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European Radiology

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Open Access 01-06-2010 | Chest

Image quality and diagnostic accuracy of unenhanced SSFP MR angiography compared with conventional contrast-enhanced MR angiography for the assessment of thoracic aortic diseases

Authors: Mayil S. Krishnam, Anderanik Tomasian, Sachin Malik, Vibhas Desphande, Gerhard Laub, Stefan G. Ruehm

Published in: European Radiology | Issue 6/2010

Abstract

Objectives

The purpose of this study was to determine the image quality and diagnostic accuracy of three-dimensional (3D) unenhanced steady state free precession (SSFP) magnetic resonance angiography (MRA) for the evaluation of thoracic aortic diseases.

Methods

Fifty consecutive patients with known or suspected thoracic aortic disease underwent free-breathing ECG-gated unenhanced SSFP MRA with non-selective radiofrequency excitation and contrast-enhanced (CE) MRA of the thorax at 1.5 T. Two readers independently evaluated the two datasets for image quality in the aortic root, ascending aorta, aortic arch, descending aorta, and origins of supra-aortic arteries, and for abnormal findings. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were determined for both datasets. Sensitivity, specificity, and diagnostic accuracy of unenhanced SSFP MRA for the diagnosis of aortic abnormalities were determined.

Results

Abnormal aortic findings, including aneurysm (n = 47), coarctation (n = 14), dissection (n = 12), aortic graft (n = 6), intramural hematoma (n = 11), mural thrombus in the aortic arch (n = 1), and penetrating aortic ulcer (n = 9), were confidently detected on both datasets. Sensitivity, specificity, and diagnostic accuracy of SSFP MRA for the detection of aortic disease were 100% with CE-MRA serving as a reference standard. Image quality of the aortic root was significantly higher on SSFP MRA (P < 0.001) with no significant difference for other aortic segments (P > 0.05). SNR and CNR values were higher for all segments on SSFP MRA (P < 0.01).

Conclusion

Our results suggest that free-breathing navigator-gated 3D SSFP MRA with non-selective radiofrequency excitation is a promising technique that provides high image quality and diagnostic accuracy for the assessment of thoracic aortic disease without the need for intravenous contrast material.

Gebker R, Gomaa O, Schnackenburg B, Rebakowski J, Fleck E, Nagel E (2007) Comparison of different MRI techniques for the assessment of thoracic aortic pathology: 3D contrast enhanced MR angiography, turbo spin-echo and balanced steady state free precession. Int J Cardiovasc Imaging 23(6):747–756CrossRefPubMed

Groves EM, Bireley W, Dill K, Carroll TJ, Carr JC (2007) Quantitative analysis of ECG-gated high-resolution contrast-enhanced MR angiography of the thoracic aorta. AJR Am J Roentgenol 188(2):522–528CrossRefPubMed

Prince MR, Narasimham DL, Jacoby WT et al (1996) Three-dimensional gadolinium-enhanced MR angiography of the thoracic aorta. AJR Am J Roentgenol 166:1387–1397PubMed

Krinsky GA, Reuss PM, Lee VS et al (1999) Thoracic aorta: comparison of single-dose breath-hold and double-dose non-breath-hold gadolinium-enhanced three-dimensional MR angiography. AJR Am J Roentgenol 173:145–150PubMed

Lawler LP, Fishman EK (2003) Multidetector row computed tomography of the aorta and peripheral arteries. Cardiol Clin 21:607–629CrossRefPubMed

Chiles C, Carr JJ (2005) Vascular diseases of the thorax: evaluation with multidetector CT. Radiol Clin North Am 43:543–569CrossRefPubMed

Kanal E, Broome DR, Martin DR, Thomsen HS (2008) Response to the FDA’s May 23, 2007, nephrogenic systemic fibrosis update. Radiology 246(1):11–14CrossRefPubMed

Marckmann P, Skov L, Rossen K, Heaf JG, Thomsen HS (2007) Case-control study of gadodiamide-related nephrogenic systemic fibrosis. Nephrol Dial Transplant 22(11):3174–3178CrossRefPubMed

Sadowski EA, Bennett LK, Chan MR et al (2007) Nephrogenic systemic fibrosis: risk factors and incidence estimation. Radiology 243(1):148–157CrossRefPubMed

10.

Russo V, Renzulli M, Buttazzi K, Fattori R (2006) Acquired diseases of the thoracic aorta: role of MRI and MRA. Eur Radiol 16(4):852–865CrossRefPubMed

11.

Fuchs F, Laub G, Othomo K (2003) TrueFISP—technical considerations and cardiovascular applications. Eur J Radiol 46:28–32CrossRefPubMed

12.

Tomasian A, Lohan DG, Laub G, Singhal A, Finn JP, Krishnam MS (2008) Noncontrast 3D steady state free precession magnetic resonance angiography of the thoracic central veins using nonselective radiofrequency excitation over a large field of view: initial experience. Invest Radiol 43(5):306–313CrossRefPubMed

13.

Krishnam MS, Tomasian A, Deshpande VS et al (2008) Non-contrast 3D SSFP MR angiography of the whole chest using non-selective RF excitation over a large field of view: comparison with single-phase 3D contrast-enhanced MRA. Invest Radiol 43(6):411–420CrossRefPubMed

14.

Brittain JH, Hu BS, Wright GA, Meyer CH, Macovski A, Nishimura DG (1995) Coronary angiography with magnetization-prepared T2 contrast. Magn Reson Med 33(5):689–696CrossRefPubMed

15.

Shea SM, Deshpande VS, Chung YC (2002) Three-dimensional true-FISP imaging of the coronary arteries: improved contrast with T2-preparation. J Magn Reson Imaging 15:597–602CrossRefPubMed

16.

Deshpande VS, Krishnam MS, Ruehm SG et al (2006) Non-contrast MR angiography of the heart and great vessels using SSFP with non-selective excitation (abstract). In: Proceedings of the Fourteenth Scientific Meeting of the International Society for Magnetic Resonance in Medicine. International Society for Magnetic Resonance in Medicine, Seattle, p 383

17.

Griswold MA, Jakob PM, Heidemann RM et al (2002) Generalized autocalibrating partially parallel acquisitions (GRAPPA). Magn Reson Med 47:1202–1210CrossRefPubMed

18.

Reddy GP, Higgins CB (2000) MR imaging of the thoracic aorta. Magn Reson Imaging Clin N Am 8(1):1–15PubMed

19.

Summers RM, Sostman HD, Spritzer CE et al (1996) Fast spoiled gradient-recalled MR imaging of thoracic aortic dissection: preliminary clinical experience at 1.5 T. Magn Reson Imaging 14:1–9CrossRefPubMed

20.

McCarthy RM, Deshpande VS, Beohar N et al (2007) Three-dimensional breathhold magnetization-prepared TrueFISP: a pilot study for magnetic resonance imaging of the coronary artery disease. Invest Radiol 42:665–670CrossRefPubMed

21.

Pereles FS, McCarthy RM, Baskaran V, Carr JC et al (2002) Thoracic aortic dissection and aneurysm: evaluation with non-enhanced TrueFISP MR angiography in less than 4 minutes. Radiology 223:270–274CrossRefPubMed

22.

Sorensen TS, Körperich H, Greil GF et al (2004) Operator-independent isotropic three-dimensional magnetic resonance imaging for morphology in congenital heart disease: a validation study. Circulation 110:163–169CrossRefPubMed

23.

Bi X, Deshpande V, Carr J, Li D (2006) Coronary artery magnetic resonance angiography (MRA): a comparison between the whole-heart and volume targeted methods using a T2-prepared SSFP sequence. J Cardiovasc Magn Reson 8:703–707CrossRefPubMed

24.

François CJ, Tuite D, Deshpande V, Jerecic R, Weale P, Carr JC (2008) Unenhanced MA angiography of the thoracic aorta: initial clinical evaluation. AJR Am J Roentgenol 190(4):902–906CrossRefPubMed

25.

Muthupillai R, Smink J, Hong S, Ravindran R, Lee VV, Flamm SD (2006) SENSE or k-MAG to accelerate free breathing navigator-guided coronary MR angiography. AJR Am J Roentgenol 186:1669–1675CrossRefPubMed

26.

Pruessmann KP, Weiger M, Scheidegger MB, Boesinger P (1999) SENSE: sensitivity encoding for fast MRI. Magn Reson Med 42:952–962CrossRefPubMed

27.

Kellman P, McVeigh ER (2005) Image reconstruction in SNR units: a general method for SNR measurement. Magn Reson Med 54:1439–1447CrossRefPubMed

28.

Glockner JF, Hu HH, Stanley DW, Angelos L, King K (2005) Parallel MR imaging: a user’s guide. Radiographics 25:1279–1297CrossRefPubMed

Title: Image quality and diagnostic accuracy of unenhanced SSFP MR angiography compared with conventional contrast-enhanced MR angiography for the assessment of thoracic aortic diseases
Authors: Mayil S. Krishnam
Anderanik Tomasian
Sachin Malik
Vibhas Desphande
Gerhard Laub
Stefan G. Ruehm
Publication date: 01-06-2010
Publisher: Springer-Verlag
Published in: European Radiology / Issue 6/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-009-1672-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Image quality and diagnostic accuracy of unenhanced SSFP MR angiography compared with conventional contrast-enhanced MR angiography for the assessment of thoracic aortic diseases

Abstract

Objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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