Universität zu Köln

Gietzen, Carsten ORCID: 0000-0002-2354-3847, Janssen, Jan Paul ORCID: 0000-0003-0980-4606, Tristram, Juliana, Cagman, Burak, Kaya, Kenan ORCID: 0009-0008-7625-3457, Terzis, Robert ORCID: 0009-0007-1068-8477, Gertz, Roman ORCID: 0000-0002-6414-4105, Gietzen, Thorsten ORCID: 0000-0001-7948-202X, Pennig, Henry ORCID: 0000-0002-5962-1202, Bunck, Alexander C. ORCID: 0000-0003-0986-0042, Maintz, David ORCID: 0000-0002-8942-3776, Persigehl, Thorsten ORCID: 0000-0001-5928-4405, Mader, Navid ORCID: 0000-0001-6980-5761, Weiss, Kilian and Pennig, Lenhard ORCID: 0000-0002-6606-9313 (2025). Assessment of the thoracic aorta after aortic root replacement and/or ascending aortic surgery using 3D relaxation-enhanced angiography without contrast and triggering. Frontiers in Cardiovascular Medicine, 12. pp. 1-17. Frontiers. ISSN 2297-055X

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Abstract

Objective: Relaxation-Enhanced Angiography without Contrast and Triggering (REACT) is a novel 3D isotropic flow-independent non-contrast-enhanced MRA (non-CE-MRA) and has shown promising results in imaging of the thoracic aorta, primarily in patients without prior aortic surgery. The purpose of this study was to evaluate the performance of REACT after surgery of the aortic root and/or ascending aorta by performing an intraindividual comparison to CE-MRA. Material and methods: This retrospective single center study included 58 MRI studies of 34 patients [mean age at first examination 45.64 ± 11.13 years, 31 (53.44%) female] after ascending aortic surgery. MRI was performed at 1.5T using REACT (ECG- and respiratory-triggering, Compressed SENSE factor 9, acquired spatial resolution 1.69 × 1.70 × 1.70 mm 3 ) and untriggered 3D CE-MRA. Independently, two radiologists measured maximum and minimum vessel diameters (inner-edge) and evaluated image quality and motion artifacts on 5-point scales (5 = excellent) for the following levels: mid-graft, distal anastomosis, ascending aorta, aortic arch, and descending aorta. Additionally, readers evaluated MRAs for the presence of aortic dissection (AD) and graded the quality of depiction as well as their diagnostic confidence using 5-point scales (5 = excellent). Results: Vessel diameters were comparable between CE-MRA and REACT (total acquisition time: 05:42 ± 00:38 min) with good to excellent intersequence agreement (ICC = 0.86–0.96). At the distal anastomosis (minimum/maximum, p < .001/ p = .002) and at the ascending aorta (minimum/maximum, p = .002/ p = .06), CE-MRA yielded slightly larger diameters. Image quality for all levels combined was higher in REACT [median (IQR); 3.6 (3.2–3.93) vs. 3.9 (3.6–4.13), p = .002], with statistically significant differences at mid-graft [3.0 (2.5–3.63) vs. 4.0 (4.0–4.0), p < .001] and ascending aorta [3.25 (3.0–4.0) vs. 4.0 (3.5–4.0), p < .001]. Motion artifacts were more present in CE-MRA at all levels ( p < .001). Using CE-MRA as the standard of reference, readers detected all 25 cases of residual AD [Stanford type A: 21 (84.0%); Stanford type B: 4 (16.0%)] in REACT with equal quality of depiction [4.0 (3.0–4.5) vs. 4.0 (3.0–4.0), p = .41] and diagnostic confidence [4.0 (3.0–4.0) vs. 4.0 (3.0–4.0), p = .81) in both sequences. Conclusions: This study indicates the feasibility of REACT for assessment of the thoracic aorta after ascending aortic surgery and expands its clinical use for gadolinium-free MRA to these patients.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Gietzen, Carsten UNSPECIFIED https://orcid.org/0000-0002-2354-3847 UNSPECIFIED Janssen, Jan Paul UNSPECIFIED https://orcid.org/0000-0003-0980-4606 UNSPECIFIED Tristram, Juliana UNSPECIFIED UNSPECIFIED UNSPECIFIED Cagman, Burak UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaya, Kenan UNSPECIFIED https://orcid.org/0009-0008-7625-3457 UNSPECIFIED Terzis, Robert UNSPECIFIED https://orcid.org/0009-0007-1068-8477 UNSPECIFIED Gertz, Roman UNSPECIFIED https://orcid.org/0000-0002-6414-4105 UNSPECIFIED Gietzen, Thorsten UNSPECIFIED https://orcid.org/0000-0001-7948-202X UNSPECIFIED Pennig, Henry UNSPECIFIED https://orcid.org/0000-0002-5962-1202 UNSPECIFIED Bunck, Alexander C. UNSPECIFIED https://orcid.org/0000-0003-0986-0042 UNSPECIFIED Maintz, David UNSPECIFIED https://orcid.org/0000-0002-8942-3776 UNSPECIFIED Persigehl, Thorsten UNSPECIFIED https://orcid.org/0000-0001-5928-4405 UNSPECIFIED Mader, Navid UNSPECIFIED https://orcid.org/0000-0001-6980-5761 UNSPECIFIED Weiss, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Pennig, Lenhard UNSPECIFIED https://orcid.org/0000-0002-6606-9313 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-792011
Identification Number:	10.3389/fcvm.2025.1532661
Journal or Publication Title:	Frontiers in Cardiovascular Medicine
Volume:	12
Page Range:	pp. 1-17
Date:	12 March 2025
Publisher:	Frontiers
ISSN:	2297-055X
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Chirurgie > Klinik und Poliklinik für Herz- und Thoraxchirurgie Faculty of Medicine > Innere Medizin > Klinik III für Innere Medizin - Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin
Subjects:	Medical sciences Medicine
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/79201