A non-contrast self-navigated 3-dimensional MR technique for aortic root and vascular access route assessment in the context of transcatheter aortic valve replacement: proof of concept

• Published in: European radiology Vol. 26; no. 4; pp. 951 - 958
• Main Authors: Renker, Matthias, Varga-Szemes, Akos, Schoepf, U. Joseph, Baumann, Stefan, Piccini, Davide, Zenge, Michael O., Rehwald, Wolfgang G., Müller, Edgar, Rier, Jeremy D., Möllmann, Helge, Hamm, Christian W., Steinberg, Daniel H., De Cecco, Carlo N.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2016; Springer Nature B.V
• Subjects: Adult; Aortic Valve - pathology; Aortic Valve - surgery; Aortic Valve Stenosis - pathology; Aortic Valve Stenosis - surgery; Contrast agents; Contrast Media; Coronary vessels; Diagnostic Radiology; Feasibility Studies; Healthy Volunteers; Humans; Imaging; Imaging, Three-Dimensional; Internal Medicine; Interventional Radiology; Magnetic Resonance; Magnetic Resonance Angiography - methods; Magnetic resonance imaging; Magnetic Resonance Imaging, Interventional - methods; Male; Medical imaging; Medicine; Medicine & Public Health; Neuroradiology; Patients; Prospective Studies; Radiology; Transcatheter Aortic Valve Replacement - methods; Ultrasound; Venous access; United States > US; Switzerland; Germany; Renal insufficiency; Magnetic resonance imaging; Transcatheter aortic valve replacement; Aortic valve stenosis; Contrast media
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-015-3906-x

Objectives Due to the high prevalence of renal failure in transcatheter aortic valve replacement (TAVR) candidates, a non-contrast MR technique is desirable for pre-procedural planning. We sought to evaluate the feasibility of a novel, non-contrast, free-breathing, self-navigated three-dimensional (SN3D) MR sequence for imaging the aorta from its root to the iliofemoral run-off in comparison to non-contrast two-dimensional-balanced steady-state free-precession (2D-bSSFP) imaging. Methods SN3D [field of view (FOV), 220-370 mm 3 ; slice thickness, 1.15 mm; repetition/echo time (TR/TE), 3.1/1.5 ms; and flip angle, 115°] and 2D-bSSFP acquisitions (FOV, 340 mm; slice thickness, 6 mm; TR/TE, 2.3/1.1 ms; flip angle, 77°) were performed in 10 healthy subjects (all male; mean age, 30.3 ± 4.3 yrs) using a 1.5-T MRI system. Aortic root measurements and qualitative image ratings (four-point Likert-scale) were compared. Results The mean effective aortic annulus diameter was similar for 2D-bSSFP and SN3D (26.7 ± 0.7 vs. 26.1 ± 0.9 mm, p  = 0.23). The mean image quality of 2D-bSSFP (4; IQR 3-4) was rated slightly higher ( p  = 0.03) than SN3D (3; IQR 2-4). The mean total acquisition time for SN3D imaging was 12.8 ± 2.4 min. Conclusions Our results suggest that a novel SN3D sequence allows rapid, free-breathing assessment of the aortic root and the aortoiliofemoral system without administration of contrast medium. Key Points • The prevalence of renal failure is high among TAVR candidates . • Non - contrast 3D MR angiography allows for TAVR procedure planning . • The self - navigated sequence provides a significantly reduced scanning time .