"Pseudocoarctation" of the aorta: pitfall on cine MR imaging
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S A Mirowitz1, J K Lee, F R Gutierrez
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110.
Abstract:
The diagnosis of coarctation of the aorta on cine magnetic resonance imaging is based upon observation of localized narrowing in the region of the aortic isthmus with jet-like signal void areas extending distally. We observed similar findings in 8 of 20 (40%) normal volunteers examined in the sagittal oblique view. These artifactual findings relate primarily to out-of-plane motion of the thoracic aorta during a portion of the cardiac cycle, leading to partial volume averaging with pulmonary air. Awareness of this pitfall will prevent misdiagnosis of aortic coarctation in normal subjects and allow for more accurate assessment of severity of true coarctation.
Insights
Cine magnetic resonance imaging can misdiagnose coarctation of the aorta in healthy individuals due to motion artifacts. Recognizing these imaging pitfalls is crucial for accurate diagnosis and assessment of aortic coarctation severity.
Area of Science:
- Cardiovascular Imaging
- Medical Diagnostics
- Radiology
Background:
- Coarctation of the aorta diagnosis relies on identifying aortic isthmus narrowing and signal voids on cine MRI.
- Artifacts can mimic coarctation findings, potentially leading to misdiagnosis.
Purpose of the Study:
- To investigate artifactual findings on cine MRI that resemble coarctation of the aorta in normal subjects.
- To improve the accuracy of diagnosing coarctation of the aorta.
Main Methods:
- Utilized cine magnetic resonance imaging (MRI) on 20 healthy volunteers.
- Examined subjects in the sagittal oblique view to assess for aortic narrowing and signal voids.
Main Results:
- Observed findings mimicking coarctation in 40% of normal volunteers (8 of 20).
- Identified out-of-plane motion and partial volume averaging with pulmonary air as causes of artifact.
- These artifacts were particularly noted in the sagittal oblique view.
Conclusions:
- Awareness of motion-related artifacts is essential to prevent misdiagnosis of coarctation of the aorta in normal individuals.
- Distinguishing true coarctation from artifacts allows for more precise severity assessment.