Gastrointestinal Bleeding

The development of blood pool MR contrast agents may make it possible to replicate the concept of labeled red cell nuclear medicine examinations using 3D CE MRA. Although MR blood pool agents are experimental, the higher SNR and resolution of MR compared to nuclear medicine makes this a promising future technique for use in patients suspected of gastrointestinal (GI) bleeding. Arterial and venous mesenteric anatomy can be evaluated during the arterial and venous phases of blood pool contrast agent injection. By periodically re-imaging the patient over time, the accumulation of blood in the GI tract can be imaged to identify the site of GI bleeding. Just as with labeled red cells, when bleeding is intermittent, the patient can be scanned periodically, every hour or two until a bleeding episode is detected. The 3D-nature of MR imaging makes it easier to identify the specific loop of bowel that is bleeding [27-28].

Hepatic Vein Mri Images Labeled
Fig. 11. Left hepatic artery (arrowhead) arising from the left gastric artery (arrow) on a CE MRA MIP reconstruction (a) and on a volume rendered image (b) (0.1 mmol/kg Gd-BOpTA). Note that the vessels are better appreciated on the volume rendered image [Image courtesy of Dr. G. Schneider]

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Essentials of Human Physiology

Essentials of Human Physiology

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