A 2014 study comparing thoracic aortic measurements and pathology in 76 patients undergoing both contrast- and noncontrast-enhanced MRA showed high agreement between study types, with low intra- and interobserver dependency (intraclass correlation coefficient 0.99) [51]. A similar 2017 study comparing thoracic aorta measurements/findings on contrast- and noncontrast-enhanced MRA performed on a group of 50 patients favored noncontrast-enhanced MRA over contrast-enhanced MRA as the technique of choice because of superior image quality and better vessel sharpness in the ascending aorta [44]. Although these existing studies focus on the thoracic or abdominal segments of the aorta rather than the thoracoabdominal aorta, findings can likely be extrapolated to the thoracoabdominal aorta. MRA Chest and Abdomen Without and With IV Contrast Compared with MRA of the chest, abdomen, and pelvis, exclusion of the pelvis carries the benefit of faster acquisition time. However, extension to the abdomen without the pelvis involved, results in limited evaluation of the iliofemoral vessels to evaluate suitability for possible endovascular intervention or for aneurysm dilation/dissection of the iliac or femoral arteries if pathology extends to the bifurcation. Thoracoabdominal Aortic Aneurysm or Dissection MRA Chest and Abdomen Without IV Contrast Compared with MRA of the chest, abdomen, and pelvis, exclusion of the pelvis carries the benefit of faster acquisition time. However, extension to the abdomen without inclusion of the pelvis involved results in limited evaluation of the iliofemoral vessels to evaluate suitability for possible endovascular intervention or for aneurysm dilation/dissection of the iliac or femoral arteries if pathology extends to the bifurcation. Radiography Chest Chest radiographs demonstrate abnormalities in a large percentage of patients with acute thoracoabdominal pathology.
Thoracoabdominal Aneurysm or Dissection Treatment Planning and Follow Up. A 2014 study comparing thoracic aortic measurements and pathology in 76 patients undergoing both contrast- and noncontrast-enhanced MRA showed high agreement between study types, with low intra- and interobserver dependency (intraclass correlation coefficient 0.99) [51]. A similar 2017 study comparing thoracic aorta measurements/findings on contrast- and noncontrast-enhanced MRA performed on a group of 50 patients favored noncontrast-enhanced MRA over contrast-enhanced MRA as the technique of choice because of superior image quality and better vessel sharpness in the ascending aorta [44]. Although these existing studies focus on the thoracic or abdominal segments of the aorta rather than the thoracoabdominal aorta, findings can likely be extrapolated to the thoracoabdominal aorta. MRA Chest and Abdomen Without and With IV Contrast Compared with MRA of the chest, abdomen, and pelvis, exclusion of the pelvis carries the benefit of faster acquisition time. However, extension to the abdomen without the pelvis involved, results in limited evaluation of the iliofemoral vessels to evaluate suitability for possible endovascular intervention or for aneurysm dilation/dissection of the iliac or femoral arteries if pathology extends to the bifurcation. Thoracoabdominal Aortic Aneurysm or Dissection MRA Chest and Abdomen Without IV Contrast Compared with MRA of the chest, abdomen, and pelvis, exclusion of the pelvis carries the benefit of faster acquisition time. However, extension to the abdomen without inclusion of the pelvis involved results in limited evaluation of the iliofemoral vessels to evaluate suitability for possible endovascular intervention or for aneurysm dilation/dissection of the iliac or femoral arteries if pathology extends to the bifurcation. Radiography Chest Chest radiographs demonstrate abnormalities in a large percentage of patients with acute thoracoabdominal pathology.