Non-contrast MRI protocol for TAVI guidance: quiescent-interval single-shot angiography in comparison with contrast-enhanced CT

Autor: Martin Reindl, Christof Kranewitter, Sebastian J. Reinstadler, Agnes Mayr, Werner Jaschke, Bernhard Metzler, Gert Klug, Mathias Pamminger, Christina Tiller, Christian Kremser, Benjamin Henninger, Axel Bauer, Magdalena Holzknecht
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Computed Tomography Angiography
medicine.medical_treatment
Heart Valve Diseases
030204 cardiovascular system & hematology
Prosthesis
030218 nuclear medicine & medical imaging
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
cardiovascular diseases
Renal insufficiency
Cardiac imaging technique
Computed tomography angiography
Neuroradiology
Aged
80 and over
Transcatheter aortic valve implantation
medicine.diagnostic_test
business.industry
Contrast media
Ultrasound
Reproducibility of Results
Interventional radiology
General Medicine
Gold standard (test)
medicine.disease
CT angiography
Surgery
Computer-Assisted
Aortic Valve
Angiography
Female
Radiology
business
Cardiac
Magnetic Resonance Angiography
Kidney disease
Zdroj: European Radiology
ISSN: 1432-1084
0938-7994
Popis: Objectives To prospectively compare unenhanced quiescent-interval single-shot MR angiography (QISS-MRA) with contrast-enhanced computed tomography angiography (CTA) for contrast-free guidance in transcatheter aortic valve intervention (TAVI). Methods Twenty-six patients (mean age 83 ± 5 years, 15 female [58%]) referred for TAVI evaluation underwent QISS-MRA for aortoiliofemoral access guidance and non-contrast three-dimensional (3D) “whole heart” MRI for prosthesis sizing on a 1.5-T system. Contrast-enhanced CTA was performed as imaging gold standard for TAVI planning. Image quality was assessed by a 4-point Likert scale; continuous MRA and CTA measurements were compared with regression and Bland-Altman analyses. Results QISS-MRA and CTA-based measurements of aortoiliofemoral vessel diameters correlated moderately to very strong (r = 0.572 to 0.851, all p ≤ 0.002) with good to excellent inter-observer reliability (intra-class correlation coefficient (ICC) = 0.862 to 0.999, all p p = 0.041 to κ = 0.866, p r = 0.679 to 0.887, all p ≤ 0.0001) to CTA measurements. Conclusion QISS-MRA provides contrast-free access route evaluation in TAVI patients with moderate to strong correlations compared with CTA and substantial inter-observer agreement. Despite some significant differences in minimal vessel diameters, inter-method agreement for transfemoral accessibility is strong. Combination with 3D whole heart MRI facilitates unenhanced TAVI guidance. Key Points • QISS-MRA and CTA inter-method agreement for transfemoral approach is strong. • QISS-MRA is a very good alternative to CTA and MRA especially in patients with Kidney Disease Outcomes Quality Initiativestages 4 and 5. • Combination of QISS-MRA and 3D “whole heart” MRI facilitates fully unenhanced TAVI guidance.
Databáze: OpenAIRE
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