4D Flow MR Imaging Reveals a Decrease of Left Atrial Blood Flow in a Patient with Cardioembolic Cerebral Infarction after Pulmonary Left Upper Lobectomy

Maeda, Mitsuo; Takegahara, Kyoshiro; Inoue, Tatsuya; Nakaza, Masatoki; Sekine, Tetsuro; Usuda, Jitsuo

doi:10.2463/mrms.ici.2019-0142

Cited by 20 publications

(21 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is only one case report that evaluated the blood flow in the LA after LUL. 10 Phase-contrast MRI-based evaluation for the blood flow in the LA was first reported two decades ago. 11,12 Thanks to the improvement of the scan scheme and post-processing software for time-resolved 3D phase-contrast (4D flow), the detailed blood flow in the LA has been actively investigated by using this modality in the latter half of the decade.…”

Section: Introductionmentioning

confidence: 99%

“…13,15,16 In the same context, one previous case report utilizing 4D flow MRI suggested that abnormal LA blood flow after LUL causes PV stump thrombosis, resulting in embolic cerebral infarction. 10 The purpose of the current study was to clarify the blood flow pattern in the LA potentially causing the formation of thrombosis after LUL. The blood flow in the LAwas evaluated and compared between LUL patients with and without thrombosis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Dual-VENC 4D Flow MRI Can Detect Abnormal Blood Flow in the Left Atrium That Potentially Causes Thrombosis Formation after Left Upper Lobectomy

Nakaza

Maeda

Sekine

et al. 2022

MRMS

Self Cite

View full text Add to dashboard Cite

The purpose of the current study was to clarify the blood flow pattern in the left atrium (LA), potentially causing the formation of thrombosis after left upper lobectomy (LUL). The blood flow in the LA was evaluated and compared between LUL patients with and without thrombosis. For the evaluation, we applied highly accelerated 4D flow MRI with dual-velocity encoding (VENC) scheme, which was expected to be able to capture slow flow components in the LA accurately.Methods: Eight volunteers and 18 patients subjected to LUL underwent dual-VENC 4D Flow MRI. Eight patients had a history of thrombosis. We measured the blood flow velocity and stasis ratio (proportion in the volume that did not exceed 10 cm/s in any cardiac phase) in the LA and left superior pulmonary vein (LSPV) stump. For visual assessment, the presence of each collision of the blood flow from pulmonary veins and vortex flow in the LA were evaluated. Each acquired value was compared between healthy participants and LUL patients, and in LUL patients with and without thrombosis.Results: In LUL patients, blood flow velocity near the inflow part of the left superior pulmonary vein (Lt Upp) and mean velocity in the LA were lower, and stasis ratio in the LA was higher compared with healthy volunteers (Lt Upp 9.10 ± 3.09 vs.13.23 ± 14.19 cm/s, mean velocity in the LA 9.81 ± 2.49 vs. 11.40 ± 1.15 cm/s, and stasis ratio 25.28 ± 18.64 vs. 4.71 ± 3.03%, P = 0.008, 0.037, and < 0.001). There was no significant difference in any quantification values between LUL patients with and without thrombosis. For visual assessment, the thrombus formation was associated with no collision pattern (62.5% vs. 10%, P = 0.019) and not with vortex flow pattern (50% vs. 30%, P = 0.751). Conclusion:The net blood flow velocity was not associated with the thrombus formation. In contrast, a specific blood flow pattern, the absence of blood flow collision from pulmonary veins, correlates to the thrombus formation in the LA.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dual-VENC 4D Flow MRI Can Detect Abnormal Blood Flow in the Left Atrium That Potentially Causes Thrombosis Formation after Left Upper Lobectomy

Nakaza

Maeda

Sekine

et al. 2022

MRMS

Self Cite

View full text Add to dashboard Cite

show abstract

“…To accurately capture both the high-and low-velocity blood flow, multivelocity encoding (multi-VENC) 4D flow MRI with a wide dynamic range of target blood flow velocity has been proposed. 63,[65][66][67][68]…”

Section: Aortic Dissectionmentioning

confidence: 99%

Utility of 4D Flow MRI in Thoracic Aortic Diseases: A Literature Review of Clinical Applications and Current Evidence

Takahashi

Sekine

Ando

et al. 2022

MRMS

Self Cite

View full text Add to dashboard Cite

Despite the recent technical developments, surgery on the thoracic aorta remains challenging and is associated with significant mortality and morbidity. Decisions about when and if to operate are based on a balance between surgical risk and the hazard of aortic rupture. These decisions are sometimes difficult in elective cases of thoracic aortic diseases, including aneurysms and dissections. Abnormal wall stress derived from flow alterations influences disease progression. Therefore, a better understanding of the complex hemodynamic environment inside the aortic lumen will facilitate patient-specific risk assessments of complications, which enable clinicians to provide timely prophylactic interventions. Time-resolved 3D phase-contrast (4D flow) MRI has many advantages for the in vivo assessment of flow dynamics. Recent developments in 4D flow imaging techniques has led to significant advances in our understanding of physiological flow dynamics in healthy subjects and patients with thoracic aortic diseases. In this clinically focused review of thoracic aortic diseases, we demonstrate the clinical advances acquired with 4D flow MRI from published studies. We provide a systematic overview of key evidences and considerations regarding normal thoracic aortas, thoracic aortic aneurysms, aortic dissections, and thoracic aortas with prosthetic graft replacement.

show abstract

“…One of the hypotheses to explain the higher risk of thrombosis in this specific group is the existence of a longer pulmonary vein (PV) stump after LUL, which causes blood flow stasis resulting in the formation of the embolic source. 46,47,55 In addition to altered flow in the vein stump, the postoperative blood flow changes in the LA are supposed to further promote the formation of thrombosis [56][57][58][59] (Fig. 7).…”

Section: D Flow Mri Assessment Of Post-lung Surgerymentioning

confidence: 99%

4D Flow MR Imaging of the Left Atrium: What is Non-physiological Blood Flow in the Cardiac System?

et al. 2022

Self Cite

View full text Add to dashboard Cite

Most cardiac diseases cause a non-physiological blood flow pattern known as turbulence around the heart and great vessels, which further worsen the disease itself. However, there is no consensus on how blood flow can be defined in disease conditions. Especially, in the left atrium, the fact that vortex flow already exists makes this debate more complicated. 3D time-resolved phase-contrast (4D flow) MRI is expected to be able to capture blood flow patterns from multiple aspects, such as blood flow velocity, stasis, and vortex quantification. Previous studies have confirmed that physiological vortex flow is predominantly induced by the higher-volume flow from the superior left pulmonary vein. In atrial fibrillation, 4D flow MRI reveals a non-physiological blood flow pattern, which information may add value to well-established clinical risk factors. Currently, the research target of LA analysis has also widened to lung surgeons, pulmonary vein stump thrombosis after left upper lobectomy. 4D flow MRI is expected to be utilized for many more variable diseases that are currently unimaginable.

show abstract

4D Flow MR Imaging Reveals a Decrease of Left Atrial Blood Flow in a Patient with Cardioembolic Cerebral Infarction after Pulmonary Left Upper Lobectomy

Cited by 20 publications

References 16 publications

Dual-VENC 4D Flow MRI Can Detect Abnormal Blood Flow in the Left Atrium That Potentially Causes Thrombosis Formation after Left Upper Lobectomy

Dual-VENC 4D Flow MRI Can Detect Abnormal Blood Flow in the Left Atrium That Potentially Causes Thrombosis Formation after Left Upper Lobectomy

Utility of 4D Flow MRI in Thoracic Aortic Diseases: A Literature Review of Clinical Applications and Current Evidence

4D Flow MR Imaging of the Left Atrium: What is Non-physiological Blood Flow in the Cardiac System?

Contact Info

Product

Resources

About