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Treitl, Karla Maria; Maurus, Stefan; Sommer, Nora Narvina; Kooijman-Kurfürst, Hendrik; Coppenrath, Eva; Treitl, Marcus; Czihal, Michael; Hoffmann, Ulrich; Dechant, Claudia; Schulze-Koops, Hendrik und Saam, Tobias (2017): 3D-black-blood 3T-MRI for the diagnosis of thoracic large vessel vasculitis: A feasibility study. In: European Radiology, Bd. 27, Nr. 5: S. 2119-2128

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Abstract

To evaluate the feasibility of T1w-3D black-blood turbo spin echo (TSE) sequence with variable flip angles for the diagnosis of thoracic large vessel vasculitis (LVV). Thirty-five patients with LVV, diagnosed according to the current standard of reference, and 35 controls were imaged at 3.0T using 1.2 x 1.3 x 2.0 mm(3) fat-suppressed, T1w-3D, modified Volumetric Isotropic TSE Acquisition (mVISTA) pre- and post-contrast. Applying a navigator and peripheral pulse unit triggering (PPU), the total scan time was 10-12 min. Thoracic aorta and subclavian and pulmonary arteries were evaluated for image quality (IQ), flow artefact intensity, diagnostic confidence, concentric wall thickening and contrast enhancement (CWT, CCE) using a 4-point scale. IQ was good in all examinations (3.25 +/- 0.72) and good to excellent in 342 of 408 evaluated segments (83.8 %), while 84.1 % showed no or minor flow artefacts. The interobserver reproducibility for the identification of CCE and CWT was 0.969 and 0.971 (p < 0.001) with an average diagnostic confidence of 3.47 +/- 0.64. CCE and CWT were strongly correlated (Cohen's k = 0.87;P < 0.001) and significantly more frequent in the LVV-group (52.8 % vs. 1.0 %;59.8 % vs. 2.4 %;P < 0.001). Navigated fat-suppressed T1w-3D black-blood MRI with PPU-triggering allows diagnosis of thoracic LVV. aEuro cent Cross-sectional imaging is frequently applied in the diagnosis of LVV. aEuro cent Navigated, PPU-triggered, T1w-3D mVISTA pre- and post contrast takes 10-12 min. aEuro cent In this prospective, single-centre study, T1w-3D mVISTA accurately depicted large thoracic vessels. aEuro cent T1w-3D mVISTA visualized CWT/CCW as correlates of mural inflammation in LVV. aEuro cent T1w-3D mVISTA might be an alternative diagnostic tool without ionizing radiation.

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