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Marfan syndrome: evaluation with MR imaging versus CT.
R L Soulen1, E K Fishman, R E Pyeritz
1Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
Radiology
|December 1, 1987
Summary
Magnetic resonance (MR) imaging is as effective as computed tomography (CT) for diagnosing Marfan syndrome abnormalities in non-surgical patients. MR imaging is superior for postoperative evaluation and avoids radiation exposure, making it ideal for Marfan syndrome screening and follow-up.
Area of Science:
- Radiology
- Medical Imaging
- Genetics
Background:
- Marfan syndrome is a genetic disorder affecting connective tissue, often leading to cardiovascular, skeletal, and ocular abnormalities.
- Accurate and safe imaging modalities are crucial for the diagnosis, management, and monitoring of patients with Marfan syndrome, particularly given the need for serial studies.
- Computed tomography (CT) has been used, but artifact from surgical implants can limit its effectiveness.
Purpose of the Study:
- To compare the diagnostic efficacy of magnetic resonance (MR) imaging versus CT in patients with Marfan syndrome.
- To evaluate the utility of MR imaging in both non-operative and post-operative Marfan syndrome patients.
- To assess the suitability of MR imaging as a primary screening and follow-up tool for Marfan syndrome and its relatives.
Main Methods:
- Twenty-five patients diagnosed with Marfan syndrome underwent both CT and MR imaging.
- MR images were interpreted by blinded reviewers and compared against CT findings.
- The study focused on evaluating abnormalities in the aorta, dura, and hips, as well as assessing the impact of surgical valves on image quality.
Main Results:
- MR imaging demonstrated equivalence to CT in identifying aortic, dural, and hip abnormalities in patients who had not undergone surgery.
- MR imaging proved superior in evaluating postoperative patients, effectively overcoming the artifact limitations of CT caused by Bjork-Shiley or St. Jude valves.
- MR imaging produced only minor artifacts in postoperative cases, unlike CT which had significant limitations in aortic root evaluation.
Conclusions:
- Magnetic resonance imaging is a highly effective imaging modality for the evaluation of Marfan syndrome, comparable to CT in non-surgical cases.
- MR imaging offers significant advantages over CT in the assessment of postoperative patients due to its superior artifact handling.
- The absence of radiation exposure and enhanced diagnostic capabilities make MR imaging the preferred choice for the serial evaluation and screening of Marfan syndrome patients and their families.