Author/Authors :
Trojan, Michael Department of Diagnostic and Interventional Radiology - University Hospital Heidelberg - Im Neuenheimer Feld - Heidelberg, Germany , Rengier, Fabian Department of Diagnostic and Interventional Radiology - University Hospital Heidelberg - Im Neuenheimer Feld - Heidelberg, Germany , Kotelis, Drosos Department of Vascular and Endovascular Surgery - University Hospital Heidelberg - Im Neuenheimer Feld - Heidelberg, Germany , Müller-Eschner, Matthias Department of Diagnostic and Interventional Radiology - University Hospital Heidelberg - Im Neuenheimer Feld - Heidelberg, Germany , Partovi, Sasan Department of Radiology - University Hospitals Cleveland Medical Center - Case Western Reserve University - Euclid Ave - Cleveland, USA , Fink, Christian Department of Radiology - AKH Celle - Siemensplatz - Celle, Germany , Karmonik, Christof Houston Methodist Research Institute - Houston, USA , Böckler, Dittmar Department of Vascular and Endovascular Surgery - University Hospital Heidelberg - Im Neuenheimer Feld - Heidelberg, Germany , Kauczor, Hans-Ulrich Department of Diagnostic and Interventional Radiology - University Hospital Heidelberg - Im Neuenheimer Feld - Heidelberg, Germany , Tengg-Kobligk, Hendrik von Department of Diagnostic and Interventional Radiology - University Hospital Heidelberg - Im Neuenheimer Feld - Heidelberg, Germany
Abstract :
To prospectively evaluate our hypothesis that three-dimensional time-resolved contrast-enhanced magnetic resonance
angiography (TR-MRA) is able to detect hemodynamic alterations in patients with chronic expanding aortic dissection compared
to stable aortic dissections. Materials and Methods. 20 patients with chronic or residual aortic dissection in the descending aorta
and patent false lumen underwent TR-MRA of the aorta at 1.5 T and repeated follow-up imaging (mean follow-up 5.4 years).
7 patients showed chronic aortic expansion and 13 patients had stable aortic diameters. Regions of interest were placed in the
nondissected ascending aorta and the false lumen of the descending aorta at the level of the diaphragm (FL-diaphragm level)
resulting in respective time-intensity curves. Results. For the FL-diaphragm level, time-to-peak intensity and full width at half
maximum were significantly shorter in the expansion group compared to the stable group (𝑝 = 0.027 and 𝑝 = 0.003), and upward
and downward slopes of time-intensity curves were significantly steeper (𝑝 = 0.015 and 𝑝 = 0.005). The delay of peak intensity in
the FL-diaphragm level compared to the nondissected ascending aorta was significantly shorter in the expansion group compared
to the stable group (𝑝 = 0.01). Conclusions. 3D TR-MRA detects significant alterations of hemodynamics within the patent false
lumen of chronic expanding aortic dissections compared to stable aortic dissections.
