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Updated: Aug 13, 2026
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Steady state evaluation of aortic dissections: A feasibility study
Maria Luisa De Cicco1, Chiara Andreoli, Emanuele Casciani
1Radiologia DEA, Policlinico Umberto I, Università degli Studi di Roma La Sapienza, Roma. marialuisa.decicco@tiscali.it
Purpose:
One the main reasons for the limited use of MRI in the evaluation of aortic dissection in emergency conditions is its long execution time. The authors report their experience regarding a new MRI sequence that reduces execution time and avoids the use of contrast medium.
Materials And Methods:
Eighteen haemodynamically stable patients with suspected (16 cases, 3 with confirmed diagnosis of aneurysm) or known aortic dissection (2 cases) underwent in emergency conditions 1.5T MRI with Steady-State sequence (Fast Imaging Employing Steady-State Acquisition: GRE 2D; TR 3.5, TE 1.6; Flip Angle 45, bandwidth 125, matrix 224x224, NEX 1, acquisition time per slice 7 s, thickness 6-8 mm, FOV 38; 2D-GE breath-hold sequence requiring cardiac triggering). The results obtained were compared in terms of diagnostic accuracy and execution time with those of classical MRI examination (black blood T1, FSE T2 and 3D MR-angiography) or multislice CT.
Results:
The diagnostic accuracy of MRI, both with Steady-State sequence and the ''classical'' technique, and multislice CT in the diagnosis of dissection or aneurysm is equal (100%), whereas execution time is 6, 25 and 6 minutes, respectively. Multislice CT proved to be more accurate than Steady-State MRI in evaluating the renal parenchyma and the extension of the dissection to the renal arteries.
Conclusions:
The Steady-State MRI sequence provides a diagnosis of aortic dissection or aneurysmal dilatation in a short time and may represent a valuable alternative to CT in emergency settings, especially in patients with reported contraindications to iodinated contrast media.
Insights
A new MRI sequence significantly reduces aortic dissection diagnosis time without contrast media. This fast imaging employing steady-state acquisition (FIESTA) offers a valuable alternative to CT in emergency settings.
Area of Science:
- Radiology
- Cardiovascular Imaging
- Medical Diagnostics
Background:
- Aortic dissection diagnosis is time-sensitive in emergency care.
- Traditional MRI protocols for aortic dissection are lengthy.
- Contrast media may have contraindications in some patients.
Purpose of the Study:
- To evaluate a novel, rapid MRI sequence for aortic dissection.
- To assess the diagnostic accuracy and speed of the new sequence.
- To determine if the sequence can replace contrast-enhanced imaging.
Main Methods:
- Eighteen patients with suspected or known aortic dissection underwent emergency 1.5T MRI.
- A Steady-State sequence (Fast Imaging Employing Steady-State Acquisition) was utilized.
- Results were compared to conventional MRI and multislice CT.
Main Results:
- The Steady-State MRI sequence achieved 100% diagnostic accuracy for aortic dissection and aneurysms.
- Execution time was significantly reduced: 6 minutes for Steady-State MRI vs. 25 minutes for classical MRI.
- Multislice CT showed higher accuracy in evaluating renal arteries compared to Steady-State MRI.
Conclusions:
- The Steady-State MRI sequence is a rapid and accurate tool for diagnosing aortic dissection and aneurysms.
- It offers a valuable, contrast-free alternative to CT in emergency imaging.
- Further evaluation is needed for renal artery assessment compared to CT.
