Vascular Imaging Clinical Protocols: Indirect Venography














New York University School of Medicine Department of Radiology
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Vascular Imaging Clinical Protocols

Indirect Gadolinium-Venography

Last updated: 7/3/2001

Uses the same principles regardless of the location of interest. Namely it is a recirculation technique in which contrast is injected in a peripheral vein and is subsequently imaged in both arterial and venous/equilibrium phases. This allows for subtraction of the arterial phase from the late phase, resulting in a venous phase image.

Coil placement depends on the region of interest. (UE/mediastinum, LE/pelvis, portal vein/SMV etc). Position the phased array coil and/or additional coils as needed.

The IV should be placed opposite to the side of interest if arm/chest imaging is to be performed. This is to avoid artifacts in the arteries adjacent to incoming full-strength contrast during the injection.

40cc Gadolinium contrast (*) is used because we want to image into the venous phase (a complete circulation is required) and dilution occurs.

In addition to the contrast technique, time-of-flight imaging may be performed to supplement the data. A traveling saturation band is placed “down stream” to the vein (at the opposite side used as for arterial the studies).

Sequence	Plane	Comment	Film #
DB Haste	Ax ± Cor	optional	2
TrueFISP	Ax	Phased Array or Body coil by 10s	0
TOF	Ax	optional, MIP –print 2 copies	1
3D FLASH	Cor	Adjust plane as needed. 1 measure. If on 6 do all 3 stations unless otherwise specified	0
Timing Run	Ax	Thru area of interest – 1-2cc of the contrast mix at 2cc/sec followed by 20 cc saline at 2cc/sec. Time to the artery.	0
3D FLASH	Cor	2-3 measures (typically 30-40 sec gaps) Inject 40cc of Gd at 2cc/sec followed by 20cc saline at 2cc/sec. First measure, use Standard timing formula.	2 (delayed)
VIBE	Ax	1 measure through all 3 stations (2mm resolution)	0
MPR		best venous phase, unsubtracted	2

(*) The use of gadolinium contrast material for these applications represents off-label usage in the U.S. Outside the U.S., please consult your country's regulations for local guidelines.

NOTE: These protocols apply to Siemens Symphony (with Quantum gradients) and Sonata systems. While they reflect the protocols used at NYU Medical Center, NYU is not responsible for their application elsewhere.