without the use of ionizing radiation or iodinated contrast media. To illustrate this assertion, we describe two cases from our institution in which MR angiography was successfully performed specifically for this indication.

Keywords

MRI; Hemorrhage; Gadofosveset

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Potter, G.D. and Sellin, J.H. (1988) Lower Gastrointestinal Bleeding. Gastroenterology Clinics of North America, 17, 341-355.
[2]	Moody, A.R. (2003) Magnetic Resonance Direct Thrombus Imaging. Journal of Thrombosis and Haemostasis, 1, 1403-1409. http://dx.doi.org/10.1046/j.1538-7836.2003.00333.x
[3]	Jaeckle, T., Stuber, G. and Hoffman, M.H. (2008) Acute Gastrointestinal Bleeding: Value of MDCT. Abdominal Imaging, 33, 285-293. http://dx.doi.org/10.1007/s00261-007-9263-8
[4]	Al Qahtani, A.R., Satin, R., Stern, J., et al. (2002) Investigative Modalities for Massive Lower Gastrointestinal Bleeding. World Journal of Surgery, 26, 620-625. http://dx.doi.org/10.1007/s00268-001-0279-x
[5]	Walsh, R.M., Anain, P. and Geisinger, M. (1999) Role of Angiography and Embolization for Massive Gastroduodenal Hemorrhage. Journal of Gastrointestinal Surgery, 3, 61-65. http://dx.doi.org/10.1016/S1091-255X(99)80010-9
[6]	Vreeburg, E.M., Snel, P. and De Brujine, J.W. (1997) Acute Upper Gastrointestinal Bleeding in the Amsterdam Area: Incidence, Diagnosis and Clinical Outcome. American Journal of Gastroenterology, 92, 236-243.
[7]	Ernst, O., Bulois, P., Sain-Drenant, S., Leroy, C., Paris, J.-C. and Sergent, G. (2003) Helical CT in Acute Lower Gastrointestinal Bleeding. European Radiology, 13, 114-117.
[8]	Miller, F.H. and Hwang, C.M. (2004) An Initial Experience Using Helical CT Imaging to Detect Obscure Gastrointestinal Bleeding. Journal of Clinical Imaging, 28, 245-251. http://dx.doi.org/10.1016/S0899-7071(03)00193-1
[9]	Frattaroli, F., Casciani, E., Spoletini, D., et al. (2009) Prospective Study Comparing Multi-Detector Row CT and Endoscopy in Acute Gastrointestinal Bleeding. World Journal of Surgery, 33, 2209-2217. http://dx.doi.org/10.1007/s00268-009-0156-6
[10]	Kotek, J., Lebduskova, P., Hermann, P., et al, (2003) Lanthanide (III) Complexes of Novel Mixed Carboxylic-Phosphorus Acid Derivatives of Diethylenetriamine: A Step towards More Efficient MRI Contrast Agents. Chemistry, 9, 5899-5915. http://dx.doi.org/10.1002/chem.200305155
[11]	Henness, S. and Keating, G. (2006) Gadofosveset. Drugs, 66, 851-857. http://dx.doi.org/10.2165/00003495-200666060-00008
[12]	Fink, C., Goyen, M. and Lotz, J. (2007) Magnetic Resonance Angiography with Blood-Pool Contrast Agents: Future Applications. European Radiology, 17, B38-B44.
[13]	Anzidei, M., Napoli, A. and Marincola, B. (2009) Gadofesveset-Enhanced MR Angiography of Carotid Arteries: Does Steady-State Imaging Improve Accuracy of First-Pass Imaging? Comparison with Selective Digital Subtraction Angiography. Radiology, 251, 457-466. http://dx.doi.org/10.1148/radiol.2512081197
[14]	Hilfiker, P.R., Weishaupt, D. and Kacl, G.M. (1999) Comparison of Three Dimensional Magnetic Resonance Imaging in Conjunction with a Blood Pool Contrast Agent and Nuclear Scintigraphy for the Detection of Experimentally Induced Gastrointestinal Bleeding. Gut, 45, 581-587. http://dx.doi.org/10.1136/gut.45.4.581
[15]	Yoon, W., Kim, J.K., Kim, Y.H., et al. (2002) Bronchial and Nonbronchial Systemic Arterial Embolization for Life-Threatening Hemoptysis: A Comprehensive Review. Radiographics, 22, 1395-1409. http://dx.doi.org/10.1148/rg.226015180
[16]	Cornelissen, S., Prokop, M. and Verhagen, H. (2010) Detection of Occult Endoleaks after Endovascular Treatment of Abdominal Aortic Aneurysm Using Magnetic Resonance Imaging with a Blood Pool Agent. Investigative Radiology, 45, 1-6. http://dx.doi.org/10.1097/RLI.0b013e3181e992ac