4D-Flow MRI: Technique and Applications

Sträter, Alexandra; Huber, Armin; Rudolph, Jan Daniel; Berndt, Maria; Rasper, Michael; Rummeny, Ernst J.; Nadjiri, Jonathan

doi:10.1055/a-0647-2021

Cited by 29 publications

(32 citation statements)

References 41 publications

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“…[33][34][35][36] In summary, 4D flow MRI can be a useful tool as an add-on to standard MRI sequences for investigating the relationship between carotid stenosis and cerebral hemodynamics and optimize patient selection and reduce the need for other testing. [37] The distribution of cerebral blood flow after CEA Changes in cerebral hemodynamics after CEA or carotid artery stenting (CAS) are dependent on the timing of the blood flow measurement. Previous studies have found postoperative increases in CBF, blood flow velocity and BFR hours to days after CEA or CAS.…”

Section: Possible Clinical Applications For Flow Mrimentioning

confidence: 99%

Quantification and mapping of cerebral hemodynamics before and after carotid endarterectomy, using four-dimensional flow magnetic resonance imaging

Zarrinkoob

Wåhlin

Ambarki

et al. 2021

Journal of Vascular Surgery

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Section: Possible Clinical Applications For Flow Mrimentioning

confidence: 99%

Quantification and mapping of cerebral hemodynamics before and after carotid endarterectomy, using four-dimensional flow magnetic resonance imaging

Zarrinkoob

Wåhlin

Ambarki

et al. 2021

Journal of Vascular Surgery

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“…Thanks to development of new and high resolution imaging techniques like time-resolved three-dimensional phase contrast MRI (Kozerke et al, 2001;Frydrychowicz et al, 2007) also known as 4D flow MRI, hemodynamics have gained attention in the BAV field. This technique allows quality and quantitative flow measurement, like flow velocity, flow direction, wall shear stress, complex flow patterns, etc (Sträter et al, 2018). The progress of development of new imaging techniques in the cardiovascular field has also helped acquire more fast and accurate data in order to obtain prognosis or diagnosis of several diseases.…”

Section: Hemodynamics Alterations In Bav Diseasementioning

confidence: 99%

Bicuspid Aortic Valve and Endothelial Dysfunction: Current Evidence and Potential Therapeutic Targets

2020

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Bicuspid aortic valve (BAV), the most frequent congenital heart malformation, is characterized by the presence of a two-leaflet aortic valve instead of a three-leaflet one. BAV disease progression is associated with valvular dysfunction (in the form of stenosis or regurgitation) and aortopathy, which can lead to aneurysm and aortic dissection. This morphological abnormality modifies valve dynamics and promotes eccentric blood flow, which gives rise to alterations of the flow pattern and wall shear stress (WSS) of the ascending aorta. Recently, evidence of endothelial dysfunction (ED) in BAV disease has emerged. Different studies have addressed a reduced endothelial functionality by analyzing various molecular biomarkers and cellular parameters in BAV patients. Some authors have found impaired functionality of circulating endothelial progenitors in these patients, associating it with valvular dysfunction and aortic dilation. Others focused on systemic endothelial function by measuring artery flow-mediated dilation (FMD), showing a reduced FMD in BAV individuals. Novel biomarkers like increased endothelial microparticles (EMP), which are related to ED, have also been discovered in BAV patients. Finally, latest studies indicate that in BAV, endothelial-to-mesenchymal transition (EndoMT) may also be de-regulated, which could be caused by genetic, hemodynamic alterations, or both. Different hypothesis about the pathology of ED in BAV are nowadays being debated. Some authors blamed this impaired functionality just on genetic abnormalities, which could lead to a pathological aorta. Nevertheless, thanks to the development of new and high-resolution imaging techniques like 4D flow MRI, hemodynamics has gained great attention. Based on latest studies, alterations in blood flow seem to cause proper modification of the endothelial cells (ECs) function and morphology. It also seems to be associated with aortic dilation and decreased vasodilators expression, like nitric oxide (NO). Although nowadays ED in BAV has been reported by many, it is not clear which its main cause may be. Comprehending the pathways that promote ED and its relevance in BAV could help further understand and maybe prevent the serious consequences of this disease. This review will discuss the ED present in BAV, focusing on the latest evidence, biomarkers for ED and potential therapeutic targets (Figure 1).

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“…Quantitative flow analyses are obtained by placing arbitrary analysis planes using the 4D flow MRI-derived angiograms for correct orientation. 4D flow MRI-derived analyses of time-resolved flow velocities and flow rates are made equivalent to 2D phase contrast flow measurements: a local acceleration of flow velocity indicates a stenosis and a reduced flow rate indicates a reduced blood supply of the downstream organ [1]. If spatial resolution suffices to visualize a reliable flow profile within the vessel lumen, helical and vortical flows, flow eccentricity, and wall shear stress (WSS) can be evaluated [13].…”

Section: D Flow Mri Data Analysismentioning

confidence: 99%

“…1A, ▶ Video 1A). Velocity-coded angiograms can be obtained for each timeframe and are visualized as pathlines or streamlines within the vessel lumen [1] (▶ Fig. 1B, ▶ Video 1B).…”

Section: D Flow Mri Data Analysismentioning

confidence: 99%

“…Four-dimensional flow magnetic resonance imaging (4D flow MRI) is a three-dimensional and time-resolved phase contrast imaging technique allowing characterization of blood flows within the entire vasculature [1][2][3]. 4D flow MRI enables the visualization of physiological and pathological flow patterns by registration of both morphology and velocity data [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

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Abdominal Applications of 4D Flow MRI

Riedel

Lenz

Fischer

et al. 2020

Rofo

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Background Four-dimensional flow magnetic resonance imaging (4D flow MRI) provides volumetric and time-resolved visualization and quantification of blood flow. This review presents an overview of possible applications of 4D flow MRI for non-invasive assessment of abdominal hemodynamics. Method This review is based on the authors’ experience and the current literature. A PubMed database literature research was performed in December 2019 focusing on abdominal applications of 4D flow MRI. We illustrated the review with exemplary figures and movies of clinical cases from our institution. Results and Conclusion 4D flow MRI offers the possibility of comprehensive assessment of abdominal blood flows in different vascular territories and organ systems. Results of recent studies indicate that 4D flow MRI improves understanding of altered hemodynamics in patients with abdominal disease and may be useful for monitoring therapeutic response. Future studies with larger cohorts aiming to integrate 4D flow MRI in the clinical routine setting are needed. Key Points: Citation Format

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4D-Flow MRI: Technique and Applications

Cited by 29 publications

References 41 publications

Quantification and mapping of cerebral hemodynamics before and after carotid endarterectomy, using four-dimensional flow magnetic resonance imaging

Quantification and mapping of cerebral hemodynamics before and after carotid endarterectomy, using four-dimensional flow magnetic resonance imaging

Bicuspid Aortic Valve and Endothelial Dysfunction: Current Evidence and Potential Therapeutic Targets

Abdominal Applications of 4D Flow MRI

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