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Unenhanced MR Angiography of the Thoracic Aorta: Initial Clinical Evaluation

¹ Department of Radiology, Northwestern University, Chicago, IL.
² Present address: Department of Radiology, University of Wisconsin-Madison, 600 Highland Ave., Madison, WI 53792.
³ MR Research and Development, Siemens Medical Solutions, Inc., Malvern, PA.

OBJECTIVE. In patients with difficult IV access or renal insufficiency, or in those who are pregnant, we hypothesized than an unenhanced 3D segmented steady-state free precession (SSFP) MR angiography (MRA) technique would be an alternative to contrast-enhanced MR angiography (CE-MRA) for the evaluation of vasculature.

MATERIALS AND METHODS. MRA examinations of the thoracic aorta were retrospectively reviewed in 23 patients in whom both CE-MRA and 3D SSFP were performed. CE-MRA was performed using an ECG-gated gradient-echo FLASH sequence. Three-dimensional SSFP MRA was performed during free breathing using a motion-adaptive navigator technique. Quantitative assessment of the 3D SSFP and CE-MRA image sets was performed by comparing the aortic lumen diameter. The quality of the images of the aortic root (scale of 1–5) and the presence of cardiovascular and noncardiovascular pathology were independently determined for both techniques by two reviewers. Bland-Altman and Wilcoxon's signed-rank analyses were performed.

RESULTS. The difference in orthogonal measurements of the aortic diameter between those made on images from the 3D SSFP and those made from the CE-MRA sequences was –0.042 cm. The aortic root was better visualized with 3D SSFP: score of 3.78 (of 5) for CE-MRA versus score of 4.65 (of 5) for 3D SSFP (p < 0.05).

CONCLUSION. In patients in whom contrast material is contraindicated, unenhanced MRA using a 3D SSFP technique can be performed.

Keywords: angiography • aorta • MRI • steady-state free precession • thoracic aorta