Prospective Evaluation of High-Resolution MRI Using Gadofosveset for Stent-Graft Planning: Comparison With CT Angiography in 30 Patients

The purpose of our study was to compare high-resolution gadofosveset-enhanced MR angiography (MRA) with the reference standard CT angiography (CTA) in planning endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms. Thirty consecutive patients were included in this prospective study. CTA was performed routinely before EVAR for stent-graft implantation planning and selection. In addition, first-pass and, after a delay of 10 minutes, steady-state MRA were performed using the blood pool contrast agent gadofosveset for study purposes. Standard diameter and length parameters for stent-graft evaluation rendered from CTA and MRA were compared. According to the results of MRA measurements, stent-grafts were selected for each patient and compared with the device actually implanted. Image quality was assessed using subjective image quality parameters. Diameter and length measurements showed small but significant differences (p < 0.001) between MRA and CTA. Stent-graft selection according to these measurements showed 100% concordance between both modalities. Subjective imaging parameters showed significantly better results for CTA compared with MRA (p < 0.001). In this study, MRA using a blood pool contrast agent has shown the ability to provide reliable and exact measurements before EVAR, allowing noninvasive planning of the intervention despite lower image-quality and without the disadvantages of ionizing radiation and nephrotoxicity.