3D MRI provides improved visualization and detection of aortic arch plaques compared to transesophageal echocardiography

Publication

3D MRI provides improved visualization and detection of aortic arch plaques compared to transesophageal echocardiography

Journal Paper/Review - May 2, 2012

Harloff Andreas, Weiller Cornelius, Vach Werner, Frydrychowicz Alex, Weber Johannes, Helbing Thomas, Wallis Wolf, Assefa Dawit, Simon Jan, Brendecke Stefanie Marie, Markl Michael

Citation

Harloff A, Weiller C, Vach W, Frydrychowicz A, Weber J, Helbing T, Wallis W, Assefa D, Simon J, Brendecke S, Markl M. 3D MRI provides improved visualization and detection of aortic arch plaques compared to transesophageal echocardiography. J Magn Reson Imaging 2012; 36:604-11.

Type

Journal Paper/Review (English)

Journal

J Magn Reson Imaging 2012; 36

Publication Date

May 2, 2012

Issn Electronic

1522-2586

Pages

604-11

Brief description/objective

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 mm(3) ). 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.