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Background Obtaining adequate venous access is a recurrent problem in patients where long term access is required for the intravenous administration of prolonged antibiotics or parenteral nutrition. Assessment of vein adequacy and patency is clinically important in these patients. Time Resolved Angiography with interleaved stochastic trajectories (TWIST) is a technique that creates a sequential series of multiplanar images during passage of intravenous contrast (Figure 1). TWIST has proven to be very useful in the assessment of vascular haemodynamics such as in arteriovenous malformations (AVMs), fistulas and shunts as well as the investigation of central thoracic veins. Our centre routinely uses TWIST MRA in patients with complex congenital heart disease, particularly for the assessment of complex cardiac connections such as repaired Tetralogy of Fallot, and demonstration of the Fontan circulation.

TWIST-MR-Angiography to aid central venous access in challenging patients. A single centre experience