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European Radiology

, Volume 30, Issue 2, pp 1041–1044 | Cite as

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

  • Stefan MaurusEmail author
  • Nora N. Sommer
  • Hendrik Kooijman
  • Eva Coppenrath
  • Matthias Witt
  • Hendrik Schulze-Koops
  • Michael Czihal
  • Ulrich Hoffmann
  • Tobias Saam
  • Karla M. Treitl
Magnetic Resonance
  • 81 Downloads

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.

Keywords

Vasculitis Aortitis Magnetic resonance imaging 

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

Notes

Funding information

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

Compliance with ethical standards

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

Supplementary material

330_2019_6432_MOESM1_ESM.docx (42 kb)
ESM 1 (DOCX 42 kb)

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Stefan Maurus
    • 1
    Email author
  • Nora N. Sommer
    • 1
  • Hendrik Kooijman
    • 2
  • Eva Coppenrath
    • 1
  • Matthias Witt
    • 3
  • Hendrik Schulze-Koops
    • 3
  • Michael Czihal
    • 4
  • Ulrich Hoffmann
    • 4
  • Tobias Saam
    • 5
  • Karla M. Treitl
    • 1
    • 6
  1. 1.Department of Radiology, University HospitalLMU MunichMunichGermany
  2. 2.Philips HealthcareHamburgGermany
  3. 3.Division of Rheumatology and Clinical Immunology, Medical Clinic and Policlinic IV, University HospitalLMU MunichMunichGermany
  4. 4.Division of Vascular Medicine, Medical Clinic and Policlinic IV, University HospitalLMU MunichMunichGermany
  5. 5.Radiologisches Zentrum RosenheimRosenheimGermany
  6. 6.German Center for Cardiovascular Disease Research (DZHK e. V.)MunichGermany

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