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Diagnostic value of the flow profile in the distal descending aorta by phase‐contrast magnetic resonance for predicting severe coarctation of the aorta
Author(s) -
Muzzarelli Stefano,
Ordovas Karen Gomes,
Hope Michael D.,
Meadows Jeffery J.,
Higgins Charles B.,
Meadows Alison Knauth
Publication year - 2011
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.22566
Subject(s) - magnetic resonance imaging , descending aorta , cardiology , medicine , aorta , diastole , radiology , nuclear magnetic resonance , blood pressure , physics
Abstract Purpose: To compare aortic flow profiles at the level of the proximal descending (PDAo) and distal descending aorta (DDAo) in patients investigated for coarctation of the aorta (CoA), and compare their respective diagnostic value for predicting severe CoA. Diastolic flow decay in the PDAo predicts severe CoA, but flow measurements at this level are limited by flow turbulence, aliasing, and stent‐related artifacts. Materials and Methods: We studied 49 patients evaluated for CoA with phase contrast magnetic resonance imaging (PC‐MRI). Parameters of diastolic flow decay in the PDAo and DDAo were compared. Their respective diagnostic value was compared with the standard reference of transcatheter peak gradient ≥20 mmHg. Results: Flow measurement in the PDAo required repeated acquisition with adjustment of encoding velocity or location of the imaging plane in 69% of patients; measurement in the DDAo was achieved in single acquisition in all cases. Parameters of diastolic flow decay in the PDAo and DDAo, including rate‐corrected (RC) deceleration time and RC flow deceleration yielded a good correlation ( r = 0.78; P < 0.01, and r = 0.92; P < 0.01), and a similar diagnostic value for predicting severe CoA. The highest diagnostic accuracy was achieved by RC deceleration time at DDAo (sensitivity 85%, specificity 85%). Conclusion: Characterization of aortic flow profiles at the DDAo offers a quick and reliable noninvasive means of assessing hemodynamically significant CoA. J. Magn. Reson. Imaging 2011;33:1440–1446. © 2011 Wiley‐Liss, Inc.