Purpose:To evaluate an improved image acquisition and data-processing strategy for assessing aortic vascular geometry and 3D blood flow at 3T.
Materials and Methods:In a study with five normal volunteers and seven patients with known aortic pathology, prospectively ECG-gated cine three-dimensional (3D) MR velocity mapping with improved navigator gating, real-time adaptive k-space ordering and dynamic adjustment of the navigator acceptance criteria was performed. In addition to morphological information and three-directional blood flow velocities, phase-contrast (PC)-MRA images were derived from the same data set, which permitted 3D isosurface rendering of vascular boundaries in combination with visualization of blood-flow patterns.Results: Analysis of navigator performance and image quality revealed improved scan efficiencies of 63.6% Ϯ 10.5% and temporal resolution (Ͻ50 msec) compared to previous implementations. Semiquantitative evaluation of image quality by three independent observers demonstrated excellent general image appearance with moderate blurring and minor ghosting artifacts. Results from volunteer and patient examinations illustrate the potential of the improved image acquisition and data-processing strategy for identifying normal and pathological blood-flow characteristics.
Conclusion:Navigator-gated time-resolved 3D MR velocity mapping at 3T in combination with advanced data processing is a powerful tool for performing detailed assessments of global and local blood-flow characteristics in the aorta to describe or exclude vascular alterations.
A three-dimensional computational fluid dynamics (CFD) method has been developed to simulate the flow in a pumping left ventricle. The proposed method uses magnetic resonance imaging (MRI) technology to provide a patient specific, time dependent geometry of the ventricle to be simulated. Standard clinical imaging procedures were used in this study. A two-dimensional time-dependent orifice representation of the heart valves was used. The location and size of the valves is estimated based on additional long axis images through the valves. A semi-automatic grid generator was created to generate the calculation grid. Since the time resolution of the MR scans does not fit the requirements of the CFD calculations a third order bezier approximation scheme was developed to realize a smooth wall boundary and grid movement. The calculation was performed by a Navier-Stokes solver using the arbitrary Lagrange-Euler (ALE) formulation. Results show that during diastole, blood flow through the mitral valve forms an asymmetric jet, leading to an asymmetric development of the initial vortex ring. These flow features are in reasonable agreement with in vivo measurements but also show an extremely high sensitivity to the boundary conditions imposed at the inflow. Changes in the atrial representation severely alter the resulting flow field. These shortcomings will have to be addressed in further studies, possibly by inclusion of the real atrial geometry, and imply additional requirements for the clinical imaging processes.
Purpose: To detect and investigate details in left ventricular (LV) motion patterns with a temporal resolution comparable to that of echocardiography.
Material and Methods:To assess global and regional myocardial motion in high temporal detail, respiratory-gated MR phase-contrast measurements with three-directional velocity encoding (venc) were performed in 12 healthy volunteers and two patients with LV hypertrophy in basal, midventricular, and apical locations of the LV with a temporal resolution of 13.8 msec.
Results:The volunteer data revealed details in LV motion patterns that were known only from echocardiography. For all volunteers, characteristic myocardial motion patterns, such as triphasic global diastolic expansion, could be detected with high accuracy. One volunteer underwent an additional echocardiographic measurement in order to corroborate the complex motion features as measured by MRI. Patient examinations revealed substantial changes in diastolic function compared to motion patterns in healthy volunteers.
Conclusion:The proposed high-temporal-resolution velocitymapping technique provides previously undetectable information on LV performance, and is highly promising for the detection of local and global motion abnormalities in patients with disturbed LV performance, such as diastolic dysfunction.
The phase contrast MRI technique for high temporal resolution velocity mapping is therefore very promising for the investigation and better understanding of the myocardial motion in normal subjects and patients with disturbed left ventricular performance and may validate further testing of different models of cardiac structure.
4D flow-sensitive MRI permits the comprehensive evaluation of blood flow characteristics in patients after repair of TOF. Altered flow patterns for different surgical techniques in the small patient cohort may indicate its value for patient monitoring and potentially identifying optimal surgical strategies.
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