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01.04.2016 | Magnetic Resonance

A non-contrast self-navigated 3-dimensional MR technique for aortic root and vascular access route assessment in the context of transcatheter aortic valve replacement: proof of concept

verfasst von: Matthias Renker, Akos Varga-Szemes, U. Joseph Schoepf, Stefan Baumann, Davide Piccini, Michael O. Zenge, Wolfgang G. Rehwald, Edgar Müller, Jeremy D. Rier, Helge Möllmann, Christian W. Hamm, Daniel H. Steinberg, Carlo N. De Cecco

Erschienen in: European Radiology | Ausgabe 4/2016

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Abstract

Objectives

Due to the high prevalence of renal failure in transcatheter aortic valve replacement (TAVR) candidates, a non-contrast MR technique is desirable for pre-procedural planning. We sought to evaluate the feasibility of a novel, non-contrast, free-breathing, self-navigated three-dimensional (SN3D) MR sequence for imaging the aorta from its root to the iliofemoral run-off in comparison to non-contrast two-dimensional-balanced steady-state free-precession (2D-bSSFP) imaging.

Methods

SN3D [field of view (FOV), 220-370 mm³; slice thickness, 1.15 mm; repetition/echo time (TR/TE), 3.1/1.5 ms; and flip angle, 115°] and 2D-bSSFP acquisitions (FOV, 340 mm; slice thickness, 6 mm; TR/TE, 2.3/1.1 ms; flip angle, 77°) were performed in 10 healthy subjects (all male; mean age, 30.3 ± 4.3 yrs) using a 1.5-T MRI system. Aortic root measurements and qualitative image ratings (four-point Likert-scale) were compared.

Results

The mean effective aortic annulus diameter was similar for 2D-bSSFP and SN3D (26.7 ± 0.7 vs. 26.1 ± 0.9 mm, p = 0.23). The mean image quality of 2D-bSSFP (4; IQR 3-4) was rated slightly higher (p = 0.03) than SN3D (3; IQR 2-4). The mean total acquisition time for SN3D imaging was 12.8 ± 2.4 min.

Conclusions

Our results suggest that a novel SN3D sequence allows rapid, free-breathing assessment of the aortic root and the aortoiliofemoral system without administration of contrast medium.

Key Points

• The prevalence of renal failure is high among TAVR candidates.

• Non-contrast 3D MR angiography allows for TAVR procedure planning.

• The self-navigated sequence provides a significantly reduced scanning time.

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Titel: A non-contrast self-navigated 3-dimensional MR technique for aortic root and vascular access route assessment in the context of transcatheter aortic valve replacement: proof of concept
verfasst von: Matthias Renker
Akos Varga-Szemes
U. Joseph Schoepf
Stefan Baumann
Davide Piccini
Michael O. Zenge
Wolfgang G. Rehwald
Edgar Müller
Jeremy D. Rier
Helge Möllmann
Christian W. Hamm
Daniel H. Steinberg
Carlo N. De Cecco
Publikationsdatum: 01.04.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 4/2016
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3906-x

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A non-contrast self-navigated 3-dimensional MR technique for aortic root and vascular access route assessment in the context of transcatheter aortic valve replacement: proof of concept