Volume 58, Issue 4 pp. 1258-1267

Research Article

Dynamic Contrast-Enhanced MRI in Abdominal Aortic Aneurysms as a Potential Marker for Disease Progression

Ang Zhou PhD,

Ang Zhou PhD

orcid.org/0000-0003-1450-9169

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

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Joseph R. Leach MD, PhD,

Joseph R. Leach MD, PhD

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

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Chengcheng Zhu PhD,

Chengcheng Zhu PhD

orcid.org/0000-0001-6898-549X

Department of Radiology, University of Washington, Seattle, Washington, USA

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Huiming Dong PhD,

Huiming Dong PhD

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

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Fei Jiang PhD,

Fei Jiang PhD

Department of Biostatistics, University of California San Francisco, San Francisco, California, USA

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Yoo Jin Lee MD,

Yoo Jin Lee MD

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

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James Iannuzzi MD, MPH,

James Iannuzzi MD, MPH

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

Department of Surgery, University of California San Francisco, San Francisco, California, USA

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Warren Gasper MD,

Warren Gasper MD

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

Department of Surgery, University of California San Francisco, San Francisco, California, USA

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David Saloner PhD,

David Saloner PhD

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

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Michael D. Hope MD,

Michael D. Hope MD

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

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Dimitrios Mitsouras PhD,

Corresponding Author

Dimitrios Mitsouras PhD

[email protected]

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

Address reprint requests to: D.M., 4150 Clement Street, Box 114, San Francisco, California 94121, USA. E-mail: [email protected]

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Ang Zhou PhD,

Ang Zhou PhD

orcid.org/0000-0003-1450-9169

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

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Joseph R. Leach MD, PhD,

Joseph R. Leach MD, PhD

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

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Chengcheng Zhu PhD,

Chengcheng Zhu PhD

orcid.org/0000-0001-6898-549X

Department of Radiology, University of Washington, Seattle, Washington, USA

Search for more papers by this author

Huiming Dong PhD,

Huiming Dong PhD

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

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Fei Jiang PhD,

Fei Jiang PhD

Department of Biostatistics, University of California San Francisco, San Francisco, California, USA

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Yoo Jin Lee MD,

Yoo Jin Lee MD

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

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James Iannuzzi MD, MPH,

James Iannuzzi MD, MPH

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

Department of Surgery, University of California San Francisco, San Francisco, California, USA

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Warren Gasper MD,

Warren Gasper MD

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

Department of Surgery, University of California San Francisco, San Francisco, California, USA

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David Saloner PhD,

David Saloner PhD

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

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Michael D. Hope MD,

Michael D. Hope MD

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

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Dimitrios Mitsouras PhD,

Corresponding Author

Dimitrios Mitsouras PhD

[email protected]

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

Address reprint requests to: D.M., 4150 Clement Street, Box 114, San Francisco, California 94121, USA. E-mail: [email protected]

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First published: 06 February 2023

https://doi.org/10.1002/jmri.28640

Citations: 2

Grant sponsor: VA Merit Award; grant number: I01CX002071-01A1.

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Abstract

Background

Abdominal aortic aneurysms (AAAs) may rupture before reaching maximum diameter (D_max) thresholds for repair. Aortic wall microvasculature has been associated with elastin content and rupture sites in specimens, but its relation to progression is unknown.

Purpose

To investigate whether dynamic contrast-enhanced (DCE) MRI of AAA is associated with D_max or growth.

Study Type

Prospective.

Population

A total of 27 male patients with infrarenal AAA (mean age ± standard deviation = 75 ± 5 years) under surveillance with DCE MRI and 2 years of prior follow-up intervals with computed tomography (CT) or MRI.

Field Strength/Sequence

A 3-T, dynamic three-dimensional (3D) fast gradient-echo stack-of-stars volumetric interpolated breath-hold examination (Star-VIBE).

Assessment

Wall voxels were manually segmented in two consecutive slices at the level of D_max. We measured slope to 1-minute and area under the curve (AUC) to 1 minute and 4 minutes of the signal intensity change postcontrast relative to that precontrast arrival, and, K^trans, a measure of microvascular permeability, using the Patlak model. These were averaged over all wall voxels for association to D_max and growth rate, and, over left/right and anterior/posterior quadrants for testing circumferential homogeneity. D_max was measured orthogonal to the aortic centerline and growth rate was calculated by linear fit of D_max measurements.

Statistical Tests

Pearson correlation and linear mixed effects models. A P value <0.05 was considered statistically significant.

Results

In 44 DCE MRIs, mean D_max was 45 ± 7 mm and growth rate in 1.5 ± 0.4 years of prior follow-up was 1.7 ± 1.2 mm per year. DCE measurements correlated with each other (Pearson r = 0.39–0.99) and significantly differed between anterior/posterior versus left/right quadrants. DCE measurements were not significantly associated with D_max (P = 0.084, 0.289, 0.054 and 0.255 for slope, AUC at 1 minute and 4 minutes, and K^trans, respectively). Slope and 4 minutes AUC significantly associated with growth rate after controlling for D_max.

Conclusion

Contrast uptake may be increased in lateral aspects of the AAA. Contrast enhancement 1-minute slope and 4-minutes AUC may be associated with a period of recent AAA growth that is independent of D_max.

Evidence Level

Technical Efficacy

Stage 2.

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Citing Literature

Volume58, Issue4

October 2023

Pages 1258-1267

Dynamic Contrast-Enhanced MRI in Abdominal Aortic Aneurysms as a Potential Marker for Disease Progression

Abstract

Background

Purpose

Study Type

Population

Field Strength/Sequence

Assessment

Statistical Tests

Results

Conclusion

Evidence Level

Technical Efficacy

References

Citing Literature

References

Information

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Dynamic Contrast-Enhanced MRI in Abdominal Aortic Aneurysms as a Potential Marker for Disease Progression

Abstract

Background

Purpose

Study Type

Population

Field Strength/Sequence

Assessment

Statistical Tests

Results

Conclusion

Evidence Level

Technical Efficacy

References

Citing Literature

References

Related

Information