3D black-blood 3T-MRI for the diagnosis of abdominal large vessel vasculitis
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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.
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).
T1-mVISTA enables the evaluation of the MAWT and allows the detection of abdominal LVV.
• 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.
KeywordsVasculitis Aortitis Magnetic resonance imaging
Concentric contrast enhancement
Concentric wall thickening
Enhanced T1 high-resolution isotropic volume excitation
Flow artifact intensity
Large vessel vasculitis
Mean aortic wall thickness
Magnetic resonance imaging
Modified volumetric isotropic TSE acquisition
Turbo spin echo
The authors state that this work has not received any funding.
Compliance with ethical standards
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.
Written informed consent was obtained from all subjects (patients) in this study.
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.
• case-control study
• performed at one institution
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