Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

Perspectives of Magnetic Resonance

Imaging (MRI) for aortic

aneurysms and dissections

Dr. med. Jonathan Nadjiri

Institut of diagnostic and interventional Radiology

Direktor of the Institut: Univ.-Prof. Dr. Ernst J. Rummeny

Technical University of Munich

7th Munich Vascular Conference:

AORTIC ISSUES (AOR) - LECTURE HALL C

Research Group of Cardiovascular Imaging

Dr. med. Jonathan Nadjiri, Dr. med. Alexandra Sträter, PD Dr. med. Daniela Münzel, Dr. med. Michael Rasper

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

No disclosures

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

Agenda:

✓Current role of MRI in aortic disease

✓Examples of applications

✓Possibilities & perspective

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

Current role of MRI in aortic disease:

➢ …mainly in CT:

➢ Fast

➢ Few contraindications

➢ Available

➢ Established

➢ Technically easy

➢ Requires only little cooperation

from patient.

Eligible for intensive care patients

CTA

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

➢ …mainly in CT:

➢ Fast

➢ Few contraindications

➢ Available

➢ Established

➢ Technically easy

➢ Requires only little cooperation

from patient.

Heutige Rolle der MRT in der

Aortendiganostik:What is the current role of MRI in aortic disease now?

MRA

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

➢ Main arguments for MRI:

➢ More young patients with more follow up-exams.

➢ Native examinations in MR allow for vascular imaging.

➢ First evaluation of diameters of the aorta.

➢ Follow up-exams.

➢ More information

➢ Function (flow measurement)

➢ Function (wall movement)

➢ Perfusion imaging

What is the current role of MRI in aortic disease now?

Evaluation of prognosis

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

Application: Rule out Endoleak -

Angiography and perfusion

Additional

information

MRA CTA with Gd MRA Perfusion

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

Application: Rule out Endoleak - data overview

Journal of Endovascular Therapy (2016)European Journal of Vascular and Endovascular Surgery (2013)

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

Application: Morphologic imaging without use of

contrast agent

SSFP-Sequences

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

SSFP-Sequeces SSFP-Sequences (Trufi 3D)

Application: Morphologic imaging without use of

contrast agent

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

Application: Magnetic Resonance Angiography

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

Application: Rule out dissection - data overview

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

Perspective: New prognostic parameter

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

NURadiology

Copyright NURadiology

Perspective: New prognostic parameter

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

Perspective: New prognostic parameterValve-Related Hemodynamics Mediate Human

Bicuspid Aortopathy

David G. Guzzardi, Alex J. Barker, Pim van Ooij, S.

Chris Malaisrie, Jyothy J. Puthumana, Darrell D.

Belke, Holly E.M. Mewhort, Daniyil A. Svystonyuk,

Sean Kang, Subodh Verma, Jeremy Collins, James

Carr, Robert O. Bonow, Michael Markl, James D.

Thomas, Patrick M. McCarthy, Paul W.M. Fedak

Journal of the American College of Cardiology Aug

2015, 66 (8) 892-900; DOI:

10.1016/j.jacc.2015.06.1310

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

Summary:

➢ Diagnostic potential of MR exhibits that of the CT in many

vascular applications

➢ Many opportunities: E.g. prognostic data or diagnostic

➢ Eligible for frequent follow-up examinations; in some cases

without contrast agent

➢ Complicated and time consuming examination

Perspectives of Magnetic Resonance Imaging (MRI) for aortic aneurysms and dissections

Jonathan Nadjiri, M.D. | Technical University Munich | Munich | 08.12.2017

7th Munich Vascular Conference | AORTIC ISSUES (AOR) - LECTURE HALL C

Thank you very much for your attention!