Advertisement

European Radiology

, Volume 16, Issue 3, pp 676–684 | Cite as

Congenital diseases of the thoracic aorta. Role of MRI and MRA

  • Vincenzo Russo
  • Matteo Renzulli
  • Cesare La Palombara
  • Rossella FattoriEmail author
Vascular-Interventional

Abstract

Aortic malformations may be associated with other congenital heart abnormalities or may present independently, as incidental findings in asymptomatic patients. For more than 30 years, conventional imaging techniques for detection and assessment of congenital anomalies of the aorta have been chest X-ray, echocardiography and angiography. In recent times, considerable interest in congenital aortic diseases has been shown, due to technical progresses of noninvasive imaging modalities. Among them, magnetic resonance imaging (MRI) almost certainly offers the greatest advantages, especially in young patients in which a radiation exposure must be avoided as much as possible. MRI provides an excellent visualization of vascular structures with a wide field of view, well suited for evaluation of the thoracic aorta malformations. With the implementation of magnetic resonance angiography (MRA) it is also possible to depict any relationship with supra-aortic or mediastinal vessels. Phase contrast technique allows identification of the hemodynamic significance of the aortic alteration. Some technical considerations, which include fast spin-echo, gradient-echo and, especially, MRA techniques with phase-contrast and contrast enhanced methods, are discussed and applied in the evaluation of congenital thoracic aorta diseases.

Keywords

Congenital disease Thoracic aorta Magnetic resonance 

References

  1. 1.
    Sakuma H, Bourne MW, O’Sullivan M et al (1996) Evaluation of thoracic aortic dissection using breath-holding Cine MRI. J Comput Assist Tomogr 20:45–50CrossRefPubMedGoogle Scholar
  2. 2.
    Niezen RA, Doornbos J, van der Wall EE, de Roos A (1998) Measurement of aortic and pulmonary flow with MRI at rest and during physical exercise. J Comput Assist Tomogr 22:194–201CrossRefPubMedGoogle Scholar
  3. 3.
    Powell AJ, Maier SE, Chung T, Geva T (2000) Phase-velocity cine magnetic resonance imaging measurement of pulsatile blood flow in children and young adults: in vitro and in vivo validation. Pediatr Cardiol 21:104–110CrossRefPubMedGoogle Scholar
  4. 4.
    Bogren HG, Buonocore MH (1999) 4D magnetic resonance velocity mapping of blood flow patterns in the aorta in young vs elderly normal subjects. J Magn Reson Imaging 10:861–869CrossRefPubMedGoogle Scholar
  5. 5.
    Simpson IA, Chung KJ, Glass RF, Sahn DJ, Sherman FS, Hesselink J (1988) Cine magnetic resonance imaging for evaluation of anatomy and flow relations in infants and children with coarctation of the aorta. Circulation 78:142–148PubMedGoogle Scholar
  6. 6.
    Mohiaddin RH, Kilner PT, Rees S et al (1993) Magnetic resonance volume flow and jet velocity mapping in aortic coarctation. J Am Coll Cardiol 22:1515–1521PubMedCrossRefGoogle Scholar
  7. 7.
    Groenink M, de Roos A, Mulder BJM, Spaan JAE, van der Wall EE (1998) Changes in aortic distensibility and pulse wave velocity assessed with magnetic resonance imaging following beta-blockers therapy in the Marfan syndrome. Am J Cardiol 82:203–208PubMedCrossRefGoogle Scholar
  8. 8.
    Fattori R, Bacchi Reggiani L, Pepe G et al (2000) MRI evaluation of aortic elastic properties as early expression of Marfan Syndrome. J Cardiovasc Magn Reson 4:43–48Google Scholar
  9. 9.
    Steffens JC, Bourne MW, Sakuma H et al (1994) Quantitation of collateral blood flow in coarctation of the aorta by velocity encoded cine magnetic resonance imaging. Circulation 90:937–943PubMedGoogle Scholar
  10. 10.
    Debatin JF, Hany TF (1998) MR-based assessment of vascular morphology and function. Eur Radiol 8:528–539PubMedCrossRefGoogle Scholar
  11. 11.
    Sodickson DK, McKenzie CA, Li W, Wolff S, Manning WJ, Edelman RR (2000) Contrast-enhanced 3D MR angiography with simultaneous acquisition of spatial harmonics: a pilot study. Radiology 217:284–289PubMedGoogle Scholar
  12. 12.
    Lee VS, Martin DJ, Krinsky GA, Rofsky NM (2000) Gadolinium-enhanced MR angiography: artifacts and pitfalls. AJR Am J Roentgenol 175:197–205PubMedGoogle Scholar
  13. 13.
    Neimatallah MA, Ho VB, Dong Q et al (1999) Gadolinium-enhanced 3D magnetic resonance angiography of the thoracic vessels. J Magn Reson Imaging 10:758–770PubMedCrossRefGoogle Scholar
  14. 14.
    Goyen M, Ruehm SG, Debatin JF (2000) MR-angiography: the role of contrast agents. Eur J Radiol 34:247–256PubMedCrossRefGoogle Scholar
  15. 15.
    Prince MR, Narasimham DL, Jacoby WT et al (1996) Three dimensional Gadolinium-enhanced MR angiography of the thoracic aorta. AJR Am J Roentgenol 166:1387–1397PubMedGoogle Scholar
  16. 16.
    Krinsky G, Rofsky N, Flyer M et al (1996) Gadolinium-enhanced three dimensional MR angiography of acquired arch vessels disease. AJR Am J Roentgenol 167:981–987PubMedGoogle Scholar
  17. 17.
    Krinsky G, Rofsky N, De Corato DR et al (1997) Thoracic aorta: comparison of Gadolinium-enhanced three dimensional MR angiography with conventional MR imaging. Radiology 202:183–193PubMedGoogle Scholar
  18. 18.
    Riederer SJ, Bernstein MA, Breen JF, Busse RF, Ehman RL, Fain SB, Hulshizer TC, Huston J III, King BF, Kruger DG, Rossman PJ, Shah S (2000) Three-dimensional contrast-enhanced MR angiography with real-time fluoroscopic triggering: design specifications and technical reliability in 330 patient studies. Radiology 215:584–593PubMedGoogle Scholar
  19. 19.
    Thiene G, Frescura C (1999) Etiology and pathology of aortic arch malformations. In: Nienaber CA, Fattori R (eds) Diagnosis and treatment of aortic diseases. Kluwer, Dordrecht, pp 225–269Google Scholar
  20. 20.
    Soler R, Rodriguez E, Requejo I, Fernandez R, Raposo I (1998) Magnetic resonance imaging of congenital abnormalities of the thoracic aorta. Eur Radiol 8:540–546CrossRefPubMedGoogle Scholar
  21. 21.
    Bakker DA, Berger RM, Witsenburg M, Bogers AJ (1999) Vascular rings: a rare cause of common respiratory symptoms. Acta Paediatr 88:947–952PubMedCrossRefGoogle Scholar
  22. 22.
    Kersting-Sommerhoff BA, Sechtem UP, Fisher MR, Higgins CB (1987) MR imaging of congenital anomalies of the aortic arch. AJR Am J Roentgenol 149:9–13PubMedGoogle Scholar
  23. 23.
    Delabrousse E, Kastler B, Bernard Y, Couvreur M, Clair C (2000) MR diagnosis of a congenital abnormality of the thoracic aorta with an aneurysm of the right subclavian artery presenting as a Horner’s syndrome in an adult. Eur Radiol 10:650–652PubMedCrossRefGoogle Scholar
  24. 24.
    Carpenter JP, Holland GA, Golden MA et al (1997) Magnetic resonance angiography of the aortic arch. J Vasc Surg 25:145–151PubMedCrossRefGoogle Scholar
  25. 25.
    Amparo EG, Higgins CB, Shafton EP (1984) Demonstration of coarctation of the aorta by magnetic resonance imaging. AJR Am J Roentgenol 143:1192–1194PubMedGoogle Scholar
  26. 26.
    Godart F, Labrot G, Devos P, McFadden E, Rey C, Beregi JP (2002) Coarctation of the aorta: comparison of aortic dimensions between conventional MR imaging, 3D MR angiography and conventional angiography. Eur Radiol 12:2034–2039PubMedGoogle Scholar
  27. 27.
    Muhler EG, Neuerburg JM, Ruben A, Grabitz RG, Gunther RW, Messmer BJ, von Bernuth G (1993) Evaluation of aortic coarctation after surgical repair: role of magnetic resonance imaging and Doppler ultrasound. Br Heart J 70:285–290PubMedCrossRefGoogle Scholar
  28. 28.
    Nielsen JC, Powell AJ, Gauvreau K, Marcus EN, Prakash A, Geva T (2005) Magnetic resonance imaging predictors of coarctation severity. Circulation 111:622–628Google Scholar
  29. 29.
    Julsrud PR, Breen JF, Felmlee JP, Warnes CA, Connolly HM, Schaff HV (1997) Coarctation of the aorta: collateral flow assessment with phase-contrast MR angiography. AJR Am J Roentgenol 169:1735–1742PubMedGoogle Scholar
  30. 30.
    Paddon AJ, Nicholson AA, Ettles DF, Travis SJ, Dyet JF (2000) Long-term follow-up of percutaneous balloon angioplasty in adult aortic coarctation. Cardiovasc Inter Radiol 23:364–367CrossRefGoogle Scholar
  31. 31.
    Messmer BJ, Minale C, Muhler E, von Bernuth G (1991) Surgical correction of coarctation in early infancy: does surgical technique influence the result? Ann Thorac Surg 52:594–600; discussion 601–603PubMedCrossRefGoogle Scholar
  32. 32.
    Presbitero P, Demarie D, Villani M, Perinetto EA, Riva G, Orzan F, Bobbio M, Morea M, Brusca A (1987) Long term results (15–30 years) of surgical repair of aortic coarctation. Br Heart J 57:462–467PubMedCrossRefGoogle Scholar
  33. 33.
    Kron IL, Flanagan TL, Rheuban KS, Carpenter MA, Gutgesell HP Jr, Blackbourne LH, Nolan SP (1990) Incidence and risk of reintervention after coarctation repair. Ann Thorac Surg 49:920–925; discussion 925–926PubMedCrossRefGoogle Scholar
  34. 34.
    Therrien J, Thorne SA, Wright A, Kilner PJ, Somerville J (2000) Repaired coarctation: a “cost-effective” approach to identify complications in adults. J Am Coll Cardiol 35:997–1002CrossRefPubMedGoogle Scholar
  35. 35.
    Bogaert J, Kuzo R, DymorKovski S et al (2000) Follow-up of patients with previous treatment for coarctation of the thoracic aorta: comparison between contrast enhanced MR angiography and fast spin-echo MR imaging. Eur Radiol 10:1047–1054Google Scholar
  36. 36.
    Celermajer DS, Greaves K (2002) Survivors of coarctation repair: fixed but not cured. Heart 88:113–114CrossRefPubMedGoogle Scholar
  37. 37.
    Baur LH, Vliegen HW, van der Wall EE, Hazekamp M, Bootsma M, de Roos A, Bruschke AV (2000) Imaging of an aneurysm of the sinus of Valsalva with transesophageal echocardiography, contrast angiography and MRI. Int J Card Imaging 16:35–41CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Vincenzo Russo
    • 1
  • Matteo Renzulli
    • 1
  • Cesare La Palombara
    • 1
  • Rossella Fattori
    • 1
    Email author
  1. 1.Department of Radiology, Cardiovascular UnitPoliclinico S. OrsolaBolognaItaly

Personalised recommendations