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Clinical Trial
. 2017 Nov 28:2017:5428914.
doi: 10.1155/2017/5428914. eCollection 2017.

Time-Resolved Three-Dimensional Contrast-Enhanced Magnetic Resonance Angiography in Patients with Chronic Expanding and Stable Aortic Dissections

Michael Trojan  1 , Fabian Rengier  1   2 , Drosos Kotelis  3 , Matthias Müller-Eschner  1 , Sasan Partovi  4 , Christian Fink  5 , Christof Karmonik  6 , Dittmar Böckler  3 , Hans-Ulrich Kauczor  1 , Hendrik von Tengg-Kobligk  1   2   7
Affiliations
Clinical Trial

Time-Resolved Three-Dimensional Contrast-Enhanced Magnetic Resonance Angiography in Patients with Chronic Expanding and Stable Aortic Dissections

Michael Trojan et al. Contrast Media Mol Imaging. .

Abstract

Objective: To prospectively evaluate our hypothesis that three-dimensional time-resolved contrast-enhanced magnetic resonance angiography (TR-MRA) is able to detect hemodynamic alterations in patients with chronic expanding aortic dissection compared to stable aortic dissections.

Materials and methods: 20 patients with chronic or residual aortic dissection in the descending aorta and patent false lumen underwent TR-MRA of the aorta at 1.5 T and repeated follow-up imaging (mean follow-up 5.4 years). 7 patients showed chronic aortic expansion and 13 patients had stable aortic diameters. Regions of interest were placed in the nondissected ascending aorta and the false lumen of the descending aorta at the level of the diaphragm (FL-diaphragm level) resulting in respective time-intensity curves.

Results: For the FL-diaphragm level, time-to-peak intensity and full width at half maximum were significantly shorter in the expansion group compared to the stable group (p = 0.027 and p = 0.003), and upward and downward slopes of time-intensity curves were significantly steeper (p = 0.015 and p = 0.005). The delay of peak intensity in the FL-diaphragm level compared to the nondissected ascending aorta was significantly shorter in the expansion group compared to the stable group (p = 0.01).

Conclusions: 3D TR-MRA detects significant alterations of hemodynamics within the patent false lumen of chronic expanding aortic dissections compared to stable aortic dissections.

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Figures

Figure 1
Figure 1
Representative time steps of a time-resolved MRA data set in a patient with aortic dissection Stanford type B. Note the gradual filling of the true lumen (anterior) and the false lumen (posterior) with the contrast medium followed by decrease of the intensity in both lumina.
Figure 2
Figure 2
Time-intensity curves as measured by time-resolved MRA in representative patients with chronic expanding aortic dissection (a) and chronic stable aortic dissection (b). x-axis is plotted in minutes; y-axis is dimensionless with 1 representing peak enhancement. For each patient, two curves are shown. The continuous line represents the intensity in the nondissected proximal aorta; the dashed line represents the intensity in the false lumen at the level of the diaphragm. Time to peak (TTP) and full width at half maximum (FWHM) are illustrated for the dashed curve. Upward and downward slopes (in blue) are visualized for the continuous line on the left.
See this image and copyright information in PMC

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