Non-contrast enhanced navigator-gated balanced steady state free precession magnetic resonance angiography as a preferred magnetic resonance technique for assessment of the thoracic aorta

Aim: To compare the objective and subjective image quality of non-contrast three-dimensional (3D) navigator-gated balanced steady state free precession magnetic resonance angiography (NC-MRA) and contrast-enhanced magnetic resonance angiography (CE-MRA) along the entire thoracic aorta. Materials and methods: Fifty consecutive patients with thoracic aortic disease underwent NC-MRA and CE-MRA using a 1.5 T MRI system. Vessel sharpness was assessed using signal intensity profiles at five predefined levels of the thoracic aorta. Two readers scored subjective quality. Manual diameter measurements of both readers were used for calculation of interobserver variation. Results: NC-MRA resulted in significantly sharper delineation of the aortic root, ascending aorta, and distal descending aorta compared to CE-MRA. Sharpness was comparable at the level of the arch and proximal descending aorta. NC-MRA resulted in significantly better subjective image quality. Interobserver agreement for diameter measurements was excellent for both techniques. Conclusion: NC-MRA resulted in superior image quality for assessment of the thoracic aorta and in better vessel sharpness for assessment of the aortic root and ascending aorta, when compared to CE-MRA. NC-MRA can be considered the MRA technique of choice for the assessment of the thoracic aorta diameters in clinical practice. - Highlights: • By preference, thoracic aorta pathology is assessed with MRA. • For this assessment non-contrast navigator bSSFP (NC-MRA) can be considered favourable. • Objective and subjective quality of NC-MRA were superior to contrast-enhanced MRA. • NC-MRA results in better vessel sharpness compared to contrast enhanced-MRA.