Vascular artifact mimicking thrombosis on MR imaging using ferumoxytol as a contrast agent in abdominal vascular assessment

J Vasc Interv Radiol. 2014 Jun;25(6):969-76. doi: 10.1016/j.jvir.2013.12.019. Epub 2014 Mar 14.

Abstract

Purpose: To describe an artifact that mimics thrombosis when assessing abdominal vasculature on magnetic resonance (MR) imaging using ferumoxytol in patients with contraindications to gadolinium-based contrast agents and to evaluate factors that may contribute to this artifact.

Materials and methods: Three radiologists in consensus retrospectively evaluated 61 abdominal MR imaging examinations using ferumoxytol as an intravenous contrast agent for the presence of an observed artifact that can mimic thrombosis. Patient demographics and contrast agent bolus concentrations were compared with an unpaired Wilcoxon signed rank test.

Results: An artifact mimicking thrombosis was observed in 30 of 61 examinations, all on the arterial phase sequences. In examinations with this artifact, the average concentration of administered ferumoxytol was greater than in examinations where the artifact was not observed (P < .01). Several additional vascular findings were observed, including portal vein thrombosis (n = 2) and aneurysm (n = 1), renal vein thrombosis (n = 2), abdominal aortic aneurysm (n = 1), abdominal and iliac artery dissection (n = 3), and sequelae of portal hypertension (n = 8).

Conclusions: Although MR imaging using ferumoxytol as an intravenous contrast agent can be useful in detecting abdominal vascular abnormalities, an artifact mimicking vascular thrombosis was observed in nearly half of the examinations.

MeSH terms

  • Abdomen / blood supply*
  • Administration, Intravenous
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arteries / pathology
  • Artifacts*
  • Contrast Media* / administration & dosage
  • Female
  • Ferrosoferric Oxide* / administration & dosage
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Thrombosis / diagnosis*
  • Veins / pathology
  • Venous Thrombosis / diagnosis
  • Young Adult

Substances

  • Contrast Media
  • Ferrosoferric Oxide