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Thoracic Aorta: Rapid Black-Blood MR Imaging with Half-Fourier Rapid Acquisition with Relaxation Enhancement with or without Electrocardiographic Triggering¹

¹ From the Department of Radiology, New York University Medical Center, MRI Dept, 530 First Ave, New York, NY 10016. Received October 1, 1998; revision requested November 23; revision received December 22; accepted April 8, 1999. Address reprint requests to G.A.K.

View larger version (19K): [in a new window]   Figure 1. Timing diagram of the black-blood half-Fourier RARE sequence. The acquisition is triggered by the ECG R wave, at which time spins are inverted by means of a nonselective 180° pulse. Immediately afterward, spins within the imaging section are returned to their equilibrium position by means of a section-selective 180° pulse. After a delay (inversion time [TI], chosen such that the recovering blood magnetization is passing through zero), the half-Fourier RARE acquisition is started.

View larger version (112K): [in a new window]   Figure 2a. (a-c) Axial images obtained with three black-blood pulse sequences show a normal thoracic aorta. (a) ECG-triggered half-Fourier RARE image (acquisition time, 41 seconds). (b) Nontriggered half-Fourier RARE image (acquisition time, 31 seconds). (c) ECG-triggered turbo SE image (imaging time, 2 minutes 51 seconds). The ascending (A) and descending (D) thoracic aorta demonstrate uniform flow void in a and nonuniform intravascular signal intensity in the descending aorta in both b and c.

View larger version (108K): [in a new window]   Figure 2b. (a-c) Axial images obtained with three black-blood pulse sequences show a normal thoracic aorta. (a) ECG-triggered half-Fourier RARE image (acquisition time, 41 seconds). (b) Nontriggered half-Fourier RARE image (acquisition time, 31 seconds). (c) ECG-triggered turbo SE image (imaging time, 2 minutes 51 seconds). The ascending (A) and descending (D) thoracic aorta demonstrate uniform flow void in a and nonuniform intravascular signal intensity in the descending aorta in both b and c.

View larger version (117K): [in a new window]   Figure 2c. (a-c) Axial images obtained with three black-blood pulse sequences show a normal thoracic aorta. (a) ECG-triggered half-Fourier RARE image (acquisition time, 41 seconds). (b) Nontriggered half-Fourier RARE image (acquisition time, 31 seconds). (c) ECG-triggered turbo SE image (imaging time, 2 minutes 51 seconds). The ascending (A) and descending (D) thoracic aorta demonstrate uniform flow void in a and nonuniform intravascular signal intensity in the descending aorta in both b and c.

View larger version (112K): [in a new window]   Figure 3a. (a-c) Axial images depict an aneurysm of the ascending aorta associated with a left pleural effusion. Contiguous axial (a) ECG-triggered half-Fourier RARE images (acquisition time, 43 seconds) and (b) nontriggered half-Fourier RARE images (acquisition time, 31 seconds) both demonstrate an aneurysm of the ascending aorta (straight arrows). More uniform signal void is depicted in the ascending aorta in b and in the descending thoracic aorta (arrowheads) in a. (c) ECG-triggered turbo SE images (imaging time, 2 minutes 28 seconds) are degraded by motion artifacts and nonuniform aortic signal intensity. High signal intensity is present in the left atrium (curved arrows in a-c) from slow flow, in-plane flow, or both.

View larger version (107K): [in a new window]   Figure 3b. (a-c) Axial images depict an aneurysm of the ascending aorta associated with a left pleural effusion. Contiguous axial (a) ECG-triggered half-Fourier RARE images (acquisition time, 43 seconds) and (b) nontriggered half-Fourier RARE images (acquisition time, 31 seconds) both demonstrate an aneurysm of the ascending aorta (straight arrows). More uniform signal void is depicted in the ascending aorta in b and in the descending thoracic aorta (arrowheads) in a. (c) ECG-triggered turbo SE images (imaging time, 2 minutes 28 seconds) are degraded by motion artifacts and nonuniform aortic signal intensity. High signal intensity is present in the left atrium (curved arrows in a-c) from slow flow, in-plane flow, or both.

View larger version (91K): [in a new window]   Figure 3c. (a-c) Axial images depict an aneurysm of the ascending aorta associated with a left pleural effusion. Contiguous axial (a) ECG-triggered half-Fourier RARE images (acquisition time, 43 seconds) and (b) nontriggered half-Fourier RARE images (acquisition time, 31 seconds) both demonstrate an aneurysm of the ascending aorta (straight arrows). More uniform signal void is depicted in the ascending aorta in b and in the descending thoracic aorta (arrowheads) in a. (c) ECG-triggered turbo SE images (imaging time, 2 minutes 28 seconds) are degraded by motion artifacts and nonuniform aortic signal intensity. High signal intensity is present in the left atrium (curved arrows in a-c) from slow flow, in-plane flow, or both.

View larger version (106K): [in a new window]   Figure 4a. (a-c) Axial images depict aortic dissection involving the descending thoracic aorta (Stanford type B). (a) ECG-triggered half-Fourier RARE image (acquisition time, 79 seconds) and (b) nontriggered half-Fourier RARE image (acquisition time, 31 seconds) both demonstrate a normal aortic root (A) and an intimal flap (arrow) in the descending thoracic aorta, with patency of both lumina. (c) ECG-triggered turbo SE image (imaging time, 2 minutes 17 seconds) is degraded by motion artifacts and nonuniform signal intensity within both lumina. A = aortic root, arrow indicates intimal flap.

View larger version (100K): [in a new window]   Figure 4b. (a-c) Axial images depict aortic dissection involving the descending thoracic aorta (Stanford type B). (a) ECG-triggered half-Fourier RARE image (acquisition time, 79 seconds) and (b) nontriggered half-Fourier RARE image (acquisition time, 31 seconds) both demonstrate a normal aortic root (A) and an intimal flap (arrow) in the descending thoracic aorta, with patency of both lumina. (c) ECG-triggered turbo SE image (imaging time, 2 minutes 17 seconds) is degraded by motion artifacts and nonuniform signal intensity within both lumina. A = aortic root, arrow indicates intimal flap.

View larger version (111K): [in a new window]   Figure 4c. (a-c) Axial images depict aortic dissection involving the descending thoracic aorta (Stanford type B). (a) ECG-triggered half-Fourier RARE image (acquisition time, 79 seconds) and (b) nontriggered half-Fourier RARE image (acquisition time, 31 seconds) both demonstrate a normal aortic root (A) and an intimal flap (arrow) in the descending thoracic aorta, with patency of both lumina. (c) ECG-triggered turbo SE image (imaging time, 2 minutes 17 seconds) is degraded by motion artifacts and nonuniform signal intensity within both lumina. A = aortic root, arrow indicates intimal flap.

View larger version (122K): [in a new window]   Figure 5a. (a-e) Axial images depict an aneurysm of the entire thoracic aorta with associated thrombus. (a) ECG-triggered half-Fourier RARE image (acquisition time, 46 seconds) and (b) nontriggered half-Fourier RARE image (acquisition time, 30 seconds) both demonstrate aneurysmal dilatation of the ascending (A) and descending (D) aorta. The thrombus (arrow in a and b) in the posterior descending thoracic aorta is well demarcated from the flow void seen anteriorly in the patent lumen. (c) ECG-triggered turbo SE image (imaging time, 2 minutes 12 seconds) is degraded by motion artifacts and nonuniform aortic signal intensity. It is difficult to differentiate flowing blood from thrombus (arrow) in the descending thoracic aorta. A = ascending aorta. (d) Axial reformation image from breath-hold, gadolinium-enhanced, three-dimensional MR angiogram demonstrates flow within the ascending aorta (arrow) and anterior aspect of the descending aorta (arrowhead). The nonenhanced posterior thrombus (T) is difficult to distinguish from contiguous lung and chest wall. (e) Oblique sagittal, maximum intensity projection image from breath-hold, gadolinium-enhanced, three-dimensional MR angiogram demonstrates the aneurysmal thoracic aorta and brachiocephalic trunk (arrow).

View larger version (111K): [in a new window]   Figure 5b. (a-e) Axial images depict an aneurysm of the entire thoracic aorta with associated thrombus. (a) ECG-triggered half-Fourier RARE image (acquisition time, 46 seconds) and (b) nontriggered half-Fourier RARE image (acquisition time, 30 seconds) both demonstrate aneurysmal dilatation of the ascending (A) and descending (D) aorta. The thrombus (arrow in a and b) in the posterior descending thoracic aorta is well demarcated from the flow void seen anteriorly in the patent lumen. (c) ECG-triggered turbo SE image (imaging time, 2 minutes 12 seconds) is degraded by motion artifacts and nonuniform aortic signal intensity. It is difficult to differentiate flowing blood from thrombus (arrow) in the descending thoracic aorta. A = ascending aorta. (d) Axial reformation image from breath-hold, gadolinium-enhanced, three-dimensional MR angiogram demonstrates flow within the ascending aorta (arrow) and anterior aspect of the descending aorta (arrowhead). The nonenhanced posterior thrombus (T) is difficult to distinguish from contiguous lung and chest wall. (e) Oblique sagittal, maximum intensity projection image from breath-hold, gadolinium-enhanced, three-dimensional MR angiogram demonstrates the aneurysmal thoracic aorta and brachiocephalic trunk (arrow).

View larger version (101K): [in a new window]   Figure 5c. (a-e) Axial images depict an aneurysm of the entire thoracic aorta with associated thrombus. (a) ECG-triggered half-Fourier RARE image (acquisition time, 46 seconds) and (b) nontriggered half-Fourier RARE image (acquisition time, 30 seconds) both demonstrate aneurysmal dilatation of the ascending (A) and descending (D) aorta. The thrombus (arrow in a and b) in the posterior descending thoracic aorta is well demarcated from the flow void seen anteriorly in the patent lumen. (c) ECG-triggered turbo SE image (imaging time, 2 minutes 12 seconds) is degraded by motion artifacts and nonuniform aortic signal intensity. It is difficult to differentiate flowing blood from thrombus (arrow) in the descending thoracic aorta. A = ascending aorta. (d) Axial reformation image from breath-hold, gadolinium-enhanced, three-dimensional MR angiogram demonstrates flow within the ascending aorta (arrow) and anterior aspect of the descending aorta (arrowhead). The nonenhanced posterior thrombus (T) is difficult to distinguish from contiguous lung and chest wall. (e) Oblique sagittal, maximum intensity projection image from breath-hold, gadolinium-enhanced, three-dimensional MR angiogram demonstrates the aneurysmal thoracic aorta and brachiocephalic trunk (arrow).

View larger version (57K): [in a new window]   Figure 5d. (a-e) Axial images depict an aneurysm of the entire thoracic aorta with associated thrombus. (a) ECG-triggered half-Fourier RARE image (acquisition time, 46 seconds) and (b) nontriggered half-Fourier RARE image (acquisition time, 30 seconds) both demonstrate aneurysmal dilatation of the ascending (A) and descending (D) aorta. The thrombus (arrow in a and b) in the posterior descending thoracic aorta is well demarcated from the flow void seen anteriorly in the patent lumen. (c) ECG-triggered turbo SE image (imaging time, 2 minutes 12 seconds) is degraded by motion artifacts and nonuniform aortic signal intensity. It is difficult to differentiate flowing blood from thrombus (arrow) in the descending thoracic aorta. A = ascending aorta. (d) Axial reformation image from breath-hold, gadolinium-enhanced, three-dimensional MR angiogram demonstrates flow within the ascending aorta (arrow) and anterior aspect of the descending aorta (arrowhead). The nonenhanced posterior thrombus (T) is difficult to distinguish from contiguous lung and chest wall. (e) Oblique sagittal, maximum intensity projection image from breath-hold, gadolinium-enhanced, three-dimensional MR angiogram demonstrates the aneurysmal thoracic aorta and brachiocephalic trunk (arrow).

View larger version (97K): [in a new window]   Figure 5e. (a-e) Axial images depict an aneurysm of the entire thoracic aorta with associated thrombus. (a) ECG-triggered half-Fourier RARE image (acquisition time, 46 seconds) and (b) nontriggered half-Fourier RARE image (acquisition time, 30 seconds) both demonstrate aneurysmal dilatation of the ascending (A) and descending (D) aorta. The thrombus (arrow in a and b) in the posterior descending thoracic aorta is well demarcated from the flow void seen anteriorly in the patent lumen. (c) ECG-triggered turbo SE image (imaging time, 2 minutes 12 seconds) is degraded by motion artifacts and nonuniform aortic signal intensity. It is difficult to differentiate flowing blood from thrombus (arrow) in the descending thoracic aorta. A = ascending aorta. (d) Axial reformation image from breath-hold, gadolinium-enhanced, three-dimensional MR angiogram demonstrates flow within the ascending aorta (arrow) and anterior aspect of the descending aorta (arrowhead). The nonenhanced posterior thrombus (T) is difficult to distinguish from contiguous lung and chest wall. (e) Oblique sagittal, maximum intensity projection image from breath-hold, gadolinium-enhanced, three-dimensional MR angiogram demonstrates the aneurysmal thoracic aorta and brachiocephalic trunk (arrow).