Pennig, Lenhard, Wagner, Anton, Weiss, Kilian, Lennartz, Simon, Huntgeburth, Michael, Hickethier, Tilman, Maintz, David, Naehle, Claas Philip, Bunck, Alexander Christian and Doerner, Jonas . Comparison of a novel Compressed SENSE accelerated 3D modified relaxation-enhanced angiography without contrast and triggering with CE-MRA in imaging of the thoracic aorta. Int. J. Cardiovasc. Imaging. DORDRECHT: SPRINGER. ISSN 1573-0743

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Abstract

To compare a novel Compressed SENSE accelerated ECG- and respiratory-triggered flow-independent 3D isotropic Relaxation-Enhanced Angiography without Contrast and Triggering (modified REACT) with standard non-ECG-triggered 3D contrast-enhanced magnetic resonance angiography (CE-MRA) for imaging of the thoracic aorta in patients with connective tissue diseases (CTD) or other aortic diseases using manual and semiautomatic measurement approaches. This retrospective, single-center analysis of 30 patients (June-December 2018) was conducted by two radiologists, who independently measured aortic diameters on modified REACT and CE-MRA using manual (Multiplanar-Reconstruction) and semiautomatic (Advanced Vessel Analysis) measurement tools on seven levels (inner edge): Aortic annulus and sinus, sinotubular junction, mid- and high-ascending aorta, aortic isthmus, and descending aorta. Bland-Altman analysis was conducted to evaluate differences between the mean values of aortic width and ICCs were calculated to assess interobserver agreement. For each level, image quality was evaluated on a four-point scale in consensus with Wilcoxon matched-pair test used to evaluate for differences between both MRA techniques. Additionally, evaluation time for each measurement technique was noted, which was compared applying one-way ANOVA. When comparing both imaging and measurement methods, CE-MRA (mean difference 0.24 +/- 0.27 mm) and the AVA-tool (- 0.21 +/- 0.15 mm) yielded higher differences compared to modified REACT (- 0.11 +/- 0.11 mm) and the MPR-tool (0.07 +/- 0.21 mm) for all measurement levels combined without yielding clinical significance. There was an excellent interobserver agreement between modified REACT and CE-MRA using both tools of measurement (ICC > 0.9). Modified REACT (average acquisition time 06:34 +/- 01:36 min) provided better image quality from aortic annulus to mid-ascending aorta (p < 0.05), whereas at distal measurement levels, no significant differences were noted. Regarding time requirement, no statistical significance was found between both measurement techniques (p = 0.08). As a novel non-CE-MRA technique, modified REACT allows for fast imaging of the thoracic aorta with higher image quality in the proximal aorta than CE-MRA enabling a reliable measurement of vessel dimensions without the need for contrast agent. Thus, it represents a clinically suitable alternative for patients requiring repetitive imaging. Manual and semiautomatic measurement approaches provided comparable results without significant difference in time need.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Pennig, LenhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wagner, AntonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weiss, KilianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lennartz, SimonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Huntgeburth, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hickethier, TilmanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maintz, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Naehle, Claas PhilipUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bunck, Alexander ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doerner, JonasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-322558
DOI: 10.1007/s10554-020-01979-2
Journal or Publication Title: Int. J. Cardiovasc. Imaging
Publisher: SPRINGER
Place of Publication: DORDRECHT
ISSN: 1573-0743
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
MAGNETIC-RESONANCE ANGIOGRAPHY; DIAMETER MEASUREMENTS; MARFAN-SYNDROME; GADOLINIUM; DISEASE; HEART; SSFP; TOMOGRAPHY; GUIDELINES; MANAGEMENTMultiple languages
Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical ImagingMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/32255

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