Validation of thoracic aortic dimensions on ECG-triggered SSFP as alternative to contrast-enhanced MRA
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Validation of thoracic aortic dimensions on ECG-triggered SSFP as alternative to contrast-enhanced MRA G. J. H. Snel 1 & L. M. Hernandez 1 & R. H. J. A. Slart 2,3 & C. T. Nguyen 4,5 & D. E. Sosnovik 4,5,6 & V. M. van Deursen 7 & R. A. J. O. Dierckx 2 & B. K. Velthuis 8 & R. J. H. Borra 1,2 & N. H. J. Prakken 1 Received: 31 December 2019 / Revised: 7 April 2020 / Accepted: 15 May 2020 # The Author(s) 2020
Abstract Objectives Assessment of thoracic aortic dimensions with non-ECG-triggered contrast-enhanced magnetic resonance angiography (CE-MRA) is accompanied with motion artefacts and requires gadolinium. To avoid both motion artefacts and gadolinium administration, we evaluated the similarity and reproducibility of dimensions measured on ECG-triggered, balanced steady-state free precession (SSFP) MRA as alternative to CE-MRA. Methods All patients, with varying medical conditions, referred for thoracic aortic examination between September 2016 and March 2018, who underwent non-ECG-triggered CE-MRA and SSFP-MRA (1.5 T) were retrospectively included (n = 30). Aortic dimensions were measured after double-oblique multiplanar reconstruction by two observers at nine landmarks predefined by literature guidelines. Image quality was scored at the sinus of Valsalva, mid-ascending aorta and mid-descending aorta by semi-automatically assessing the vessel sharpness. Results Aortic dimensions showed high agreement between non-ECG-triggered CE-MRA and SSFP-MRA (r = 0.99, p < 0.05) without overestimation or underestimation of aortic dimensions in SSFP-MRA (mean difference, 0.1 mm; limits of agreement, − 1.9 mm and 1.9 mm). Intra- and inter-observer variabilities were significantly smaller with SSFP-MRA for the sinus of Valsalva and sinotubular junction. Image quality of the sinus of Valsalva was significantly better with SSFP-MRA, as fewer images were of impaired quality (3/30) than in CE-MRA (21/30). Reproducibility of dimensions was significantly better in images scored as good quality compared to impaired quality in both sequences. Conclusions Thoracic aortic dimensions measured on SSFP-MRA and non-ECG-triggered CE-MRA were similar. As expected, SSFP-MRA showed better reproducibility close to the aortic root because of lesser motion artefacts, making it a feasible noncontrast imaging alternative.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00330-020-06963-x) contains supplementary material, which is available to authorized users. * G. J. H. Snel [email protected] 1
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Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA 02129, USA
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Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA 02129, USA
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Division of Health Sciences and Technology, Harvard-MIT, 7 Massachusetts Avenue, Cambridge, MA 02139, USA
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Department of Cardiology, University Medical Center Groningen,
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