Non-contrast MRI protocol for TAVI guidance: quiescent-interval single-shot angiography in comparison with contrast-enhanced CT
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 fe...
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| Veröffentlicht in: | European radiology 2020-09, Vol.30 (9), p.4847-4856 |
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| creator | Pamminger, Mathias Klug, Gert Kranewitter, Christof Reindl, Martin Reinstadler, Sebastian J. Henninger, Benjamin Tiller, Christina Holzknecht, Magdalena Kremser, Christian Bauer, Axel Jaschke, Werner Metzler, Bernhard Mayr, Agnes |
| description | 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
|
| doi_str_mv | 10.1007/s00330-020-06832-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7431439</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2434612118</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-1f2fc0985b1285047b821e7adabf34ded083e1f4eaee1f841e02d69ba32763c43</originalsourceid><addsrcrecordid>eNp9kctu1DAUhi0EotPCC7BAltiwMfjW2GaBVI0ojFRAQgNby3GcxFXGTm2nqCteHQ_TlsuChXUsne_85_ID8IzgVwRj8TpjzBhGmNbXSEaReABWhNcPwZI_BCusmERCKX4EjnO-xBgrwsVjcMQoI1JytQI_PsWAbAwlmVzgxy8bOKdYoo0T7GOC27NvGzgsvjPBujfwavEuWxcK8qG4dG0mmH0YJofyGAs0YfBxSGYeb6AP0MbdbJLPMcDvvozwrg1yYdzrdXC9fQIe9WbK7ultPAFfz99t1x_Qxef3m_XZBbJc8IJIT3uLlTxtCZWnmItWUuKE6UzbM965DkvmSM-dcTVIThymXaNaw6homOXsBLw96M5Lu3PdfodkJj0nvzPpRkfj9d-Z4Ec9xGstOKsnVVXg5a1AileLy0XvfD3FNJng4pI1rUxDVaNwRV_8g17GJYW6nqac8YZQQmSl6IGyKeacXH8_DMF6768--Kurv_qXv1rUoud_rnFfcmdoBdgByDUVBpd-9_6P7E8TPbNH</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2434612118</pqid></control><display><type>article</type><title>Non-contrast MRI protocol for TAVI guidance: quiescent-interval single-shot angiography in comparison with contrast-enhanced CT</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Pamminger, Mathias ; Klug, Gert ; Kranewitter, Christof ; Reindl, Martin ; Reinstadler, Sebastian J. ; Henninger, Benjamin ; Tiller, Christina ; Holzknecht, Magdalena ; Kremser, Christian ; Bauer, Axel ; Jaschke, Werner ; Metzler, Bernhard ; Mayr, Agnes</creator><creatorcontrib>Pamminger, Mathias ; Klug, Gert ; Kranewitter, Christof ; Reindl, Martin ; Reinstadler, Sebastian J. ; Henninger, Benjamin ; Tiller, Christina ; Holzknecht, Magdalena ; Kremser, Christian ; Bauer, Axel ; Jaschke, Werner ; Metzler, Bernhard ; Mayr, Agnes</creatorcontrib><description>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
< 0.0001) regarding QISS assessment. Mean diameters of the infrarenal aorta and iliofemoral vessels differed significantly (bias 0.37 to 0.98 mm,
p
= 0.041 to < 0.0001) between the two modalities. However, inter-method decision for transfemoral access route was comparable (
κ
= 0.866,
p
< 0.0001). Aortic root parameters assessed by 3D whole heart MRI strongly correlated (
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.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-020-06832-7</identifier><identifier>PMID: 32318849</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Access routes ; Aged, 80 and over ; Angiography ; Aorta ; Aortic valve ; Aortic Valve - diagnostic imaging ; Aortic Valve - surgery ; Blood vessels ; Cardiac ; Computed tomography ; Computed Tomography Angiography - methods ; Contrast Media - pharmacology ; Correlation analysis ; Correlation coefficient ; Correlation coefficients ; Diagnostic Radiology ; Diameters ; Evaluation ; Female ; Heart ; Heart Valve Diseases - diagnosis ; Heart Valve Diseases - surgery ; Heart valves ; Humans ; Image enhancement ; Image quality ; Imaging ; Internal Medicine ; Interventional Radiology ; Kidney diseases ; Magnetic Resonance Angiography - methods ; Magnetic resonance imaging ; Male ; Medical imaging ; Medicine ; Medicine & Public Health ; Neuroradiology ; Prostheses ; Quality assessment ; Radiology ; Regression analysis ; Reproducibility of Results ; Rheumatic heart disease ; Surgery, Computer-Assisted - methods ; Transcatheter Aortic Valve Replacement - methods ; Ultrasound</subject><ispartof>European radiology, 2020-09, Vol.30 (9), p.4847-4856</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-1f2fc0985b1285047b821e7adabf34ded083e1f4eaee1f841e02d69ba32763c43</citedby><cites>FETCH-LOGICAL-c474t-1f2fc0985b1285047b821e7adabf34ded083e1f4eaee1f841e02d69ba32763c43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-020-06832-7$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-020-06832-7$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32318849$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pamminger, Mathias</creatorcontrib><creatorcontrib>Klug, Gert</creatorcontrib><creatorcontrib>Kranewitter, Christof</creatorcontrib><creatorcontrib>Reindl, Martin</creatorcontrib><creatorcontrib>Reinstadler, Sebastian J.</creatorcontrib><creatorcontrib>Henninger, Benjamin</creatorcontrib><creatorcontrib>Tiller, Christina</creatorcontrib><creatorcontrib>Holzknecht, Magdalena</creatorcontrib><creatorcontrib>Kremser, Christian</creatorcontrib><creatorcontrib>Bauer, Axel</creatorcontrib><creatorcontrib>Jaschke, Werner</creatorcontrib><creatorcontrib>Metzler, Bernhard</creatorcontrib><creatorcontrib>Mayr, Agnes</creatorcontrib><title>Non-contrast MRI protocol for TAVI guidance: quiescent-interval single-shot angiography in comparison with contrast-enhanced CT</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>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
< 0.0001) regarding QISS assessment. Mean diameters of the infrarenal aorta and iliofemoral vessels differed significantly (bias 0.37 to 0.98 mm,
p
= 0.041 to < 0.0001) between the two modalities. However, inter-method decision for transfemoral access route was comparable (
κ
= 0.866,
p
< 0.0001). Aortic root parameters assessed by 3D whole heart MRI strongly correlated (
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.</description><subject>Access routes</subject><subject>Aged, 80 and over</subject><subject>Angiography</subject><subject>Aorta</subject><subject>Aortic valve</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - surgery</subject><subject>Blood vessels</subject><subject>Cardiac</subject><subject>Computed tomography</subject><subject>Computed Tomography Angiography - methods</subject><subject>Contrast Media - pharmacology</subject><subject>Correlation analysis</subject><subject>Correlation coefficient</subject><subject>Correlation coefficients</subject><subject>Diagnostic Radiology</subject><subject>Diameters</subject><subject>Evaluation</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Valve Diseases - diagnosis</subject><subject>Heart Valve Diseases - surgery</subject><subject>Heart valves</subject><subject>Humans</subject><subject>Image enhancement</subject><subject>Image quality</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Kidney diseases</subject><subject>Magnetic Resonance Angiography - methods</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroradiology</subject><subject>Prostheses</subject><subject>Quality assessment</subject><subject>Radiology</subject><subject>Regression analysis</subject><subject>Reproducibility of Results</subject><subject>Rheumatic heart disease</subject><subject>Surgery, Computer-Assisted - methods</subject><subject>Transcatheter Aortic Valve Replacement - methods</subject><subject>Ultrasound</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kctu1DAUhi0EotPCC7BAltiwMfjW2GaBVI0ojFRAQgNby3GcxFXGTm2nqCteHQ_TlsuChXUsne_85_ID8IzgVwRj8TpjzBhGmNbXSEaReABWhNcPwZI_BCusmERCKX4EjnO-xBgrwsVjcMQoI1JytQI_PsWAbAwlmVzgxy8bOKdYoo0T7GOC27NvGzgsvjPBujfwavEuWxcK8qG4dG0mmH0YJofyGAs0YfBxSGYeb6AP0MbdbJLPMcDvvozwrg1yYdzrdXC9fQIe9WbK7ultPAFfz99t1x_Qxef3m_XZBbJc8IJIT3uLlTxtCZWnmItWUuKE6UzbM965DkvmSM-dcTVIThymXaNaw6homOXsBLw96M5Lu3PdfodkJj0nvzPpRkfj9d-Z4Ec9xGstOKsnVVXg5a1AileLy0XvfD3FNJng4pI1rUxDVaNwRV_8g17GJYW6nqac8YZQQmSl6IGyKeacXH8_DMF6768--Kurv_qXv1rUoud_rnFfcmdoBdgByDUVBpd-9_6P7E8TPbNH</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Pamminger, Mathias</creator><creator>Klug, Gert</creator><creator>Kranewitter, Christof</creator><creator>Reindl, Martin</creator><creator>Reinstadler, Sebastian J.</creator><creator>Henninger, Benjamin</creator><creator>Tiller, Christina</creator><creator>Holzknecht, Magdalena</creator><creator>Kremser, Christian</creator><creator>Bauer, Axel</creator><creator>Jaschke, Werner</creator><creator>Metzler, Bernhard</creator><creator>Mayr, Agnes</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200901</creationdate><title>Non-contrast MRI protocol for TAVI guidance: quiescent-interval single-shot angiography in comparison with contrast-enhanced CT</title><author>Pamminger, Mathias ; Klug, Gert ; Kranewitter, Christof ; Reindl, Martin ; Reinstadler, Sebastian J. ; Henninger, Benjamin ; Tiller, Christina ; Holzknecht, Magdalena ; Kremser, Christian ; Bauer, Axel ; Jaschke, Werner ; Metzler, Bernhard ; Mayr, Agnes</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-1f2fc0985b1285047b821e7adabf34ded083e1f4eaee1f841e02d69ba32763c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Access routes</topic><topic>Aged, 80 and over</topic><topic>Angiography</topic><topic>Aorta</topic><topic>Aortic valve</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - surgery</topic><topic>Blood vessels</topic><topic>Cardiac</topic><topic>Computed tomography</topic><topic>Computed Tomography Angiography - methods</topic><topic>Contrast Media - pharmacology</topic><topic>Correlation analysis</topic><topic>Correlation coefficient</topic><topic>Correlation coefficients</topic><topic>Diagnostic Radiology</topic><topic>Diameters</topic><topic>Evaluation</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Valve Diseases - diagnosis</topic><topic>Heart Valve Diseases - surgery</topic><topic>Heart valves</topic><topic>Humans</topic><topic>Image enhancement</topic><topic>Image quality</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Kidney diseases</topic><topic>Magnetic Resonance Angiography - methods</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroradiology</topic><topic>Prostheses</topic><topic>Quality assessment</topic><topic>Radiology</topic><topic>Regression analysis</topic><topic>Reproducibility of Results</topic><topic>Rheumatic heart disease</topic><topic>Surgery, Computer-Assisted - methods</topic><topic>Transcatheter Aortic Valve Replacement - methods</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pamminger, Mathias</creatorcontrib><creatorcontrib>Klug, Gert</creatorcontrib><creatorcontrib>Kranewitter, Christof</creatorcontrib><creatorcontrib>Reindl, Martin</creatorcontrib><creatorcontrib>Reinstadler, Sebastian J.</creatorcontrib><creatorcontrib>Henninger, Benjamin</creatorcontrib><creatorcontrib>Tiller, Christina</creatorcontrib><creatorcontrib>Holzknecht, Magdalena</creatorcontrib><creatorcontrib>Kremser, Christian</creatorcontrib><creatorcontrib>Bauer, Axel</creatorcontrib><creatorcontrib>Jaschke, Werner</creatorcontrib><creatorcontrib>Metzler, Bernhard</creatorcontrib><creatorcontrib>Mayr, Agnes</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pamminger, Mathias</au><au>Klug, Gert</au><au>Kranewitter, Christof</au><au>Reindl, Martin</au><au>Reinstadler, Sebastian J.</au><au>Henninger, Benjamin</au><au>Tiller, Christina</au><au>Holzknecht, Magdalena</au><au>Kremser, Christian</au><au>Bauer, Axel</au><au>Jaschke, Werner</au><au>Metzler, Bernhard</au><au>Mayr, Agnes</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Non-contrast MRI protocol for TAVI guidance: quiescent-interval single-shot angiography in comparison with contrast-enhanced CT</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2020-09-01</date><risdate>2020</risdate><volume>30</volume><issue>9</issue><spage>4847</spage><epage>4856</epage><pages>4847-4856</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>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
< 0.0001) regarding QISS assessment. Mean diameters of the infrarenal aorta and iliofemoral vessels differed significantly (bias 0.37 to 0.98 mm,
p
= 0.041 to < 0.0001) between the two modalities. However, inter-method decision for transfemoral access route was comparable (
κ
= 0.866,
p
< 0.0001). Aortic root parameters assessed by 3D whole heart MRI strongly correlated (
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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32318849</pmid><doi>10.1007/s00330-020-06832-7</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0938-7994 |
| ispartof | European radiology, 2020-09, Vol.30 (9), p.4847-4856 |
| issn | 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7431439 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Access routes Aged, 80 and over Angiography Aorta Aortic valve Aortic Valve - diagnostic imaging Aortic Valve - surgery Blood vessels Cardiac Computed tomography Computed Tomography Angiography - methods Contrast Media - pharmacology Correlation analysis Correlation coefficient Correlation coefficients Diagnostic Radiology Diameters Evaluation Female Heart Heart Valve Diseases - diagnosis Heart Valve Diseases - surgery Heart valves Humans Image enhancement Image quality Imaging Internal Medicine Interventional Radiology Kidney diseases Magnetic Resonance Angiography - methods Magnetic resonance imaging Male Medical imaging Medicine Medicine & Public Health Neuroradiology Prostheses Quality assessment Radiology Regression analysis Reproducibility of Results Rheumatic heart disease Surgery, Computer-Assisted - methods Transcatheter Aortic Valve Replacement - methods Ultrasound |
| title | Non-contrast MRI protocol for TAVI guidance: quiescent-interval single-shot angiography in comparison with contrast-enhanced CT |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T21%3A56%3A29IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Non-contrast%20MRI%20protocol%20for%20TAVI%20guidance:%20quiescent-interval%20single-shot%20angiography%20in%20comparison%20with%20contrast-enhanced%20CT&rft.jtitle=European%20radiology&rft.au=Pamminger,%20Mathias&rft.date=2020-09-01&rft.volume=30&rft.issue=9&rft.spage=4847&rft.epage=4856&rft.pages=4847-4856&rft.issn=0938-7994&rft.eissn=1432-1084&rft_id=info:doi/10.1007/s00330-020-06832-7&rft_dat=%3Cproquest_pubme%3E2434612118%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2434612118&rft_id=info:pmid/32318849&rfr_iscdi=true |