Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland.
Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
J Cardiovasc Magn Reson. 2021 Jul 12;23(1):94. doi: 10.1186/s12968-021-00774-9.
The native balanced steady state with free precession (bSSFP) magnetic resonance angiography (MRA) technique has been shown to provide high diagnostic image quality for thoracic aortic disease. This study compares a 3D radial respiratory self-navigated native MRA (native-SN-MRA) based on a bSSFP sequence with conventional Cartesian, 3D, contrast-enhanced MRA (CE-MRA) with navigator-gated respiration control for image quality of the entire thoracic aorta.
Thirty-one aortic native-SN-MRA were compared retrospectively (63.9 ± 10.3 years) to 61 CE-MRA (63.1 ± 11.7 years) serving as a reference standard. Image quality was evaluated at the aortic root/ascending aorta, aortic arch and descending aorta. Scan time was recorded. In 10 patients with both MRA sequences, aortic pathologies were evaluated and normal and pathologic aortic diameters were measured. The influence of artifacts on image quality was analyzed.
Compared to the overall image quality of CE-MRA, the overall image quality of native-SN-MRA was superior for all segments analyzed (aortic root/ascending, p < 0.001; arch, p < 0.001, and descending, p = 0.005). Regarding artifacts, the image quality of native-SN-MRA remained superior at the aortic root/ascending aorta and aortic arch before and after correction for confounders of surgical material (i.e., susceptibility-related artifacts) (p = 0.008 both) suggesting a benefit in terms of motion artifacts. Native-SN-MRA showed a trend towards superior intraindividual image quality, but without statistical significance. Intraindividually, the sensitivity and specificity for the detection of aortic disease were 100% for native-SN-MRA. Aortic diameters did not show a significant difference (p = 0.899). The scan time of the native-SN-MRA was significantly reduced, with a mean of 05:56 ± 01:32 min vs. 08:51 ± 02:57 min in the CE-MRA (p < 0.001).
Superior image quality of the entire thoracic aorta, also regarding artifacts, can be achieved with native-SN-MRA, especially in motion prone segments, in addition to a shorter acquisition time.
自由进动的原生平衡稳态（bSSFP）磁共振血管造影（MRA）技术已被证明可提供用于胸主动脉疾病的高诊断图像质量。本研究比较了一种基于 bSSFP 序列的 3D 径向呼吸自导航原生 MRA（原生-SN-MRA）与传统的笛卡尔、3D、对比增强 MRA（CE-MRA），后者采用导航门控呼吸控制用于整个胸主动脉的图像质量。
回顾性比较了 31 例主动脉原生-SN-MRA（63.9±10.3 岁）与 61 例 CE-MRA（63.1±11.7 岁）作为参考标准。在主动脉根部/升主动脉、主动脉弓和降主动脉评估图像质量。记录扫描时间。在 10 例同时进行两种 MRA 序列的患者中，评估了主动脉病变并测量了正常和病理性主动脉直径。分析了伪影对图像质量的影响。
与 CE-MRA 的整体图像质量相比，原生-SN-MRA 在分析的所有节段均具有更好的整体图像质量（主动脉根部/升主动脉，p<0.001；弓部，p<0.001，降主动脉，p=0.005）。关于伪影，在对手术材料的混杂因素（即，与敏感性相关的伪影）进行校正之前和之后，原生-SN-MRA 在主动脉根部/升主动脉和主动脉弓处的图像质量仍保持更好（校正后均为 p=0.008），这表明在运动伪影方面具有优势。原生-SN-MRA 显示出更好的个体内图像质量的趋势，但没有统计学意义。个体内，原生-SN-MRA 检测主动脉疾病的敏感性和特异性均为 100%。主动脉直径无显著差异（p=0.899）。原生-SN-MRA 的扫描时间明显缩短，平均为 05:56±01:32 分钟，而 CE-MRA 为 08:51±02:57 分钟（p<0.001）。
原生-SN-MRA 可获得整个胸主动脉的更高图像质量，尤其是在运动敏感的节段，同时还具有更短的采集时间，此外还可改善伪影。
