title: 3D-black-blood 3T-MRI for the diagnosis of thoracic large vessel vasculitis: A feasibility study.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  Thirty-five patients with LVV, diagnosed according to the current standard of reference, and 35 controls were imaged at 3.0T using 1.2 × 1.3 × 2.0 mm3fat-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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  Navigated fat-suppressed T1w-3D black-blood MRI with PPU-triggering allows diagnosis of thoracic LVV.
  
  
  CONCLUSIONS
  • Cross-sectional imaging is frequently applied in the diagnosis of LVV. • Navigated, PPU-triggered, T1w-3D mVISTA pre- and post contrast takes 10-12 min. • In this prospective, single-centre study, T1w-3D mVISTA accurately depicted large thoracic vessels. • T1w-3D mVISTA visualized CWT/CCW as correlates of mural inflammation in LVV. • T1w-3D mVISTA might be an alternative diagnostic tool without ionizing radiation.
authors: Institute for Clinical Radiology, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany. karlamaria.treitl@med.uni-muenchen.de.|German Center for Cardiovascular Disease Research (DZHK e. V.), Pettenkoferstr. 8a, 80336, Munich, Germany. karlamaria.treitl@med.uni-muenchen.de.
authors: Karla Maria
authors: http://orcid.org/0000-0002-3748-4614
authors: KM
authors: Treitl
authors: Institute for Clinical Radiology, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany.
authors: Stefan
authors: S
authors: Maurus
authors: Institute for Clinical Radiology, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany.
authors: Nora Narvina
authors: NN
authors: Sommer
authors: Philips Healthcare, Lübeckertordamm 5, 20099, Hamburg, Germany.
authors: Hendrik
authors: H
authors: Kooijman-Kurfuerst
authors: Institute for Clinical Radiology, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany.
authors: Eva
authors: E
authors: Coppenrath
authors: Institute for Clinical Radiology, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany.
authors: Marcus
authors: M
authors: Treitl
authors: Division of Vascular Medicine, Medical Clinic and Policlinic IV, LMU Munich, Pettenkoferstr. 8a, D-80336, Munich, Germany.
authors: Michael
authors: M
authors: Czihal
authors: Division of Vascular Medicine, Medical Clinic and Policlinic IV, LMU Munich, Pettenkoferstr. 8a, D-80336, Munich, Germany.
authors: Ulrich
authors: U
authors: Hoffmann
authors: Division of Rheumatology and Clinical Immunology, Medical Clinic and Policlinic IV, LMU Munich, Pettenkoferstr. 8a, D-80336, Munich, Germany.
authors: Claudia
authors: C
authors: Dechant
authors: Division of Rheumatology and Clinical Immunology, Medical Clinic and Policlinic IV, LMU Munich, Pettenkoferstr. 8a, D-80336, Munich, Germany.
authors: Hendrik
authors: H
authors: Schulze-Koops
authors: Institute for Clinical Radiology, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany.|German Center for Cardiovascular Disease Research (DZHK e. V.), Pettenkoferstr. 8a, 80336, Munich, Germany.
authors: Tobias
authors: T
authors: Saam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001025:Aortitis / Q000000981:diagnostic imaging; D016477:Artifacts; D005240:Feasibility Studies; D005260:Female; D013700:Giant Cell Arteritis / Q000000981:diagnostic imaging; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D015203:Reproducibility of Results; D013348:Subclavian Artery / Q000000981:diagnostic imaging; D013625:Takayasu Arteritis / Q000000981:diagnostic imaging; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods; D014657:Vasculitis / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Aortitis; Giant cell arteritis; Magnetic resonance imaging; Systemic vasculitis; Takayasu arteritis