3T 心电门控磁共振血管成像用于升主动脉手术后的随访。
ECG-gated MR angiography at 3T for follow-up after surgery involving the ascending aorta.
机构信息
Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center, Rostock, Germany.
Radiology Practice, Medical Care Center, Parchim, Germany.
出版信息
Medicine (Baltimore). 2023 Jun 2;102(22):e33864. doi: 10.1097/MD.0000000000033864.
We aimed to evaluate electrocardiogram (ECG)-gated MR angiography (MRA) in the follow-up after surgery involving the ascending aorta regarding technical feasibility, image quality, spectrum of findings, and their implications for clinical management. We retrospectively analyzed a cohort of 19 patients (median age 59 years, range 38-79 years), who underwent MRA for follow-up imaging after surgery involving the ascending aorta. Our magnetic resonance imaging protocol consisted of a time-resolved, non-ECG-gated MRA and an ECG-gated MRA performed at 3T. Median examination duration was 25 minutes (range 11-41 minutes). All examinations were assessed by 2 readers in consensus for image quality on a 5-point scale ranging from 1 (non-diagnostic) to 5 (excellent). MRA examinations and patient charts were analyzed for diagnostic findings and their consequences for further management. Subjective image quality was rated as "sufficient" (score 3.1 ± 1.1) for the aortic root and as "good" to "excellent" for the ascending aorta (score 4.5 ± 0.7), aortic arch (4.5 ± 0.7), supra-aortic branches (4.5 ± 0.6) and descending aorta (4.6 ± 0.7). Abnormal findings were seen in 6 patients (32%) including progressive diameter of remaining aneurysm or dissection (3 patients, 16%) and suture aneurysms (3 patients, 16%). In all 6 of these patients, abnormal findings at MRA had consequences for clinical management. ECG-gated MR angiography at 3T yields good image quality for post-operative surveillance after aortic surgery involving the ascending aorta. This technique may serve as an alternative to computed tomography particularly in younger patients with repeated follow-up.
我们旨在评估心电图(ECG)门控磁共振血管造影(MRA)在涉及升主动脉手术随访中的技术可行性、图像质量、发现范围及其对临床管理的影响。我们回顾性分析了 19 例患者(中位数年龄 59 岁,范围 38-79 岁)的队列,这些患者因涉及升主动脉的手术而接受 MRA 随访成像。我们的磁共振成像方案包括时间分辨、非 ECG 门控 MRA 和 3T 时 ECG 门控 MRA。中位检查时间为 25 分钟(范围 11-41 分钟)。所有检查均由 2 位读者进行共识评估,图像质量评分为 5 分制(1 分为非诊断性,5 分为优秀)。对 MRA 检查和患者图表进行分析,以确定诊断发现及其对进一步管理的影响。主动脉根部的主观图像质量评分为“尚可”(得分为 3.1±1.1),升主动脉、主动脉弓、主动脉弓分支和降主动脉的图像质量评分为“良好”至“优秀”(分别为 4.5±0.7、4.5±0.7、4.5±0.6 和 4.6±0.7)。6 例患者(32%)出现异常发现,包括残余动脉瘤或夹层的直径进展(3 例,16%)和缝合动脉瘤(3 例,16%)。在所有这 6 例患者中,MRA 的异常发现对临床管理产生了影响。3T 时 ECG 门控 MRA 可为涉及升主动脉的主动脉手术后的术后监测提供良好的图像质量。该技术可替代计算机断层扫描,特别是在需要多次随访的年轻患者中。