Abstract
BackgroundThe 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.MethodsThirty-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.ResultsCompared 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).ConclusionsSuperior 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.
Highlights
The native balanced steady state with free precession magnetic resonance angiography (MRA) technique has been shown to provide high diagnostic image quality for thoracic aortic disease
Previous studies demonstrated the usefulness of native balanced steadystate free precession acquisition techniques for obtaining high diagnostic accuracy and image quality of the thoracic aorta [4, 5]
Because ECG synchronization and respiration control are required in contrast enhanced (CE)-MRA, the scan time was in the range of minutes rather than approximately 20 s
Summary
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 Car‐ tesian, 3D, contrast-enhanced MRA (CE-MRA) with navigator-gated respiration control for image quality of the entire thoracic aorta. Magnetic resonance angiography (MRA) has been established for serial follow up studies of patients with known aortic disease [1], with the application of contrast media as a reference technique [1,2,3]. Previous studies demonstrated the usefulness of native balanced steadystate free precession (bSSFP) acquisition techniques for obtaining high diagnostic accuracy and image quality of the thoracic aorta [4, 5]. A second aspect is the data acquisition efficiency of 100%, resulting in a defined scan time independent of patient respiratory patterns, simplifying examination planning [9]
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