Courtesy of Dr Sokratis Stoumpos, this image shows coronal views of the iliac vessels (and surrounding abdominal and pelvic anatomy) in patients with chronic kidney disease imaged with three techniques: A. CT angiography (CTA) with iodine contrast, B. StarVIBE free-breathing 3D T1-weighted MRI, C. ferumoxytol-enhanced MRI (feMRI). Scans were acquired on the same day for each patient, with the StarVIBE sequence performed before ferumoxytol administration for feMRI.
Both CTA and StarVIBE show excellent delineation of areas of arterial calcification, which correspond to intraluminal filling defects in abdominal aorta in feMRI. Furthermore, arterial and venous walls and luminal characteristics are well-defined in feMRI. Importantly, ferumoxytol can be safely used as a contrast agent in patients with renal failure for whom CT angiography with iodinated contrast material (or conventional gadolinium-enhanced MRA) carry potential risks of nephrotoxicity. An additional advantage of feMRI is obtaining both arteriography and venography with a single test, enabled by the prolonged intravascular half-life of ferumoxytol.
The image is taken from a recent publication in JACC Cardiovascular Imaging:
Stoumpos S, Hall Barrientos P, Black DH, et al. Ferumoxytol MR Angiography: A Novel Technique for Assessing Iliac Vasculature in Potential Kidney Transplant Recipients. JACC Cardiovasc Imaging. 2020;13(8):1847-1848.