Klinische Anwendungen

Inhance Aortic Dissection

 

Inhance 3D Inflow IR in Aortic Dissection

NCE MRA revealing true & false lumen

Professor Wladyslaw GedroycSt Mary’s Hospital, London, UK

“It is often quite difficult on the contrast examination to differentiate the false and true lumen immediately, whereas the Inhance 3D Inflow IR sequence shows this quickly.”

Patient History

54-year-old male patient with an abdominal aorta dissection one year prior. A regular follow-up MR examination was conducted to assess the state of the aorta and assess the blood supply to the renal arteries. A renal artery that arises from false aortic lumen may not receive the appropriate amount of blood flow and the kidney may become ischemic and deteriorate.

Follow-up MR exam on previous abdominal aortic dissection. Renal arteries origin were examined to determine proper blood supply.

In this study, Inhance 3D Inflow IR clearly differentiates between true and false lumen and concludes both renal arteries arises from the true lumen.

MR Technique

Non-contrast enhanced MR angiography was performed using the Inhance 3D Inflow IR technique. High resolution acquisition (0.7 mmx0.7 mmx1 mm interpolated) was acquired in 4 min during free breathing with respiratory triggering. Breath-held contrast enhanced MRA (CE MRA) was also performed for comparison.

Inhance 3D Inflow IR is a non-contrast MRA technique that employs a large IR pulse (red) to suppress background and venous signal. As fresh blood enters the imaging volume (blue), a bright blood 3D SSFP acquisition is used to visualize the vasculature without contrast agents.

CE MRA showing dissection flap. It is difficult to identify the supplies of the renal arteries since both true and false lumen are equally visible.

A coronal MIP of Inhance 3D Inflow IR shows clearly the fast flowing true lumen (high signal intensity) supplying the left renal artery.

Review of the high-resolution axial source data of Inhance 3D Inflow IR reveals that the right renal artery also arises from the true lumen from a very anterior origin (orange arrow). The false lumen with slow inflow appears dark (blue arrow).

MR Findings

MR shows that significant dissection flap is still visible in the abdominal aorta with one faster flowing true lumen and one much slower flowing false lumen. Inhance 3D Inflow IR technique clearly differentiates between true lumen (high signal intensity due to faster inflow), and false lumen (very low signal intensity due to slow inflow). In this patient, the Inhance 3D Inflow IR technique demonstrates that the right renal artery still arises from the true lumen from a very anterior origin, whereas it was quite difficult to ascertain on the contrast enhanced acquisition.

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