Measurement accuracy of prototype non-contrast, compressed sensing-based, respiratory motion-resolved whole heart cardiovascular magnetic resonance angiography for the assessment of thoracic aortic dilatation: comparison with computed tomography angiography

Journal of Cardiovascular Magnetic Resonance

D. Alan Turner¹  Lorenzo Di Sopra²  John Heerfordt³  Davide Piccini³  Jérôme Yerly⁴  Jonathan D. Rollins⁵  Akos Varga-Szemes⁵  Robert E. Stroud⁵  Pal Suranyi⁵  U. Joseph Schoepf⁵  Basel Yacoub⁵  Fei Xiong⁶  Tilman Emrich⁷ 

[1] College of Medicine, Medical University of South Carolina, Charleston, SC, USA;Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland;Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland;Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland;Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland;Center for Biomedical Imaging (CIBM), Lausanne, Switzerland;Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, 29425, Charleston, SC, USA;Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, 29425, Charleston, SC, USA;Cardiovascular MR R&D, Siemens Medical Solutions USA Inc, Charleston, SC, USA;Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, 29425, Charleston, SC, USA;Department of Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany;German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Germany;

关键词: Aortic dilatation;    Aortic aneurysm;    Magnetic resonance angiography;    Compressed sensing;    Computed tomography;   

DOI  :  10.1186/s12968-020-00697-x

来源: Springer

【 摘 要 】

BackgroundPatients with thoracic aortic dilatation who undergo annual computed tomography angiography (CTA) are subject to repeated radiation and contrast exposure. The purpose of this study was to evaluate the feasibility of a non-contrast, respiratory motion-resolved whole-heart cardiovascular magnetic resonance angiography (CMRA) technique against reference standard CTA, for the quantitative assessment of cardiovascular anatomy and monitoring of disease progression in patients with thoracic aortic dilatation. MethodsTwenty-four patients (68.6 ± 9.8 years) with thoracic aortic dilatation prospectively underwent clinical CTA and research 1.5T CMRA between July 2017 and November 2018. Scans were repeated in 15 patients 1 year later. A prototype free-breathing 3D radial balanced steady-state free-precession whole-heart CMRA sequence was used in combination with compressed sensing-based reconstruction. Area, circumference, and diameter measurements were obtained at seven aortic levels by two experienced and two inexperienced readers. In addition, area and diameter measurements of the cardiac chambers, pulmonary arteries and pulmonary veins were also obtained. Agreement between the two modalities was assessed with intraclass correlation coefficient (ICC) analysis, Bland–Altman plots and scatter plots.ResultsArea, circumference and diameter measurements on a per-level analysis showed good or excellent agreement between CTA and CMRA (ICCs > 0.84). Means of differences on Bland–Altman plots were: area 0.0 cm2 [− 1.7; 1.6]; circumference 1.0 mm [− 10.0; 12.0], and diameter 0.6 mm [− 2.6; 3.6]. Area and diameter measurements of the left cardiac chambers showed good agreement (ICCs > 0.80), while moderate to good agreement was observed for the right chambers (all ICCs > 0.56). Similar good to excellent inter-modality agreement was shown for the pulmonary arteries and veins (ICC range 0.79–0.93), with the exception of the left lower pulmonary vein (ICC < 0.51). Inter-reader assessment demonstrated mostly good or excellent agreement for both CTA and CMRA measurements on a per-level analysis (ICCs > 0.64). Difference in maximum aortic diameter measurements at baseline vs follow up showed excellent agreement between CMRA and CTA (ICC = 0.91).ConclusionsThe radial whole-heart CMRA technique combined with respiratory motion-resolved reconstruction provides comparable anatomical measurements of the thoracic aorta and cardiac structures as the reference standard CTA. It could potentially be used to diagnose and monitor patients with thoracic aortic dilatation without exposing them to radiation or contrast media.

【 授权许可】

CC BY