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European Radiology
Published in: European Radiology 5/2017

01-05-2017 | Magnetic Resonance

3D-black-blood 3T-MRI for the diagnosis of thoracic large vessel vasculitis: A feasibility study

Authors: Karla Maria Treitl, Stefan Maurus, Nora Narvina Sommer, Hendrik Kooijman-Kurfuerst, Eva Coppenrath, Marcus Treitl, Michael Czihal, Ulrich Hoffmann, Claudia Dechant, Hendrik Schulze-Koops, Tobias Saam

Published in: European Radiology | Issue 5/2017

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Abstract

Objectives

To evaluate the feasibility of T1w-3D black-blood turbo spin echo (TSE) sequence with variable flip angles for the diagnosis of thoracic large vessel vasculitis (LVV).

Methods

Thirty-five patients with LVV, diagnosed according to the current standard of reference, and 35 controls were imaged at 3.0T using 1.2 × 1.3 × 2.0 mm3 fat-suppressed, T1w-3D, modified Volumetric Isotropic TSE Acquisition (mVISTA) pre- and post-contrast. Applying a navigator and peripheral pulse unit triggering (PPU), the total scan time was 10–12 min. Thoracic aorta and subclavian and pulmonary arteries were evaluated for image quality (IQ), flow artefact intensity, diagnostic confidence, concentric wall thickening and contrast enhancement (CWT, CCE) using a 4-point scale.

Results

IQ was good in all examinations (3.25 ± 0.72) and good to excellent in 342 of 408 evaluated segments (83.8 %), while 84.1 % showed no or minor flow artefacts. The interobserver reproducibility for the identification of CCE and CWT was 0.969 and 0.971 (p < 0.001) with an average diagnostic confidence of 3.47 ± 0.64. CCE and CWT were strongly correlated (Cohen’s k = 0.87; P < 0.001) and significantly more frequent in the LVV-group (52.8 % vs. 1.0 %; 59.8 % vs. 2.4 %; P < 0.001).

Conclusions

Navigated fat-suppressed T1w-3D black-blood MRI with PPU-triggering allows diagnosis of thoracic LVV.

Key Points

• Cross-sectional imaging is frequently applied in the diagnosis of LVV.
• Navigated, PPU-triggered, T1w-3D mVISTA pre- and post contrast takes 10–12 min.
• In this prospective, single-centre study, T1w-3D mVISTA accurately depicted large thoracic vessels.
• T1w-3D mVISTA visualized CWT/CCW as correlates of mural inflammation in LVV.
• T1w-3D mVISTA might be an alternative diagnostic tool without ionizing radiation.
Appendix
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Metadata
Title
3D-black-blood 3T-MRI for the diagnosis of thoracic large vessel vasculitis: A feasibility study
Authors
Karla Maria Treitl
Stefan Maurus
Nora Narvina Sommer
Hendrik Kooijman-Kurfuerst
Eva Coppenrath
Marcus Treitl
Michael Czihal
Ulrich Hoffmann
Claudia Dechant
Hendrik Schulze-Koops
Tobias Saam
Publication date
01-05-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4525-x

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