Measuring aortic diameter with different MR techniques: Comparison of three‐dimensional (3D) navigated steady‐state free‐precession (SSFP), 3D contrast‐enhanced magnetic resonance angiography (CE‐MRA), 2D T2 black blood, and 2D cine SSFP

Abstract

Purpose: To compare nongated three-dimensional (3D) contrast-enhanced magnetic resonance angiography (CE-MRA) with 3D-navigated cardiac-gated steady-state free-precession bright blood (3D-nav SSFP) and noncontrast 2D techniques for ascending aorta dimension measurements.Materials and Methods: Twenty-five clinical exams were reviewed to evaluate the ascending aorta at 1.5T using: breathhold cine bright blood (SSFP), cardiac-triggered T2 black blood (T2 BB), axial 3D-nav SSFP, and nongated 3D CE-MRA. Three radiologists independently measured aortic size at three specified locations for each sequence. Means, SDs, interobserver correlation, and vessel edge sharpness were statistically evaluated.Results: Measurements were greatest for 3D-nav SSFP and 3D CE-MRA and smallest for T2 BB. There was no significant difference between 3D-nav SSFP and 3D CE-MRA (P ¼ 0.43-0.86), but significance was observed comparing T2 BB to all sequences. Interobserver agreement was uniformly >0.9, with T2 BB best, followed closely by 3D-nav SSFP and 2D cine SSFP, and 3D CE-MRA being the worst. Edge sharpness was significantly poorer for 3D CE-MRA compared to the other sequences (P < 0.001). Conclusion:If diameter measurements are the main clinical concern, 3D-nav SSFP appears to be the best choice, as it has a sharp edge profile, is easy to acquire and postprocess, and shows very good interobserver correlation.

Evaluation of aortic geometries created by magnetic resonance imaging data in healthy volunteers

“…Gated 3D contrast enhanced MRI is not straightforward, but may reduce this blurring. Two-dimensional techniques, as balanced turbo field echo cine bright blood and triggered T2 black blood have shown to allow for accurate determination of aortic diameter Groth et al (2011);Potthast et al (2010), but do not provide a 3D geometry. Three-Dimensional (3D) navigated Steady-State Free-Precession (SSFP) allows for 3D assessment of the geometry without contrast injection.…”

Magnetic Resonance Imaging of the Thoracic Aorta: A Review of Technical and Clinical Aspects, Including Its Use in the Evaluation of Aneurysms and Acute Vascular Conditions

“…When vessel wall analysis is desirable, as in aortic conditions such as mural hematoma, black-blood techniques may at times provide a better wall depiction than CE-MRA (Potthast, 2010;Litmanovich, 2009 as much signal as possible from flowing blood in the vessels lumen (Fig4). Luminal signal void occurs because intravascular protons only produce signal if they are exposed to both a 90-degree excitation pulse and subsequent refocusing pulse while travelling through the image slice.…”

“…It allows the study of the extent of an aneurysm and its relationship to the aortic branches, with reproducible results (Prince, 1996;Krinsky, 1997;Debatin, 1998;Neimatallah, 1999). Breath-hold non ECG-gated CE-MRA is nevertheless more prone to motion artifacts and blurring at the aortic root, with potential implications for treatment planning (Potthast, 2010;Cigarroa, 1993). Non-contrast enhanced ECG-gated 3D-SSFP has shown good results in aneurysm imaging, providing good assessment of diameter, lumen patency and topographic evaluation, including the aortic root Potthast, 2010).…”

“…Breath-hold non ECG-gated CE-MRA is nevertheless more prone to motion artifacts and blurring at the aortic root, with potential implications for treatment planning (Potthast, 2010;Cigarroa, 1993). Non-contrast enhanced ECG-gated 3D-SSFP has shown good results in aneurysm imaging, providing good assessment of diameter, lumen patency and topographic evaluation, including the aortic root Potthast, 2010). It can also be used as a cine technique allowing for evaluation of the aortic valve in patients with ascending aortic aneurysms, providing crucial information for treatment planning (Sakamoto, 2010).…”

Comparison of Cine-MRI and Transthoracic Echocardiography for the Assessment of Aortic Root Diameters in Patients with Suspected Marfan Syndrome

“…Previous studies have compared 2 D cine-MRI sequences with 3 D non-contrast MRI and revealed that the 2 D sequences had the highest interobserver correlation. However, after critical evaluation of their data, the authors stated that this might be due to the fact that the imaging plane for cine-MRI is prescribed at the time of the scan by the technologist and later measurements are performed at this same source plane by all readers leading to a good correlation [28]. Nevertheless, this limitation is the same for echocardiographic measurements, since echocardiographic imaging was performed once by one observer per patient in our study.…”