American Journal of Roentgenology, Vol 166, 1387-1397, Copyright © 1996 by American Roentgen Ray Society

ARTICLES

Three-dimensional gadolinium-enhanced MR angiography of the thoracic aorta

MR Prince, DL Narasimham, WT Jacoby, DM Williams, KJ Cho, MV Marx and GM Deeb
Department of Radiology, University of Michigan Hospital, Ann Arbor 48109-0030, USA.

OBJECTIVE: Our objective was to evaluate image quality and preliminary clinical experience with three-dimensional gadolinium-enhanced MR angiography of the thoracic aorta. SUBJECTS AND METHODS: Ninety patients with suspected thoracic aorta pathology underwent 97 MR examinations at 1.5 T with a 4-min, three-dimensional spoiled gradient- echo techniques. Gadolinium infusion was timed for maximum arterial contrast during acquisition of the central portion of K-space. No ECG gating or breath-holding was used. All MR examinations were evaluated retrospectively for intravascular signal-to-noise ratio (SNR). In 30 of the 90 patients, results from surgery (n = 11), angiography (n = 12), or both (n = 7) were available. Four radiologists who were unaware of the angiographic or surgical findings assessed each of these 30 examinations for three types of pathology: dissection, coarctation, or aneurysm. The observers also assessed aortic branch vessel patency and vascular anomalies in the 19 patients who had angiographic correlation. RESULTS: Image quality (determined as SNR) was highest in the aortic arch, upper descending thoracic aorta, and upper abdominal aorta. We saw a small reduction in the SNR in the ascending aorta and lower descending thoracic aorta (p < .0001), attributable to cardiac and respiratory motion. Image quality was not affected by slow flow. MR imaging correctly diagnosed pathology in all 30 patients with angiographic or surgical correlation, including eight dissections, three coarctations, and 10 aneurysms. The type of the dissection was correctly determined in all eight patients. Stenoses of major branch vessel origins were detected with a sensitivity of 90% (95% bayesian confidence interval, 99-63%) and a specificity of 96% (95% bayesian confidence interval, 99-89%) in the 19 patients with angiographic correlation. Five vascular anomalies, including an aberrant right subclavian artery, a bovine arch, and three accessory renal arteries, were correctly identified. CONCLUSION: Three-dimensional gadolinium- enhanced MR angiography has the potential to accurately diagnose aortic dissection, coarctation, and aneurysm. It does not require ECG gating or breath-holding and thereby extends the diagnostic utility of MR imaging for the thoracic aorta.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				C. J. Francois, D. Tuite, V. Deshpande, R. Jerecic, P. Weale, and J. C. Carr Unenhanced MR Angiography of the Thoracic Aorta: Initial Clinical Evaluation Am. J. Roentgenol., April 1, 2008; 190(4): 902 - 906. [Abstract] [Full Text] [PDF]

				Q. Liu, J. P. Lu, F. Wang, L. Wang, and J. M. Tian Three-dimensional Contrast-enhanced MR Angiography of Aortic Dissection: A Pictorial Essay RadioGraphics, September 1, 2007; 27(5): 1311 - 1321. [Abstract] [Full Text] [PDF]

				P. Ou, D. S Celermajer, G. Calcagni, F. Brunelle, D. Bonnet, and D. Sidi Three-dimensional CT scanning: a new diagnostic modality in congenital heart disease Heart, August 1, 2007; 93(8): 908 - 913. [Abstract] [Full Text] [PDF]

				S.-F. Ko, C.-D. Liang, C.-C. Huang, S.-H. Ng, M.-J. Hsieh, J.-P. Chang, and M.-C. Chen Clinical feasibility of free-breathing, gadolinium-enhanced magnetic resonance angiography for assessing extracardiac thoracic vascular abnormalities in young children with congenital heart diseases. J. Thorac. Cardiovasc. Surg., November 1, 2006; 132(5): 1092 - 1098. [Abstract] [Full Text] [PDF]

				K. Nael, H. J. Michaely, U. Kramer, M. H. Lee, J. Goldin, G. Laub, and J. P. Finn Pulmonary Circulation: Contrast-enhanced 3.0-T MR Angiography--Initial Results Radiology, September 1, 2006; 240(3): 858 - 868. [Abstract] [Full Text] [PDF]

				V. Fuster, Z. A. Fayad, P. R. Moreno, M. Poon, R. Corti, and J. J. Badimon Atherothrombosis and High-Risk Plaque: Part II: Approaches by Noninvasive Computed Tomographic/Magnetic Resonance Imaging J. Am. Coll. Cardiol., October 4, 2005; 46(7): 1209 - 1218. [Abstract] [Full Text] [PDF]

				V. B. Ho, V. K. Bakalov, M. Cooley, P. L. Van, M. N. Hood, T. R. Burklow, and C. A. Bondy Major Vascular Anomalies in Turner Syndrome: Prevalence and Magnetic Resonance Angiographic Features Circulation, September 21, 2004; 110(12): 1694 - 1700. [Abstract] [Full Text] [PDF]

				J. W. Olin, J. A. Kaufman, D. A. Bluemke, R. O. Bonow, M. D. Gerhard, M. R. Jaff, G. D. Rubin, and W. Hall Atherosclerotic Vascular Disease Conference: Writing Group IV: Imaging Circulation, June 1, 2004; 109(21): 2626 - 2633. [Full Text] [PDF]

				R. P. Kunz, K. Oberholzer, W. Kuroczynski, G. Horstick, F. Krummenauer, M. Thelen, and K.-F. Kreitner Assessment of Chronic Aortic Dissection: Contribution of Different ECG-Gated Breath-Hold MRI Techniques Am. J. Roentgenol., May 1, 2004; 182(5): 1319 - 1326. [Abstract] [Full Text] [PDF]

				T. Sancak, A. K. Cangir, C. Atasoy, and N. Ozdemir The role of contrast enhanced three-dimensional MR angiography in pulmonary sequestration Interactive CardioVascular and Thoracic Surgery, December 1, 2003; 2(4): 480 - 482. [Abstract] [Full Text] [PDF]

				G. F. Greil, A. J. Powell, H. P. Gildein, and T. Geva Gadolinium-enhanced three-dimensional magnetic resonance angiography of pulmonary and systemic venous anomalies J. Am. Coll. Cardiol., January 16, 2002; 39(2): 335 - 341. [Abstract] [Full Text] [PDF]

				F. GODART, S. WILLOTEAUX, C. REY, B. COCHETEUX, C. FRANCART, and J.-P. BEREGI Contrast enhanced magnetic resonance angiography and pulmonary venous anomalies Heart, December 1, 2001; 86(6): 705 - 705. [Full Text]

				R. Erbel, F. Alfonso, C. Boileau, O. Dirsch, B. Eber, A. Haverich, H. Rakowski, J. Struyven, K. Radegran, U. Sechtem, et al. Diagnosis and management of aortic dissection: Task Force on Aortic Dissection, European Society of Cardiology Eur. Heart J., September 2, 2001; 22(18): 1642 - 1681. [PDF]

				A. A.W. Roest, M. N.J.M. Wasser, M. I.M. Versteegh, A. de Roos, E. E. van der Wall, W. A. Helbing, and H. W. Vliegen False Aneurysms of an Ascending-Aorta-to-Abdominal-Aorta Bypass for Coarctation of the Aorta Circulation, May 1, 2001; 103 (17): e92 - e93. [Full Text] [PDF]

				D. D. Maki, E. S. Siegelman, D. A. Roberts, R. A. Baum, and W. B. Gefter Pulmonary Arteriovenous Malformations: Three-dimensional Gadolinium-enhanced MR Angiography--Initial Experience Radiology, April 1, 2001; 219(1): 243 - 246. [Abstract] [Full Text]

				K. Bertschinger, P. C. Cassina, J. F. Debatin, and S. G. Ruehm Surveillance of Peripheral Arterial Bypass Grafts with Three-Dimensional MR Angiography: Comparison with Digital Subtraction Angiography Am. J. Roentgenol., January 1, 2001; 176(1): 215 - 220. [Abstract] [Full Text]

				J. K. De Marco, S. Schonfeld, I. Keller, and M. A. Bernstein Contrast-Enhanced Carotid MR Angiography with Commercially Available Triggering Mechanisms and Elliptic Centric Phase Encoding Am. J. Roentgenol., January 1, 2001; 176(1): 221 - 227. [Abstract] [Full Text]

				E. S. Siegelman, R. Charafeddine, A. H. Stolpen, and L. Axel Suppression of Intravascular Signal on Fat-saturated Contrast-enhanced Thoracic MR Arteriograms Radiology, October 1, 2000; 217(1): 115 - 118. [Abstract] [Full Text]

				P. J. Arpasi, K. G. Bis, A. N. Shetty, R. D. White, and O. P. Simonetti MR Angiography of the Thoracic Aorta with an Electrocardiographically Triggered Breath-Hold Contrast-enhanced Sequence RadioGraphics, January 1, 2000; 20(1): 107 - 120. [Abstract] [Full Text] [PDF]

				E. K. Yucel, C. M. Anderson, R. R. Edelman, T. M. Grist, R. A. Baum, W. J. Manning, A. Culebras, and W. Pearce Magnetic Resonance Angiography : Update on Applications for Extracranial Arteries Circulation, November 30, 1999; 100(22): 2284 - 2301. [Full Text] [PDF]

				C. A. Nienaber, R. Fattori, G. Lund, C. Dieckmann, W. Wolf, Y. von Kodolitsch, V. Nicolas, and A. Pierangeli Nonsurgical Reconstruction of Thoracic Aortic Dissection by Stent-Graft Placement N. Engl. J. Med., May 20, 1999; 340(20): 1539 - 1545. [Abstract] [Full Text] [PDF]

				D. S. Gierada and K. T. Bae Gadolinium as a CT Contrast Agent: Assessment in a Porcine Model Radiology, March 1, 1999; 210(3): 829 - 834. [Abstract] [Full Text]

				W. Kessler, G. Laub, S. Achenbach, D. Ropers, W. Moshage, and W. G. Daniel Coronary Arteries: MR Angiography with Fast Contrast-enhanced Three-dimensional Breath-hold Imaging—Initial Experience Radiology, February 1, 1999; 210(2): 566 - 572. [Abstract] [Full Text]

				G. Krinsky, N. T. Kouchoukos, and D. Dougenis Surgery of the Thoracic Aorta N. Engl. J. Med., November 13, 1997; 337(20): 1475 - 1476. [Full Text]