Thoracic aorta: comparison of gadolinium-enhanced three-dimensional MR angiography with conventional MR imaging

To evaluate gadolinium-enhanced three-dimensional magnetic resonance (MR) angiography for thoracic aortic disease and to compare this technique with conventional thoracic MR imaging.

One hundred eight consecutive patients underwent 122 thoracic MR examinations, including conventional MR imaging followed by enhanced three-dimensional MR angiography. A gradient-echo sequence was used at 1.5 T (116 examinations) and 1.0 T (6 examinations) during infusion of 0.2 mmol/kg gadopentetate dimeglumine. Two independent readers (A and B), with varied experience in thoracic MR angiography, retrospectively evaluated the images for presence of aortic dissection, aneurysm, arch vessel disease, and protruding atheroma. Correlation with findings of surgery or other imaging modalities was available in 98 cases.

Enhanced MR angiography was sensitive (92%-96%) and specific (100%) for acute and chronic aortic dissection (n = 26) and was as useful as conventional MR imaging in the diagnosis of aneurysm (n = 43) and arch vessel disease (n = 7). One of two intramural hematomas were overlooked at MR angiography by reader A, and both were overlooked by reader B.

Enhanced three-dimensional MR angiography is a rapid and accurate imaging modality in diagnosis of thoracic aortic disease but is insensitive to intramural hematoma.