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Contrast-enhanced 3D FISP MR angiography of the aortic arch ostia: preliminary results
J A Stone1, S K Mukherji, R Semelka
1Department of Radiology, Medical College of Georgia, Augusta 30912-3910, USA. jstone@mail.mcg.edu
Purpose:
The goal of this work was to evaluate three-dimensional (3D) contrast-enhanced MR angiography (MRA) for the detection of ostial stenoses of the aortic arch.
Method:
Sixteen patients with suspected carotid atherosclerotic disease prospectively underwent digital subtraction angiography of the aortic arch followed by contrast-enhanced MRA using a 3D fast imaging with steady-state precession (FISP) technique (TR = 5 ms, TE = 2 ms, flip angle = 30 degrees). Three neuroradiologists blindly measured stenoses on the catheter angiograms and MRA. Evaluation included the ostia of the innominate, left carotid, and left subclavian arteries. Any significant disagreement on catheter angiography was resolved by consensus. The MRA grades of each of the three observers were then compared with the consensus grades of the contrast angiogram.
Results:
Forty-eight vessels were scored, of which five had significant stenoses. MRA demonstrated 100% sensitivity, 89% specificity, 52% positive predictive value, and 100% negative predictive value. The Bowker test for symmetry indicated no significant difference between conventional angiography and MRA scores (p = 0.32-0.75), and there was good agreement between the three observers (weighted kappa = 0.75-0.86).
Conclusion:
Contrast-enhanced 3D FISP MRA may be a useful imaging modality for the detection of significant stenoses at the ostia of the major aortic arch branches.
Insights
Three-dimensional contrast-enhanced MR angiography (MRA) accurately detects aortic arch ostial stenoses. This imaging technique shows high sensitivity and specificity, making it a valuable tool for diagnosing these vascular conditions.
Area of Science:
- Vascular imaging
- Radiology
- Cardiovascular diagnostics
Background:
- Aortic arch ostial stenoses are significant vascular conditions.
- Accurate detection is crucial for patient management.
- Conventional angiography has limitations.
Purpose of the Study:
- To evaluate three-dimensional (3D) contrast-enhanced MR angiography (MRA) for detecting ostial stenoses of the aortic arch.
- To compare MRA performance against digital subtraction angiography.
Main Methods:
- Prospective study of 16 patients with suspected carotid atherosclerotic disease.
- Contrast-enhanced 3D fast imaging with steady-state precession (FISP) MRA was performed.
- Neuroradiologists blindly assessed stenoses in the innominate, left carotid, and left subclavian arteries.
Main Results:
- MRA demonstrated 100% sensitivity and 89% specificity for detecting significant stenoses.
- No significant difference was found between MRA and conventional angiography scores (p = 0.32-0.75).
- Excellent inter-observer agreement was noted (weighted kappa = 0.75-0.86).
Conclusions:
- Contrast-enhanced 3D FISP MRA is a potentially useful imaging modality.
- It effectively detects significant stenoses at the ostia of major aortic arch branches.
- MRA offers a valuable alternative for diagnosing these conditions.
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