A Comparative Study Of Diagnosis With MRI And Combined Echocardiography

purpose: To evaluate and compare the value of MRI with different sequences in the diagnosis of Aortic dissection (AD), including spin echo (SE), cine-MRI , MRA, dynamic contrast enhancement MRA(3D DCE-MRA), velocity encoded (VEC), transthoracic echocardiography(TIE), transesophageal echocardiography(TEE) and CT, X-ray angiography(DSA).Material and methods: 62 patients with AD underwent SE, cine-MRI and TTE, including 32 examinations of MRA; 20 examinations of 3D DCE-MRA; 23 examinations of VEC and 15 examinations of TEE. 33 Examinations of sprial CT, 29 examinations of DSA. Above-mentioned MRI, combined echocardiography, CT and DSA methods were compared with each other respectively.Results: the sensitivity of MRI, TTE in diagnosis of AD was 97%, 85%, and the specificity was 100% and 90%. The sensitivity of TEE was 100%, the sensitivity of CT was 90. 9% , the sensitivity of DSA was 89. 6% . SE is a conventional method of MRI in diagnosis of AD, but of limited value in demonstrating entry tear and branch vessels involvement. In this respect, Cine MRI and 3D DCE-MRA were superior to SE. In detecting truth and false lumen, and mural thrombus within the false lumen, VEC is the best. In showing entry tear, branch vessels involvement andmural thrombus within the false lumen, MRI has an advantage over combined echocardiography.Conclusion: MRI greatly improved the ability of AD diagnosis, especially with entry tear, and branch vessels involvement, if Cine-MRI, MRA , 3D DCE-MRA and VEC technology supported. MRI , combined echocardiography, CT and DSA are valuable methods in diagnosis of AD. For acute AD, especially very sick patients, echocardiography is more preferable, CT is near to MRI. For sub-acute or chronic AD, MRI, CT (SCT, UFCT), echocardiography are appropriate choices, but MRI is of the first choice. For patients with conservative or post-surgical, combined echocardiography is the method of choice. For patients with intervention treatment, MRA or DSA is preferable.