Accuracy of aortic pulse wave velocity assessment with velocity-encoded MRI: validation in patients with Marfan syndrome

The leading cause of premature death in patients with Marfan syndrome (MFS) is aortic dissection and subsequent rupture after progressive aorta dilatation due to increased wall stiffening. Pulse Wave Velocity (PWV), defined as the systolic flow velocity wave front propagation speed through the aorta, is a marker of wall stiffness with proven prognostic value in MFS. Recently it was demonstrated that, although time-consuming, PWV-assessment from two-directional in-plane velocity-encoded MRI covering the whole aorta in three parallel oblique-sagittal slices is the most accurate approach (1). 2-slice free-breathing through-plane velocity-encoded MRI at three locations perpendicular to the aorta (2) is traditionally used for PWV-estimation. Accelerated multi-slice acquisition with breath-holding and more-densed sampling along the aorta might improve accuracy.