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

作者：Renker Matthias; Varga Szemes Akos; Schoepf U Joseph^*; Baumann Stefan; Piccini Davide; Zenge Michael O; Rehwald Wolfgang G; Mueller Edgar; Rier Jeremy D; Moellmann Helge; Hamm Christian W; Steinberg Daniel H; De Cecco Carlo N

来源：European Radiology, 2016, 26(4): 951-958.

DOI：10.1007/s00330-015-3906-x

• Aortic valve stenosis
• Transcatheter aortic valve replacement
• Magnetic resonance imaging
• Contrast media
• Renal insufficiency

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 mm(3); slice thickness, 1.15 mm; repetition/echo time (TR/TE), 3.1/1.5 ms; and flip angle, 115A degrees] and 2D-bSSFP acquisitions (FOV, 340 mm; slice thickness, 6 mm; TR/TE, 2.3/1.1 ms; flip angle, 77A degrees) were performed in 10 healthy subjects (all male; mean age, 30.3 A +/- 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.

• 出版日期2016-4