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Assessment of chronic aortic dissection: contribution of different ECG-gated breath-hold MRI techniques

R Peter Kunz1, Katja Oberholzer, Wlodzimierz Kuroczynski

  • 1Department of Radiology, Johannes Gutenberg-University, Langenbeckstrasse 1, Mainz 55131, Germany.

AJR. American Journal of Roentgenology
|April 22, 2004
PubMed

Insights

Contrast-enhanced MRI is superior to black blood MRI for detecting intimal flaps in chronic aortic dissections. Including cine and phase-contrast techniques aids in diagnosing complications during follow-up imaging.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Medical Diagnostics

Background:

  • Chronic aortic dissections require effective imaging for assessment and follow-up.
  • Rapid MRI techniques offer potential for improved diagnostic capabilities.

Purpose of the Study:

  • To evaluate the impact of different rapid MRI techniques for chronic aortic dissection assessment.
  • To compare the efficacy of black blood MRI versus contrast-enhanced MR angiography in detecting intimal flaps.

Main Methods:

  • Fifty-three patients with Stanford type A and B aortic dissections underwent 1.5 T MRI.
  • Techniques included ECG-gated black blood sequences, 3D contrast-enhanced MR angiography, cine, and phase-contrast imaging.
  • Retrospective analysis by two radiologists assessed intimal flap detection and image quality.

Main Results:

  • Contrast-enhanced MR angiography showed higher sensitivity (87%) and specificity (94%) for thoracic aorta intimal flaps compared to black blood sequences.
  • Contrast-enhanced MR angiography was subjectively superior for flap visualization and overall image quality (p < 0.001).
  • Cine and phase-contrast imaging allowed assessment of aortic valve competence and flow quantification.

Conclusions:

  • Contrast-enhanced MR angiography is the preferred method for detecting intimal flaps and assessing supraaortic branch involvement in chronic aortic dissections.
  • Cine and phase-contrast MRI are valuable additions for diagnosing complications during follow-up.
  • Rapid MRI techniques enhance the comprehensive evaluation of chronic aortic dissections.
Abstract

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