Skip to main content
SpringerLink
Log in

3D black-blood 3T-MRI for the diagnosis of abdominal large vessel vasculitis

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To assess the value of a T1-3D black-blood turbo spin echo (TSE) sequence for the diagnosis of abdominal large vessel vasculitis (LVV).

Materials and methods

The study included 20 patients with abdominal LVV and 17 controls, who underwent a 3T-MRI scan using a modified T1-3D volumetric isotropic TSE acquisition and a segmented T1-3D turbo field echo sequence (T1-mVISTA/T1-eTHRIVE). Two radiologists independently analyzed the aorta for concentric contrast enhancement, concentric wall thickening, image quality, and flow artifact intensity (CCE/CWT/IQ/FAI; 4-point scales). The mean aortic wall thickness (MAWT) in post-contrast T1-mVISTA was compared between patients and controls.

Results

IQ of T1-mVISTA was rated good to excellent in 91.5% of 282 evaluated vessel segments with no or minor FAI present in 85.5%. The inter-observer reproducibility for the identification of CCE/CWT on T1-mVISTA was 0.92 and 0.93 (p < 0.001). The distribution of segmental inflammation in T1-mVISTA significantly correlated with T1-eTHRIVE (CCE, κ = 0.768; CWT, κ = 0.715; p < 0.001), resulting in a sensitivity, specificity, and positive predictive value of 100%, 81.3%, and 83.3%. The MAWT significantly differed between patients and controls (3.29 ± 0.81 vs. 2.24 ± 0.45 mm; p < 0.001).

Conclusions

T1-mVISTA enables the evaluation of the MAWT and allows the detection of abdominal LVV.

Key Points

• 3D T1w-mVISTA accurately depicted the large abdominal vessels.

• 3D T1w-mVISTA enables accurate measurements of the abdominal aortic wall thickness.

• 3D T1w-mVISTA is useful for the detection of abdominal LVV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

3D:

Three-dimensional

CCE:

Concentric contrast enhancement

CWT:

Concentric wall thickening

eTHRIVE:

Enhanced T1 high-resolution isotropic volume excitation

FAI:

Flow artifact intensity

IQ:

Image quality

LVV:

Large vessel vasculitis

MAWT:

Mean aortic wall thickness

MRI:

Magnetic resonance imaging

mVISTA:

Modified volumetric isotropic TSE acquisition

TSE:

Turbo spin echo

References

  1. Bley TA, Uhl M, Venhoff N, Thoden J, Langer M, Markl M (2007) 3-T MRI reveals cranial and thoracic inflammatory changes in giant cell arteritis. Clin Rheumatol 26:448–450

    Article  CAS  Google Scholar 

  2. Mugler JP 3rd (2014) Optimized three-dimensional fast-spin-echo MRI. J Magn Reson Imaging 39:745–767

    Article  Google Scholar 

  3. Sommer NN, Treitl KM, Coppenrath E et al (2018) Three-dimensional high-resolution black-blood magnetic resonance imaging for detection of arteritic anterior ischemic optic neuropathy in patients with giant cell arteritis. Invest Radiol 53:698–704

    Article  Google Scholar 

  4. Treitl KM, Maurus S, Sommer NN et al (2017) 3D-black-blood 3T-MRI for the diagnosis of thoracic large vessel vasculitis: a feasibility study. Eur Radiol 27:2119–2128

    Article  Google Scholar 

  5. Hartlage GR, Palios J, Barron BJ et al (2014) Multimodality imaging of aortitis. JACC Cardiovasc Imaging 7:605–619

    Article  Google Scholar 

  6. Hoffman GS (2003) Large-vessel vasculitis: unresolved issues. Arthritis Rheum 48:2406–2414

    Article  Google Scholar 

  7. Busse RF, Hariharan H, Vu A, Brittain JH (2006) Fast spin echo sequences with very long echo trains: design of variable refocusing flip angle schedules and generation of clinical T2 contrast. Magn Reson Med 55:1030–1037

    Article  Google Scholar 

  8. Eikendal AL, Blomberg BA, Haaring C et al (2016) 3D black blood VISTA vessel wall cardiovascular magnetic resonance of the thoracic aorta wall in young, healthy adults: reproducibility and implications for efficacy trial sample sizes: a cross-sectional study. J Cardiovasc Magn Reson 18:20

    Article  Google Scholar 

  9. Li AE, Kamel I, Rando F et al (2004) Using MRI to assess aortic wall thickness in the multiethnic study of atherosclerosis: distribution by race, sex, and age. AJR Am J Roentgenol 182:593–597

    Article  Google Scholar 

  10. Choe YH, Han BK, Koh EM, Kim DK, Do YS, Lee WR (2000) Takayasu’s arteritis: assessment of disease activity with contrast-enhanced MR imaging. AJR Am J Roentgenol 175:505–511

    Article  CAS  Google Scholar 

Download references

Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany

    Stefan Maurus, Nora N. Sommer, Eva Coppenrath & Karla M. Treitl

  2. Philips Healthcare, Hamburg, Germany

    Hendrik Kooijman

  3. Division of Rheumatology and Clinical Immunology, Medical Clinic and Policlinic IV, University Hospital, LMU Munich, Munich, Germany

    Matthias Witt & Hendrik Schulze-Koops

  4. Division of Vascular Medicine, Medical Clinic and Policlinic IV, University Hospital, LMU Munich, Munich, Germany

    Michael Czihal & Ulrich Hoffmann

  5. Radiologisches Zentrum Rosenheim, Rosenheim, Germany

    Tobias Saam

  6. German Center for Cardiovascular Disease Research (DZHK e. V.), Munich, Germany

    Karla M. Treitl

Authors
  1. Stefan Maurus
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nora N. Sommer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hendrik Kooijman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eva Coppenrath
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Matthias Witt
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hendrik Schulze-Koops
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michael Czihal
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ulrich Hoffmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tobias Saam
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Karla M. Treitl
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stefan Maurus.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Dr. med. Karla M. Treitl.

Conflict of interest

The authors of this manuscript declare relationships with the following companies: Dr. Hendrik Kooijman-Kurfuerst is a physicist who works for Philips Healthcare. He modified the original VISTA sequence and thus developed the T1-mVISTA sequence.

The other authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported as follows:

Parts of the content of this manuscript were presented at the RSNA meeting 2017 and at the ECR meeting 2017.

Methodology

• prospective

• case-control study

• performed at one institution

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 42 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Maurus, S., Sommer, N.N., Kooijman, H. et al. 3D black-blood 3T-MRI for the diagnosis of abdominal large vessel vasculitis. Eur Radiol 30, 1041–1044 (2020). https://doi.org/10.1007/s00330-019-06432-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-019-06432-0

Keywords

Search

Navigation