title: Assessment of aortic root dimensions in patients with suspected Marfan syndrome: intraindividual comparison of contrast-enhanced and non-contrast magnetic resonance angiography with echocardiography.
abstract: OBJECTIVE
  Our purpose was to evaluate intraindividually the performance of contrast-enhanced magnetic resonance angiography (MRA) and non-contrast MRA for aortic root diameter measurements and to compare the results with routinely performed echocardiography in patients with suspected Marfan syndrome.
  
  
  METHODS
  Aortic roots were examined prospectively in 51 consecutive patients with suspected Marfan syndrome by using contrast-enhanced MRA and non-contrast MRA at 1.5 T. Two readers independently measured aortic root diameters at the annulus, sinuses of Valsalva and sinutubular junction in both data sets and compared results with echocardiographic data. Intraclass correlation coefficient, Pearson correlation coefficient, Bland-Altman, and two-sided t-test were used to assess agreement between observers and methods.
  
  
  RESULTS
  38 (74.5%) of the 51 patients (25 female, 26 male; mean age 37.1 ± 13.7 years) had Marfan syndrome. Both, contrast-enhanced MRA and non-contrast MRA measurements of the sinuses of Valsalva revealed a strong correlation with echocardiography (r=0.850 and r=0.893, respectively). Intraclass correlation was markedly better for non-enhanced MRA (r=0.904) when compared to contrast-enhanced MRA (r=0.690). Image quality (p<0.001) as well as interobserver agreement (p<0.0042) of measurements of the sinuses of Valsalva was significantly better for non-enhanced MRA than for contrast-enhanced MRA.
  
  
  CONCLUSIONS
  Non-contrast MRA was more reliable and more valid than contrast-enhanced MRA for assessment of aortic root dimensions in patients with suspected Marfan syndrome. Therefore contrast agents can be omitted for establishing the diagnosis of aortic involvement in Marfan syndrome.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Hamburg, Germany. p.bannas@uke.de
authors.forename: Peter
authors.initials: P
authors.lastname: Bannas
authors.forename: Michael
authors.initials: M
authors.lastname: Groth
authors.forename: Meike
authors.initials: M
authors.lastname: Rybczynski
authors.forename: Sara
authors.initials: S
authors.lastname: Sheikhzadeh
authors.forename: Yskert
authors.initials: Y
authors.lastname: von Kodolitsch
authors.forename: Joachim
authors.initials: J
authors.lastname: Graessner
authors.forename: Gunnar
authors.initials: G
authors.lastname: Lund
authors.forename: Gerhard
authors.initials: G
authors.lastname: Adam
authors.forename: Christian R
authors.initials: CR
authors.lastname: Habermann
mesh_terms: D000328:Adult; D001027:Aortography / Q000592:standards*; D003287:Contrast Media; D004452:Echocardiography / Q000592:standards*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000592:standards*; D008297:Male; D008382:Marfan Syndrome / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D003287:Contrast Media