[Contrast-enhanced 3D MR angiography of the pulmonary arteries with integrated parallel acquisition technique (iPAT) in patients with chronic-thromboembolic pulmonary hypertension CTEPH - sagittal or coronal acquisition?].
OBJECTIVE
Comparison of two different types of contrast-enhanced 3D-MR angiography (CE-MRA) with integrated parallel acquisition technique (iPAT) in patients with chronic-thromboembolic pulmonary hypertension (CTEPH) and evaluation whether sagittal acquisition with higher resolution and minimized acquisition time is superior to common coronal orientation.


METHODS
CE-MRA was performed on 15 patients with CTEPH preoperatively and on 10 patients also postoperatively, while 5 other patients received only a postoperative MRA. All 30 MR studies with one coronal and two sagittal acquisitions were blindly evaluated and compared. The resolution of coronal and sagittal MRA was 1.3 x 0.6 x 1.4 mm (3) and 1.2 x 1.2 x 1.2 mm (3), and acquisition time 20 and 17 sec (iPAT factor 2, GRAPPA), respectively. Image quality, coverage of the pulmonary arteries, delineation of patent segmental and sub-segmental vessels and pathological findings were assessed. A total of 1980 vessels were evaluated.


RESULTS
Sagittal 3D-MRA was superior in overall image quality and complete coverage of the vessels compared to coronal MRA, 18 % of subsegmental and 4.3 % of segmental arteries as well as 1.1 % of the lobar vessels were not covered by coronal acquisition. Only 0.5 % of sagittal subsegments were missed. The number of depicted patent segmental and subsegmental arteries was higher in sagittal MRA (460 vs 489 and 573 vs 649, respectively), the total difference of patent vessels was 105. Sagittal MRA revealed more pathological findings in segmental arteries (especially thrombotic material and stenoses).


CONCLUSIONS
Sagittal CE-MRA of the pulmonary arteries with higher resolution and short acquisition time proved to be superior in all assessed criterias like image quality, vessel coverage, depiction of patent peripheral arteries and pathological findings compared to coronal MRA. The applied sagittal MRA is recommended for the routine practise in diagnostic evaluation of patients with CTEPH.
Oberholzer
K
K
Klinik für Radiologie, Johannes Gutenberg-Universität Mainz. oberholz@radiologie.klinik.uni-mainz.de
Romaneehsen
B
B
Kunz
P
P
Kramm
T
T
Thelen
M
M
Kreitner
K-F
KF
D002908:Chronic Disease; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis*; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011651:Pulmonary Artery; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000601:surgery
D003287:Contrast Media; D019786:Gadolinium DTPA