Buscar en
Gaceta Médica de Bilbao
Toda la web
Inicio Gaceta Médica de Bilbao Aplicación de la Resonancia Magnética en el diagnóstico de la patologia vascu...
Información de la revista
Vol. 102. Núm. 4.
Páginas 81-88 (Enero 2005)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 102. Núm. 4.
Páginas 81-88 (Enero 2005)
Acceso a texto completo
Aplicación de la Resonancia Magnética en el diagnóstico de la patologia vascular arterial: Angio-Resonancia
Magnetic Resonance imaging for the diagnosis of arterial vascular diseases: Mr Angiography
Visitas
8773
Ana Capalastegui
Autor para correspondencia
acapelastegui@osatek.es

Correspondencia: Ana Capelastegui. OSATEK, S.A. Unidad de Galdakao. Hospital de Galdakao. Barrio Labeaga s/n. 48960, Galdakao. Bizkaia. España UE.
, Elena Astigarraga, José Alejandro Larena
Osatek, S.A. Unidad de Galdakao. Hospital de Galdakao. Galdakao. Bizkaia. España UE.
Este artículo ha recibido
Información del artículo
Resumen

La obtención de imágenes arteriográficas mediante Resonancia Magnética.(Angio-Resonancia) es una técnica consolidada y con evidencia científica que la avala como alternativa no invasiva a la arteriografía convencional por catéter. Presenta además ventajas frente a la ecografía doppler (obtención de imágenes arteriográficas) y la arteriografía por TAC (ausencia de radiación ionizante y contrastes con un perfil más seguro), y en muchos casos aporta información adicional, de tipo anatómico o funcional. Los avances técnicos en los equipos de Resonancia en los últimos años han conseguido que estas exploraciones sean competitivas, si bien para conseguir un resultado óptimo, es importante disponer de medios técnicos y humanos adecuados, Presentamos en este artículo una revisión de las principales aplicaciones de la Angio-Resonancia en la vasculatrura intracraneal, troncos supraórticos, aorta, arterias renales, extremidades inferiores, arterias pulmonares, y otras ramas aórticas. En estos momentos, sus principales limitaciones son la menor resolución espacial (aspecto importante en territorios como las arterias pulmonares, coronarias o los vasos de pequeño calibre intrcraneales), la menor disponibilidad y sus contraindicaciones. Al ser una técnica en constante evolución, es previsible un uso creciente en la patología vascular, limitando la arteriografía convencional a un papel intervencionista.

Palabras clave:
resonancia magnética
diagnóstico
angioresonancia
patología vascular arterial
Abstract

Obtention of arteriographic images by means of Magnetic Resonance (Magnetic Resonance Angiography) is a robust technique, and scientific evidence recommends its use as a non invasive alternative to conventional catheter arteriography. In addition, it has some advantages comparing to doppler sonography (obtention of arteriographic images) and CT angiography (lack of ionising radiation and use of safer contrast media), and in many cases provides additional information, morphologic or functional. Technical advances in Magnetic Resonance systems over the last years have made this examination competitive, although obtaining an optimal result requires appropriate technical and human resources. In this article we present a review of the clinical applications of Magnetic Resonance Angiograpy in intracranial vasculature, supraortic trunks, aorta, renal arteries, inferior extremities, pulmonary arteries and other aortic vessels. At this time, main disadvantages include lower spatial resolution (important question in territories such as pulmonary and coronary arteries, and small intracranial vessels), less availability and contraindications to the technique. As this technique is continuously evolving, it is feasible to see a growing use in vascular diseases, reserving conventional arteriography to interventional procedures.

Key words:
magnetic resonance
diagnosis
magnetic resonance angiograpy
arterial vascular disease
Laburpena

Erresonantzia Magnetikoa edo Angio-erresonantziaren bitartez irudi arteriografikoak eskuratzea dagoeneko egonkorturik dagoen teknika da. Zientziaren alorrak egiaztatu duen bezala, kateter bidezko ohiko arteriografiaz gainera egun daukagun beste aukera bat da, inolako kalterik eragiten ez duena, gainera. Doppler ekografiarekin (irudi arteriografikoak eskuratzeko teknika) eta OTA bidezko arteriografiarekin erkatuz gero, abantaila handiak eskaintzen ditu. Askotan, anatomiari edo funtzionaltasunari begirako informazio gehigarria ematen du. Azken urteotan erresonantzia-ekipoetan aurrerapen tekniko ugari izan direnez, azterketa horiek oso lehiakorrak dira gaur egun; alabaina, emaitza ezin hobea erdiesteko, ezinbestekoa da bitarteko tekniko eta giza bitarteko egokiak izatea. Honako artikulu honetan, beraz, Angioerresonantziaren aplikazio nagusiak gainbegiratuko ditugu: garezur barneko basoetan, enbor supraortikoetan, aortan, giltzurrunetako arterietan, beheko gorputz-adarretan, birika-arterietan eta beste adar aortiko batzuetan, hain zuzen. Une honetan, azterketa mota honek baditu bere mugak: espazio-bereizmen txikiagoa dauka (eta ezaugarri hori oso garrantzitsua da birika-arterietan, arteria koronarioetan edo garezur barneko baso txikietan azterketa egiteko), erabilia izateko prestasun txikiagoa dauka eta kontraindikazio dezente ditu. Etengabe bilakaeran dagoen teknika denez, baso-patologian gero eta gehiago erabiliko dela aurreikusten da; hartara, ohiko arteriografiak rol interbentzionista baino ez du izango.

Giltza hitzak:
Erresonantzia magnetikoa
Diagnostikoa
Angio-erresonantzia
Arterietako Baso-patologia
El Texto completo está disponible en PDF
Referencias Bibliográficas
[1.]
Waugh J.R., Sacharias N..
Arteriograhic complications in the DSA era.
Radiology, 182 (1992), pp. 243-246
[2.]
Sturhmann M., Roefke C., Jahnke T., Cramer B.M..
Duplex sonography of renal artery stenosis: potentials and limits of frequency spectrum analysis of arterial segments compared with angiography.
Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr, 168 (1998), pp. 258-263
[3.]
Strotzer M., Fellner C.M., Geissler A., Gmeinwieser J., Kohler S.M., Krämer B.K., et al.
Noninvasive assessment of renal artery stenosis. A comparison of MR angiography, colour doppler sono-graphy and intraarterial angiography.
Acta Radiol, 36 (1995), pp. 243-247
[4.]
Kaatee R., Beek F., De Lange E., Van Leeuwe M., Smits H., Van Der Ven E., et al.
Renal artery stenosis: detection and quantification with spiral CT angiography versus optimized digital substraction angiography.
Radiology, 205 (1997), pp. 121-127
[5.]
Beregi J.P., Louvegny ., Ceugnart L., Willoteaux S., Elkohem M., Desmoucelle F., et al.
Helical CT angiography of renal arteries: two-years of experience.
J Radiol, 78 (1997), pp. 549-556
[6.]
Nelson K.L., Gifford L.M., Lauber-Huber C., Gross C.A., Lasser T.A..
Clinical safety of gadopentate dimeglumine.
Radiology, 196 (1995), pp. 439-443
[7.]
Prince M.R., Yucel E.K., Kaufman J.A., Harrison D.C., Geller S.C..
Dynamic gadolinium-enhanced three-dimensional abdominal MR arteriography.
J Magn Reson Imaging, 3 (1993), pp. 877-881
[8.]
Prince M.R., Narasimham D.L., Stanley J.C., Che-nevert T.L., Williams D.M., Marx M.V., et al.
Breath-hold gadolinium-enhanced MR angiography of the abdominal aorta and its major branches.
Radiology, 197 (1995), pp. 785-792
[9.]
Schoenber S.O., Knopp M.V., Prince M.R., Londy F., Knopp M.A..
Arterial-phase three-dimensional gadolinium magnetic resonance angiography of the renal arteries. Strategies for timing and contrast media injection: original investigation.
Invest Radiol, 33 (1998), pp. 506-514
[10.]
Goyen M., Laub G., Ladd M.E., Debatin J., Barkhausen J., Truemmler K.H., et al.
Dynamic 3D MR angiography of the pulmonary arteries in under four seconds.
Magn Reson Imaging, 13 (2001), pp. 372-377
[11.]
Davis C.P., Hany T.F., Wildermuth S., Schmidt M., Debatin J.F..
Postprocessing techniques for gadolinium-enhanced three-dimensional MR angiography.
Radiographics, 17 (1997), pp. 1061-1077
[12.]
Sohn C., Sevick R.J., Frayne R..
Contrast-enhanced MR angiography of the intracranial circulation.
Magn Reson Imaging Clin N Am, 11 (2003), pp. 599-614
[13.]
Metens T., Rio F., Baleriaux D., Roger T., David P., Rodesch G..
Intracranial aneurysms: detection with gadolinium-enhanced dynamic threee-dimensional MR angiography-initial results.
[14.]
Scarabino T., Carriero A., Giannatempo G.M., Marano R., De mathaeis P., Bonomo L., et al.
Contrast-enhanced MR angiography in the study of carotid artery stenosis: comparison with digital subtraction angiography.
J Neuroradiol, 26 (1999), pp. 87-91
[15.]
Back M.R., Rogers G.A., Wilson J.S., Johnson B.L., Shames M.L., Bandyk D.F..
Magnetic resonance angiography minimizes need for arterio-graphy after inadequate carotid duplex ultrasound scanning.
Journal of Vascular Surgery, 38 (2003), pp. 422-430
[16.]
Remonda L., Heid O., Schroth G..
Carotid artery stenosis oclusion, and pseudo-oclusion: first-pass, gadolinium-enhanced, three-dimensional MR angiography-preliminary sutdy.
[17.]
Rofsky N.M., Adelman M.A..
Gadolinium-enhanced MR angiography of the carotid arteries: a small step, a giant leap?.
[18.]
El-Sadem S.M., Grant E.G., Hathout G.M., Zimmerman P.T., Cojhen S.N., Baker J.D..
Imaging of the internal carotid artery: the dilemma of the total versus the near total oclussion.
Radiology, 221 (2001), pp. 301-308
[19.]
Auer A., Schmidauer C., Waldenberger P., Aichner F..
Magnetic resonance angiographic and clinical features of extracranial vertebral dissection.
J Neurol Neurosur Psychiatry, 64 (1998), pp. 474-481
[20.]
Helft G., Worthley S.G., Fuster V., et al.
Progression and regression of atherosclerotic lesions: monitoring with serial noninvasive magnetic resonance imaging.
Circulation, 105 (2002), pp. 993-998
[21.]
Smyth R.H., Grist T.M..
MR angiography of the abdominal aorta.
Magn Reson imaging Clin N Am, 6 (1998), pp. 321-329
[22.]
Snidow J.J., Johnson M.S., Harris V.J., Margosian P.M., Aisen A.M., Lalka S., et al.
Three-dimensional gadolinium-enhanced MR angiography for aortoiliac inflow assessment plus renal artery screening in a single breath-hold.
Radiology, 198 (1996), pp. 725-732
[23.]
Hany T.F., Debatin J.F., Leung D.A., Pfammatter T..
Evaluation of the aortoiliac and renal arteries: comparison of breath-hold, contrast-enhanced three-dimensional MR angiography with conventional catheter angiography.
Radiology, 204 (1997), pp. 357-362
[24.]
Holland G.A., Dougherty L., Carpenter J.P., Golden M.A., Gilfeather M, Slossman F., et al.
Breathhold three-dimensional gadolinium-enhanced MR angiography of the aorta and the renal and other visceral abdominal arteries.
[25.]
Krinsy G., Rofsky N.M., DeCoroto D.R., et al.
Thoracic aorta: comparison of gadoliniumenhanced threee-dimensional MR angiography with conventional MR imaging.
Radiology, 202 (1997), pp. 183-193
[26.]
Murray J.G., manisali M., Flamm S.D., et al.
Intramural hematoma of the thoracic aorta: MR image findings and their prognostic implications.
Radiology, 204 (1997), pp. 349-356
[27.]
Rieumont M.J., Kaufman J.A., Geller S.C., Yucel E.K., Cambria R.P., Fang L.S., et al.
Evaluation of renal artery stenosis with dynamic gadolinium-enhanced MR angiography.
[28.]
De Cobelli F., Vanzulli A., Sironi S., Mellone R., Angeli E., Venturini M., et al.
Renal artery stenosis: evaluation with breath-hold, three-dimensional, dynamic, gadolinium-enhanced versus three-dimensional phase-contrast MR angio-graphy.
Radiology, 205 (1997), pp. 689-695
[29.]
Prince M.R., Schoenberg S.O., Ward J.S., Londy F.J., Wakefield T.W..
Hemodynamically significant atherosclerotic renal artery stenosis: MR angio-graphic features.
Radiology, 205 (1997), pp. 128-136
[30.]
Siegelman E.S., Gilfeather M., Holland G.A., Carpenter J.P., Golden M.A., Townsend R.R., et al.
Breath-hold three-dimensional gadolinium contrast-enhanced MR angiography of the renovas-cular system.
AJR, 168 (1997), pp. 1035-1040
[31.]
Koelemay M.J., Lijmer J.G., Stoker J., Legemate D.A., Bossuyt P.M..
Magnetic resonance angio-graphy for the evaluation of lower extremity arterial disease: a meta-analysis.
JAMA, 285 (2001), pp. 1338-1345
[32.]
Visser K., Hunink M.G..
Peripheral arterial disease: gadolinium-enhanced MR angiography versus color-guided duplex US-a meta-analysis.
[33.]
Haage P., piroth W., Krombach G., Schaffter T., Günther R.W., Bücker A..
Pulmonary embolism. Comparison of angiography withh spiral computed tomography, magnetic resonance angio-graphy and real-time magnetic resonacne imaging.
American Journal of Respiratory and Critical Care Medicine, 167 (2003), pp. 729-734
[34.]
Stein P.D., Woodard P.K., Hull R.D., Kayali F., Weg J.G., Olson R.E., Fowler S.E..
Gadoliniu-enhan-ced magnetic resonance angiography for detection of acute pulmonary embolism: an in-depth review.
Chest, 124 (2003), pp. 2324-2328
[35.]
Oudkerk M., Van Beek E.J.R., Wielopolsi P., Van Ooijen P.M.A., Brouwers-Kuyper E.M.J., Bongaetrs A.H., et al.
Comparison of contrast-enhanced magnetic resonance angiography and conventional pulmonary angiography for the diagnosis of pulmonary embolism: a prospective study.
Lancet, 359 (2002), pp. 1643-1647
[36.]
Li K.C..
Mesenteric occlusive disease.
Magn Reson Imaging Clin N Am, 6 (1998), pp. 331-350
[37.]
Bowe B.C., Saraf-Lavi E., Pattany P.M..
MR angiography of the spine: update.
Magn Reson Imaging Clin N Am, 11 (2003), pp. 559-584
Copyright © 2005. Academia de Ciencias Médicas de Bilbao
Opciones de artículo
Herramientas