Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
Department of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
Contrast Media Mol Imaging. 2017 Nov 28;2017:5428914. doi: 10.1155/2017/5428914. eCollection 2017.
To prospectively evaluate our hypothesis that three-dimensional time-resolved contrast-enhanced magnetic resonance angiography (TR-MRA) is able to detect hemodynamic alterations in patients with chronic expanding aortic dissection compared to stable aortic dissections.
20 patients with chronic or residual aortic dissection in the descending aorta and patent false lumen underwent TR-MRA of the aorta at 1.5 T and repeated follow-up imaging (mean follow-up 5.4 years). 7 patients showed chronic aortic expansion and 13 patients had stable aortic diameters. Regions of interest were placed in the nondissected ascending aorta and the false lumen of the descending aorta at the level of the diaphragm (FL-diaphragm level) resulting in respective time-intensity curves.
For the FL-diaphragm level, time-to-peak intensity and full width at half maximum were significantly shorter in the expansion group compared to the stable group ( = 0.027 and = 0.003), and upward and downward slopes of time-intensity curves were significantly steeper ( = 0.015 and = 0.005). The delay of peak intensity in the FL-diaphragm level compared to the nondissected ascending aorta was significantly shorter in the expansion group compared to the stable group ( = 0.01).
3D TR-MRA detects significant alterations of hemodynamics within the patent false lumen of chronic expanding aortic dissections compared to stable aortic dissections.
前瞻性评估我们的假设，即与稳定的主动脉夹层相比，三维时间分辨对比增强磁共振血管造影（TR-MRA）能够检测慢性进行性主动脉夹层患者的血流动力学改变。
20 例慢性或降主动脉残留主动脉夹层患者在 1.5T 行主动脉 TR-MRA 检查，并进行重复随访成像（平均随访 5.4 年）。7 例患者表现为慢性主动脉扩张，13 例患者主动脉直径稳定。在膈肌水平的非夹层升主动脉和降主动脉假腔中放置感兴趣区，得出各自的时间-强度曲线。
对于假腔膈肌水平，峰值强度时间和半最大值全宽在扩张组明显短于稳定组（=0.027 和=0.003），时间-强度曲线的上升和下降斜率明显更陡（=0.015 和=0.005）。与稳定组相比，假腔膈肌水平的峰值强度延迟明显更短（=0.01）。
与稳定的主动脉夹层相比，3D TR-MRA 可检测慢性进行性主动脉夹层假腔中血流动力学的显著改变。
