Is MRI equivalent to CT in the guidance of TAVR? A pilot study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-05-07

AUTHORS

Agnes Mayr, Gert Klug, Sebastian J. Reinstadler, Hans-Josef Feistritzer, Martin Reindl, Christian Kremser, Christof Kranewitter, Nikolaos Bonaros, Guy Friedrich, Gudrun Feuchtner, Bernhard Metzler

ABSTRACT

ObjectivesTo compare a comprehensive cardiovascular magnetic resonance imaging (MRI) protocol with contrast-enhanced computed tomography angiography (CTA) for guidance in transcatheter aortic valve replacement (TAVR) evaluation.Methods and resultsNon-contrast three-dimensional (3D) ‘whole heart’ MRI imaging for aortic annulus sizing and measurements of coronary ostia heights, contrast-enhanced MRI angiography (MRA) for evaluation of transfemoral routes as well as aortoiliofemoral-CTA were performed in 16 patients referred for evaluation of TAVR. Aortic annulus measurements by MRI and CTA showed a very strong correlation (r=0.956, p<0.0001; effective annulus area for MRI 430±74 vs. 428±78 mm2 for CTA, p=0.629). Regarding decision for valve size there was complete consistency between MRI and CTA. Moreover, vessel luminal diameters and angulations of aortoiliofemoral access as measured by MRA and CTA showed overall very strong correlations (r= 0.819 to 0.996, all p<0.001), the agreement of minimal vessel diameter between the two modalities revealed a bias of 0.02 mm (upper and lower limit of agreement: 1.02 mm and -0.98 mm).ConclusionsIn patients referred for TAVR, MRI measurements of aortic annulus and minimal aortoiliofemoral diameters showed good to excellent agreement. Decisions based on MRI measurements regrading prosthesis sizing and transfemoral access would not have modified TAVR-strategy as compared to a CTA-based choice.Key Points• ‘Whole heart’ MRI and CTA measurements of aortic annulus correlate very strongly.• MRI- and CTA-based prostheses sizing are in excellent agreement.• MRA and CTA equally guide TAVR access strategy. More... »

PAGES

4625-4634

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00330-018-5386-2

DOI

http://dx.doi.org/10.1007/s00330-018-5386-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1103847566

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29736853


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29 schema:description ObjectivesTo compare a comprehensive cardiovascular magnetic resonance imaging (MRI) protocol with contrast-enhanced computed tomography angiography (CTA) for guidance in transcatheter aortic valve replacement (TAVR) evaluation.Methods and resultsNon-contrast three-dimensional (3D) ‘whole heart’ MRI imaging for aortic annulus sizing and measurements of coronary ostia heights, contrast-enhanced MRI angiography (MRA) for evaluation of transfemoral routes as well as aortoiliofemoral-CTA were performed in 16 patients referred for evaluation of TAVR. Aortic annulus measurements by MRI and CTA showed a very strong correlation (r=0.956, p<0.0001; effective annulus area for MRI 430±74 vs. 428±78 mm2 for CTA, p=0.629). Regarding decision for valve size there was complete consistency between MRI and CTA. Moreover, vessel luminal diameters and angulations of aortoiliofemoral access as measured by MRA and CTA showed overall very strong correlations (r= 0.819 to 0.996, all p<0.001), the agreement of minimal vessel diameter between the two modalities revealed a bias of 0.02 mm (upper and lower limit of agreement: 1.02 mm and -0.98 mm).ConclusionsIn patients referred for TAVR, MRI measurements of aortic annulus and minimal aortoiliofemoral diameters showed good to excellent agreement. Decisions based on MRI measurements regrading prosthesis sizing and transfemoral access would not have modified TAVR-strategy as compared to a CTA-based choice.Key Points• ‘Whole heart’ MRI and CTA measurements of aortic annulus correlate very strongly.• MRI- and CTA-based prostheses sizing are in excellent agreement.• MRA and CTA equally guide TAVR access strategy.
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35 schema:keywords CT
36 CTA measurements
37 ConclusionsIn patients
38 MRI angiography
39 MRI measurements
40 ObjectivesTo
41 TAVR
42 access
43 access strategy
44 agreement
45 angiography
46 angulation
47 annulus
48 annulus measurements
49 annulus sizing
50 aortic annulus
51 aortic annulus measurements
52 aortic annulus sizing
53 bias
54 cardiovascular magnetic resonance imaging
55 choice
56 complete consistency
57 computed tomography angiography
58 consistency
59 contrast-enhanced computed tomography angiography
60 coronary ostium height
61 correlates
62 correlation
63 decisions
64 diameter
65 evaluation
66 excellent agreement
67 guidance
68 heart
69 height
70 imaging
71 luminal diameter
72 magnetic resonance imaging
73 measurements
74 method
75 minimal vessel diameter
76 modalities
77 ostium height
78 patients
79 pilot study
80 prosthesis
81 prosthesis sizing
82 resonance imaging
83 route
84 size
85 sizing
86 strategies
87 strong correlation
88 study
89 three
90 tomography angiography
91 transfemoral access
92 transfemoral route
93 valve size
94 vessel diameter
95 vessel luminal diameter
96 whole heart
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