Dataset Information

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.

ABSTRACT:

Background

Patients 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. METHODS: Twenty-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.

Results

Area, 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??0.64). Difference in maximum aortic diameter measurements at baseline vs follow up showed excellent agreement between CMRA and CTA (ICC?=?0.91).

Conclusions

The 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.

SUBMITTER: Yacoub B

PROVIDER: S-EPMC7871614 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

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.

Yacoub Basel B Stroud Robert E RE Piccini Davide D Schoepf U Joseph UJ Heerfordt John J Yerly Jérôme J Di Sopra Lorenzo L Rollins Jonathan D JD Turner D Alan DA Emrich Tilman T Xiong Fei F Suranyi Pal P Varga-Szemes Akos A

Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 20210208 1

<h4>Background</h4>Patients 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 t ...[more]

PMID: 33557887

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Project description:Background and purposeThe diagnosis of spinal vascular malformations may be challenging on conventional MR imaging because neither the location of the signal abnormality in the spinal cord nor the level of the abnormal flow voids correlates with the level of the fistula. We conducted a retrospective evaluation of the utility of using a time-resolved imaging of contrast kinetics sequence in the diagnosis, characterization, and localization of spinal vascular malformations, comparing it with the criterion standard of spinal DSA.Materials and methodsFifty-five consecutive patients with a suspected diagnosis of spinal vascular malformation underwent time-resolved imaging of contrast kinetics followed by spinal DSA. All scans were performed on a 1.5T scanner by using a standard 8-channel spine coil and were reported by a neuroradiologist before the DSA was performed.ResultsForty-seven lesions were confirmed on time-resolved imaging of contrast kinetics and classified as spinal dural arteriovenous fistulas (n = 33, with 1 patient having a type Ib fistula), perimedullary spinal cord arteriovenous fistulas (n = 10), and intramedullary arteriovenous malformations (n = 3). One patient had an extradural spinal vascular malformation. Time-resolved imaging of contrast kinetics identified the location of the arterial feeder to within 1 vertebral level in 27/33 patients (81.8%) with spinal dural arteriovenous fistulas and correctly predicted the side in 22/33 (66.6%) patients. Perimedullary spinal cord arteriovenous fistulas were erroneously considered to represent spinal dural arteriovenous fistulas before spinal DSA. The anatomy of the arterial supply to intramedullary arteriovenous malformations was also poorly characterized on time-resolved contrast-enhanced MR angiography.ConclusionsIt has been our experience that time-resolved imaging of contrast kinetics is a useful confirmatory tool when a spinal vascular malformation is suspected on the basis of clinical and conventional MR imaging findings. As experience with the technique grows and sequences are refined, it may be possible to rely on time-resolved imaging of contrast kinetics as a screening tool for the diagnosis of spinal vascular malformations.

Project description:PURPOSE:To develop a robust and efficient reconstruction framework that provides high-quality motion-compensated respiratory-resolved images from free-breathing 3D whole-heart Cartesian coronary magnetic resonance angiography (CMRA) acquisitions. METHODS:Recently, XD-GRASP (eXtra-Dimensional Golden-angle RAdial Sparse Parallel MRI) was proposed to achieve 100% scan efficiency and provide respiratory-resolved 3D radial CMRA images by exploiting sparsity in the respiratory dimension. Here, a reconstruction framework for Cartesian CMRA imaging is proposed, which provides respiratory-resolved motion-compensated images by incorporating 2D beat-to-beat translational motion information to increase sparsity in the respiratory dimension. The motion information is extracted from interleaved image navigators and is also used to compensate for 2D translational motion within each respiratory phase. The proposed Optimized Respiratory-resolved Cartesian Coronary MR Angiography (XD-ORCCA) method was tested on 10 healthy subjects and 2 patients with cardiovascular disease, and compared against XD-GRASP. RESULTS:The proposed XD-ORCCA provides high-quality respiratory-resolved images, allowing clear visualization of the right and left coronary arteries, even for irregular breathing patterns. Compared with XD-GRASP, the proposed method improves the visibility and sharpness of both coronaries. Significant differences (p?<?.05) in visible vessel length and proximal vessel sharpness were found between the 2 methods. The XD-GRASP method provides good-quality images in the absence of intraphase motion. However, motion blurring is observed in XD-GRASP images for respiratory phases with larger motion amplitudes and subjects with irregular breathing patterns. CONCLUSION:A robust respiratory-resolved motion-compensated framework for Cartesian CMRA has been proposed and tested in healthy subjects and patients. The proposed XD-ORCCA provides high-quality images for all respiratory phases, independently of the regularity of the breathing pattern.

Dataset Information

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.

Background

Results

Conclusions

Publications

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.

Similar Datasets

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