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Salehi Ravesh M, Langguth P, Pfarr JA, Schupp J, Trentmann J, Koktzoglou I, Edelman RR, Graessner J, Greiser A, Hautemann D, Hennemuth A, Both M, Jansen O, Hövener JB, Schäfer JP. Non-contrast-enhanced magnetic resonance imaging for visualization and quantification of endovascular aortic prosthesis, their endoleaks and aneurysm sacs at 1.5 T. Magn Reson Imaging 2019; 60:164-172. [PMID: 31075419 DOI: 10.1016/j.mri.2019.05.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/07/2019] [Accepted: 05/04/2019] [Indexed: 01/28/2023]
Abstract
PURPOSE After an endovascular aortic aneurysm repair (EVAR), a follow-up at 1, 6 and every 12 months is recommended for remainder of the patient's life. The diagnostic standard methods for diagnosing endoleaks and visualization of aneurysms in EVAR-patients are: invasive digital subtraction angiography (DSA), contrast enhanced (CE) computed tomographic angiography (CE-CTA), and magnetic resonance angiography (CE-MRA). These techniques, however, require the use of iodine- or gadolinium-based contrast agents with rare, but possibly life threatening side effects such as renal impairment, thyrotoxicosis and allergic reactions, nephrogenic systemic fibrosis, and cerebral gadolinium deposition. The aim of this prospective study was to compare a non-contrast-enhanced MRI protocol (consist of four MRI methods) with DSA and CE-CTA for visualization and quantification of endovascular aortic prosthesis, their endoleaks and aneurysms. MATERIAL AND METHODS Eight patients (mean age 76.8 ± 4.9 years, 63% male), whose thoracic, abdominal, or iliac aneurysms were treated with different endovascular prosthesis and suffered from type I-V endoleaks, were examined on a 1.5 Tesla MR system. Quiescent-interval slice selective MR angiography (QISS-MRA), 4-dimensional (4D)-flow MRI, T1- and T2-mapping, as well as DSA and CE-CTA were used for the visualization and quantification of endoprosthesis, endoleaks, and aneurysms in these patients. RESULTS QISS-MRA provided good visualization of endoleaks and comparable quantification of aneurysm size with respect to CE-CTA and DSA. The 4D-flow MRI provided additional information about the wall shear stress, which could not be determined using DSA. In contrast to CE-CTA, T1- and T2-mapping provided detailed information about heterogeneous areas within an aneurysm sac. CONCLUSIONS Compared to DSA and CE-CTA, the proposed MRI methods provide improved anatomical and functional information for various types of endoprostheses and endoleaks. In addition, hemodynamic parameters of the aorta and information on the content of aneurysm sac are provided as well. Within the frame of personalized medicine, the personalized diagnosis enabled by this non-CE MRI protocol is the foundation for a personalized and successful treatment.
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Affiliation(s)
- Mona Salehi Ravesh
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany; Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany.
| | - Patrick Langguth
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Julian Andreas Pfarr
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Jasper Schupp
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Jens Trentmann
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Ioannis Koktzoglou
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA; University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - Robert R Edelman
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | | | | - Marcus Both
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Olav Jansen
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Jan-Bernd Hövener
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Jost Philipp Schäfer
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
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Bertrand-Grenier A, Lerouge S, Tang A, Salloum E, Therasse E, Kauffmann C, Héon H, Salazkin I, Cloutier G, Soulez G. Abdominal aortic aneurysm follow-up by shear wave elasticity imaging after endovascular repair in a canine model. Eur Radiol 2016; 27:2161-2169. [PMID: 27572808 DOI: 10.1007/s00330-016-4524-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 07/20/2016] [Accepted: 07/21/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To investigate if shear wave imaging (SWI) can detect endoleaks and characterize thrombus organization in abdominal aortic aneurysms (AAAs) after endovascular aneurysm repair. METHODS Stent grafts (SGs) were implanted in 18 dogs after surgical creation of type I endoleaks (four AAAs), type II endoleaks (13 AAAs) and no endoleaks (one AAA). Color flow Doppler ultrasonography (DUS) and SWI were performed before SG implantation (baseline), on days 7, 30 and 90 after SG implantation, and on the day of the sacrifice (day 180). Angiography, CT scans and macroscopic tissue sections obtained on day 180 were evaluated for the presence, size and type of endoleaks, and thrombi were characterized as fresh or organized. Endoleak areas in aneurysm sacs were identified on SWI by two readers and compared with their appearance on DUS, CT scans and macroscopic examination. Elasticity moduli were calculated in different regions (endoleaks, and fresh and organized thrombi). RESULTS All 17 endoleaks (100 %) were identified by reader 1, whereas 16 of 17 (94 %) were detected by reader 2. Elasticity moduli in endoleaks, and in areas of organized thrombi and fresh thrombi were 0.2 ± 0.4, 90.0 ± 48.2 and 13.6 ± 4.5 kPa, respectively (P < 0.001 between groups). SWI detected endoleaks while DUS (three endoleaks) and CT (one endoleak) did not. CONCLUSIONS SWI has the potential to detect endoleaks and evaluate thrombus organization based on the measurement of elasticity. KEY POINTS • SWI has the potential to detect endoleaks in post-EVAR follow-up. • SWI has the potential to characterize thrombus organization in post-EVAR follow-up. • SWI may be combined with DUS in post-EVAR surveillance of endoleak.
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Affiliation(s)
- Antony Bertrand-Grenier
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Laboratoire de biorhéologie et d'ultrasonographie médicale, CRCHUM, Montréal, Québec, Canada.,Laboratoire clinique de traitement d'images, CRCHUM, Montréal, Québec, Canada.,Département de physique, Université de Montréal, Montréal, Québec, Canada
| | - Sophie Lerouge
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Laboratoire de biomatériaux endovasculaire, CRCHUM, Montréal, Québec, Canada.,Département de génie mécanique, École de technologie supérieure, Montréal, Québec, Canada
| | - An Tang
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Laboratoire clinique de traitement d'images, CRCHUM, Montréal, Québec, Canada.,Département de radiologie, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.,Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, Québec, Canada.,Institut de génie biomédical, Université de Montréal, Montréal, Québec, Canada
| | - Eli Salloum
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Laboratoire de biorhéologie et d'ultrasonographie médicale, CRCHUM, Montréal, Québec, Canada.,Laboratoire clinique de traitement d'images, CRCHUM, Montréal, Québec, Canada
| | - Eric Therasse
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Département de radiologie, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.,Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, Québec, Canada
| | - Claude Kauffmann
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Laboratoire clinique de traitement d'images, CRCHUM, Montréal, Québec, Canada.,Département de radiologie, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.,Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, Québec, Canada
| | - Hélène Héon
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | - Igor Salazkin
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | - Guy Cloutier
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Laboratoire de biorhéologie et d'ultrasonographie médicale, CRCHUM, Montréal, Québec, Canada.,Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, Québec, Canada.,Institut de génie biomédical, Université de Montréal, Montréal, Québec, Canada
| | - Gilles Soulez
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada. .,Laboratoire clinique de traitement d'images, CRCHUM, Montréal, Québec, Canada. .,Département de radiologie, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada. .,Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, Québec, Canada. .,Institut de génie biomédical, Université de Montréal, Montréal, Québec, Canada.
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