3D-black-blood 3T-MRI for the diagnosis of thoracic large vessel vasculitis: A feasibility study

• DOI: 10.1007/s00330-016-4525-x
• Publication Date: 2016-08-10T05:51:29Z
• Authors: Karla Maria Treitl; Stefan Maurus; Nora Narvina Sommer; Hendrik Kooijman-...; Eva Coppenrath; Marcus Treitl; Michael Czihal; Ulrich Hoffmann; Claudia Dechant; Hendrik Schulze-K...; Tobias Saam
• Keywords: Adult; Aged, 80 and over; Male; Aortitis; Giant Cell Arteritis; Subclavian Artery; Reproducibility of Results; Aorta, Thoracic; Middle Aged; Pulmonary Artery; Magnetic Resonance Imaging; Takayasu Arteritis; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Image Interpretation, Computer-Assisted; Feasibility Studies; Humans; Female; Prospective Studies; Ultrasonography, Doppler, Color; Artifacts; Aged

To evaluate the feasibility of T1w-3D black-blood turbo spin echo (TSE) sequence with variable flip angles for the diagnosis of thoracic large vessel vasculitis (LVV).Thirty-five patients with LVV, diagnosed according to the current standard of reference, and 35 controls were imaged at 3.0T using 1.2 × 1.3 × 2.0 mm3 fat-suppressed, T1w-3D, modified Volumetric Isotropic TSE Acquisition (mVISTA) pre- and post-contrast. Applying a navigator and peripheral pulse unit triggering (PPU), the total scan time was 10-12 min. Thoracic aorta and subclavian and pulmonary arteries were evaluated for image quality (IQ), flow artefact intensity, diagnostic confidence, concentric wall thickening and contrast enhancement (CWT, CCE) using a 4-point scale.IQ was good in all examinations (3.25 ± 0.72) and good to excellent in 342 of 408 evaluated segments (83.8 %), while 84.1 % showed no or minor flow artefacts. The interobserver reproducibility for the identification of CCE and CWT was 0.969 and 0.971 (p < 0.001) with an average diagnostic confidence of 3.47 ± 0.64. CCE and CWT were strongly correlated (Cohen's k = 0.87; P < 0.001) and significantly more frequent in the LVV-group (52.8 % vs. 1.0 %; 59.8 % vs. 2.4 %; P < 0.001).Navigated fat-suppressed T1w-3D black-blood MRI with PPU-triggering allows diagnosis of thoracic LVV.• Cross-sectional imaging is frequently applied in the diagnosis of LVV. • Navigated, PPU-triggered, T1w-3D mVISTA pre- and post contrast takes 10-12 min. • In this prospective, single-centre study, T1w-3D mVISTA accurately depicted large thoracic vessels. • T1w-3D mVISTA visualized CWT/CCW as correlates of mural inflammation in LVV. • T1w-3D mVISTA might be an alternative diagnostic tool without ionizing radiation.