Fast spoiled gradient-recalled MR imaging of thoracic aortic dissection: preliminary clinical experience at 1.5 T

Area of Science:

• Radiology
• Cardiovascular Imaging
• Medical Diagnostics

Background:

• Thoracic aortic dissection (TAD) is a life-threatening condition requiring prompt diagnosis.
• Magnetic resonance (MR) imaging is a key modality for evaluating the aorta.
• Fast spoiled gradient-recalled (FSPGR) sequences offer rapid image acquisition.

Purpose of the Study:

• To evaluate the diagnostic performance of fast spoiled gradient-recalled (FSPGR) magnetic resonance (MR) imaging for thoracic aortic dissection (TAD).
• To assess the sensitivity and specificity of FSPGR imaging in identifying TAD.
• To determine the reliability of FSPGR in classifying the type of aortic dissection.

Main Methods:

• Twenty-eight patients with suspected TAD underwent MR imaging, including FSPGR and cine or cardiac-gated spin-echo sequences.
• FSPGR images were interpreted by three readers for TAD presence/absence.
• Receiver operating characteristic (ROC) analysis was performed to assess diagnostic performance.

Main Results:

• At 90% specificity, FSPGR sensitivity for TAD ranged from 52% to 90% across readers.
• Pulsatility artifacts and mural thrombus caused false readings.
• The correct dissection type was identified in only 65% of true-positive cases.

Conclusions:

• FSPGR MR imaging has a limited role in screening for and rapid evaluation of TAD, especially in unstable patients.
• Diagnostic accuracy is reader-dependent and susceptible to artifacts.
• Additional MR imaging sequences are necessary for accurate TAD diagnosis and classification.