3D MRI provides improved visualization and detection of aortic arch plaques compared to transesophageal echocardiography
3D MRI provides improved visualization and detection of aortic arch plaques compared to transesophageal echocardiography
复制标题
DOI：
10.1002/jmri.23679
复制
发表时间：
2012-09-01
影响因子：
4.4
通讯作者：
Markl, Michael
中科院分区：
文献类型：
--
作者：
Harloff, Andreas;Brendecke, Stefanie Marie;Markl, Michael
目的：比较3D磁共振成像（3D MRI）与经食管超声心动图（TEE）检测复杂主动脉斑块（≥ 4 mm厚、溃疡或含有移动的血栓）的效果。材料与方法：总共前瞻性纳入了99例急性隐源性卒中和TEE显示≥ 3 mm厚主动脉斑块的连续患者。3D MRI包括T1加权亮血MRI，完全覆盖主动脉（空间分辨率1 mm 3）。通过MRI和TEE评估升主动脉（AAo）、主动脉弓（AA）和降主动脉（DAo）的壁厚和复杂斑块的发生率以及每个节段的图像质量。结果：MRI检测到的复杂斑块多于TEE（MRI vs. TEE）：AAo 13 vs. 7; AA 37 vs. 11; DAo差异较小：101 vs. 70。AAo和AA的MRI图像质量较高（P < 0.001），而DAo的TEE图像质量较上级（P < 0.001）。MRI显示，在包括TEE在内的完整常规诊断后，58例患者中有19例（32.8%）的近端主动脉中存在额外的复杂斑块，这些患者被归类为隐源性。结论：由于改善了主动脉的可视化，3D MRI可以检测比TEE更复杂的斑块。这使得3D MRI对隐源性卒中患者和评估主动脉粥样硬化最佳治疗的试验特别有价值。J. Magn. Reson. Imaging 2012;36：604611. (C)2012 Wiley Periodicals，Inc.
Purpose: To compare 3D magnetic resonance imaging (3D MRI) with transesophageal echocardiography (TEE) for the detection of complex aortic plaques (=4 mm thick, ulcerated, or containing mobile thrombi). Materials and Methods: In all, 99 consecutive patients with acute cryptogenic stroke and =3 mm thick aortic plaques in TEE were prospectively included. 3D MRI comprised T1-weighted bright blood MRI with complete aortic coverage (spatial resolution 1 mm3). Wall thickness and occurrence of complex plaques in ascending aorta (AAo), aortic arch (AA), and descending aorta (DAo) and image quality for each segment was rated for MRI and TEE. Results: MRI detected more complex plaques than TEE (MRI vs. TEE): AAo 13 vs. 7; AA 37 vs. 11; differences were smaller in the DAo: 101 vs. 70. Image quality was higher for MRI in AAo and AA (P < 0.001) and superior for TEE in DAo (P < 0.001). MRI revealed additional complex plaques in the proximal aorta in 19 of 58 patients (32.8%) categorized as cryptogenic after complete routine diagnostics including TEE. Conclusion: Due to improved visualization of the aorta 3D MRI allows to detect more complex plaques than TEE. This renders 3D MRI particularly valuable for patients with cryptogenic stroke and for trials evaluating optimal treatment in aortic atherosclerosis. J. Magn. Reson. Imaging 2012;36:604611. (C) 2012 Wiley Periodicals, Inc.