Comparison of Preoperative Three-Dimensional Gadolinium-Enhanced Magnetic Resonance Imaging to the Operative Assessment of Abdominal Aortic Aneurysm Anatomy: A Retrospective Study

The purpose of this paper was to compare gadolinium-enhanced magnetic resonance angiography (MRA) and operative evaluation of the anatomic extent of abdominal aortic aneurysms (AAA) and assessment of other visceral arteries and common iliac arteries. A retrospective study was performed on 47 patients who had preoperative gadolinium- enhanced MRA and subsequent AAA repair. The original MRA interpretations were compared to the operative findings. In cases where there was a discrepancy, the MRAs were reassessed. MRA correctly evaluated the proximal extent (distance from renal vessels) of the AAA in 45 of 47 patients (96%), and in all (100%) patients MRA identified the distal extent (relation to aortic bifurcation or extension into iliac vessels) of the aneurysm. Ten of 15 accessory renal arteries were correctly identified (67%). Four of the five missed accessory renal arteries were identified on reassessment. MRA correctly diagnosed 10/12 cases of inferior mesenteric artery (IMA) occlusion. Two, which were called occluded, were found to be patent on reassessment. MRA correctly diagnosed six retroaortic left renal veins. Three-dimensional magnetic resonance angiography with intravenous admin istration of gadolinium is a noninvasive method for the preoperative evaluation of abdominal aortic aneurysms. MRA with IV gadolinium can accurately evaluate AAA anatomy before surgical repair.