TY - JOUR
T1 - Composite graft replacement of the ascending aorta
T2 - Leakage detection with gadolinium-enhanced MR imaging
AU - Fattori, Rossella
AU - Descovìch, Benedetta
AU - Bertaccini, Paola
AU - Celletti, Francesca
AU - Caldarera, Ilaria
AU - Pierangeli, Angelo
AU - Gavelli, Giampaolo
PY - 1999/8
Y1 - 1999/8
N2 - PURPOSE: To assess the value of magnetic resonance (MR) imaging in the detection of postoperative complications after composite valve graft replacement. MATERIALS AND METHODS: Spin-echo and gradient-echo MR imaging was performed in 52 patients 1/2 to 200 months after composite graft replacement of the ascending aorta (22 for dissection, 30 for aneurysm). The prosthetic aortic segment, distal and proximal anastomoses, general morphologic characteristics, and diameter of the reimplanted coronary arteries were evaluated. In patients with abnormal perigraft thickening, additional spin-echo imaging was performed after injection of gadopentetate dimeglumine. RESULTS: Normal postoperative perigraft thickening (≤ 10 mm) was observed in 42 patients. Ten patients had abnormal periprosthetic thickening of 15-52 mm. Gadolinium-enhanced MR imaging demonstrated leakage in five of those 10 patients. The lack of enhancement excluded the presence of bleeding in the remaining five patients (three with chronic hematomas, one with infection, and one with granulation tissue). These findings were confirmed at surgery or with subsequent follow-up MR examinations. CONCLUSION: MR imaging was an optimal imaging modality for evaluating the morphologic characteristics of composite grafts and reimplanted coronary arteries. Gadolinium-enhanced MR imaging is a simple, accurate, and noninvasive method for detecting a leak, which necessitates urgent repeat surgery.
AB - PURPOSE: To assess the value of magnetic resonance (MR) imaging in the detection of postoperative complications after composite valve graft replacement. MATERIALS AND METHODS: Spin-echo and gradient-echo MR imaging was performed in 52 patients 1/2 to 200 months after composite graft replacement of the ascending aorta (22 for dissection, 30 for aneurysm). The prosthetic aortic segment, distal and proximal anastomoses, general morphologic characteristics, and diameter of the reimplanted coronary arteries were evaluated. In patients with abnormal perigraft thickening, additional spin-echo imaging was performed after injection of gadopentetate dimeglumine. RESULTS: Normal postoperative perigraft thickening (≤ 10 mm) was observed in 42 patients. Ten patients had abnormal periprosthetic thickening of 15-52 mm. Gadolinium-enhanced MR imaging demonstrated leakage in five of those 10 patients. The lack of enhancement excluded the presence of bleeding in the remaining five patients (three with chronic hematomas, one with infection, and one with granulation tissue). These findings were confirmed at surgery or with subsequent follow-up MR examinations. CONCLUSION: MR imaging was an optimal imaging modality for evaluating the morphologic characteristics of composite grafts and reimplanted coronary arteries. Gadolinium-enhanced MR imaging is a simple, accurate, and noninvasive method for detecting a leak, which necessitates urgent repeat surgery.
KW - Aorta, grafts and prostheses
KW - Aorta, MR
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M3 - Article
C2 - 10429720
AN - SCOPUS:0345551957
VL - 212
SP - 573
EP - 577
JO - Radiology
JF - Radiology
SN - 0033-8419
IS - 2
ER -