Detection of mural inflammation with low b-value diffusion-weighted imaging in patients with active Takayasu Arteritis

Abstract

Objectives

To evaluate the performance of low b-value diffusion-weighted imaging (DWI) for detection of inflamed vessels in active Takayasu arteritis (TA).

Methods

Forty patients with active TA involving the thoracic aorta and its super-aortic branches underwent low b-value (50 s/mm2) DWI, T2-weighted imaging (T2WI), and delayed enhancement T1-weighted imaging (DEI). Corresponding images on these 3 sequences at the same diseased level were evaluated qualitatively and quantitatively using Friedman and Kruskal-Wallis test, and the agreement between them in detection of inflamed vessels was assessed using Cochran’s Q test.

Results

The overall image quality of DEI, DWI, and T2WI was scored 7.97 ± 1.15, 7.32 ± 1.73, and 6.51 ± 1.69 respectively. The score of DEI and DWI was higher than that of T2WI (p < 0.001). The quality of blood suppression was rated higher in DWI than T2WI and DEI (p < 0.001). Both the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the diseased vessel walls measured on DEI and DWI were significantly higher than those on T2WI (p < 0.001). However, there was no significant difference in SNR and CNR between DEI and DWI (p = 0.283 and 0.063). In detection of mural inflammation, significant advantage was observed when comparing the findings from DEI/DWI to those from T2WI (p < 0.001). But no significant difference was found between the findings of DWI and DEI (p > 0.99).

Conclusions

Low b-value DWI may be used as a promising alternative to DEI for detecting inflamed vessels in active TA.

Key Points

Currently, the most widely used imaging modality in detection of mural inflammation is contrast-enhanced MRI.

Low b-value DWI is shown comparable to contrast-enhanced MRI and superior to T2WI in identifying mural inflammation in patients with active Takayasu arteritis.

Low b-value DWI is a fast and unenhanced MRI technique which may potentially replace contrast-enhanced MRI in identifying disease activity of Takayasu arteritis.

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Abbreviations

CNR:

Contrast-to-noise ratio

DEI:

Delayed enhancement T1-weighted imaging

DWI:

Diffusion-weighted imaging

ECG:

Electrocardiography

MRI:

Magnetic resonance imaging

ROI :

Region of interest

SD:

Standard deviation

SI:

Signal intensity

SNR:

Signal-to-noise ratio

T1WI:

T1-weighted imaging

T2WI:

T2-weighted imaging

TA:

Takayasu arteritis

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Correspondence to Jiang Lin.

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The scientific guarantor of this publication is Jiang Lin.

Conflict of interest

Caixia Fu is an employee of Siemens Shenzhen Magnetic Resonance Ltd. She herself contributed to the acquisition of the images and revision of the submitted work, but was not involved in the analysis and interpretation of data. Other authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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Institutional Review Board approval was obtained.

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• performed at one institution

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Yang, H., Lv, P., Zhang, R. et al. Detection of mural inflammation with low b-value diffusion-weighted imaging in patients with active Takayasu Arteritis. Eur Radiol (2021). https://doi.org/10.1007/s00330-021-07725-z

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Keywords

  • Takayasu arteritis
  • Magnetic resonance imaging
  • Diffusion magnetic resonance imaging
  • Aorta