Thoracic aorta diameters in Marfan patients: Intraindividual comparison of 3D modified relaxation-enhanced angiography without contrast and triggering (REACT) with transthoracic echocardiography

• Published in: International journal of cardiology 2023-11, Vol.390, p.131203-131203, Article 131203
• Main Authors: Gietzen, Carsten, Pennig, Lenhard, von Stein, Jennifer, Guthoff, Henning, Weiss, Kilian, Gertz, Roman, Thürbach, Iris, Bunck, Alexander C., Maintz, David, Baldus, Stephan, Ten Freyhaus, Henrik, Hohmann, Christopher, von Stein, Philipp
• Format: Article
• Language: English
• Subjects: Ascending aorta; Connective tissue disease; Magnetic resonance angiography; Marfan syndrome; Non-contrast magnetic resonance angiography; Transthoracic echocardiography
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2023.131203

To compare the measurement of aortic diameters using a novel flow-independent MR-Angiography (3D modified Relaxation-Enhanced Angiography without Contrast and Triggering (modified REACT)) and transthoracic echocardiography (TTE) in Marfan syndrome (MFS) patients. This retrospective, single-center analysis included 46 examinations of 32 MFS patients (mean age 37.5 ± 11.3 years, 17 women, no prior aortic surgery) who received TTE and 3D modified REACT (ECG- and respiratory-triggering, Compressed SENSE factor 9 for acceleration of image acquisition) of the thoracic aorta. Aortic diameters (sinus of Valsalva (SV), sinotubular junction (STJ), and ascending aorta (AoA)) were independently measured by two cardiologists in TTE (leading-edge) and two radiologists in modified REACT (inner-edge, using multiplanar reconstruction). Intraclass correlation coefficient, Bland-Altman analyses, and Pearson's correlation (r) were used to assess agreement between observers and methods. Interobserver correlation at the SV, STJ, and AoA were excellent for both, TTE (ICC = 0.95–0.98) and modified REACT (ICC = 0.99–1.00). There was no significant difference between TTE and modified REACT for diameters measured at the SV (39.24 ± 3.24 mm vs. 39.63 ± 3.76 mm; p = 0.26; r = 0.78) and the STJ (35.16 ± 4.47 mm vs. 35.37 ± 4.74 mm; p = 0.552; r = 0.87). AoA diameters determined by TTE were larger than in modified REACT (34.29 ± 5.31 mm vs. 30.65 ± 5.64 mm; p