A feasibility study to evaluate splanchnic arterial and venous hemodynamics by flow-sensitive 4D MRI compared with Doppler ultrasound in patients with cirrhosis and controls

Stanković, Zoran; Csatari, Zoltan; Deibert, Peter; Euringer, Wulf; Jung, Bernd; Kreisel, Wolfgang; Geiger, Julia; Russe, Maximilian; Langer, Mathias; Markl, Michael

doi:10.1097/meg.0b013e32835e1297

Cited by 41 publications

(45 citation statements)

References 22 publications

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“…Systolic flow patterns, which can give a qualitative sense of hemodynamics, as has been shown in other work investigating the relationship between flow patterns and energy loss, 26 are readily apparent in 4D flow MIPs. Though previous methods 14, 16, 17, 21 have means of displaying flow patterns as well, they involve an additional step and result in longer processing times. Data and segmentation quality are also evident in the 4D flow MIPs.…”

Section: Discussionmentioning

confidence: 99%

Efficient method for volumetric assessment of peak blood flow velocity using 4D flow MRI

Rose

Jarvis

Chowdhary

et al. 2016

J. Magn. Reson. Imaging

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Purpose To test the feasibility and effectiveness of using maximum intensity plots (MIPs) based on 4D flow MRI velocity data to assess systolic peak velocities in a cohort of bicuspid aortic valve (BAV) patients. Materials and Methods 4D flow MRI at 1.5 T was performed on 51 BAV patients. MIPs were generated from the 4D flow MRI velocity data and used by 2 users to determine peak velocities in 3 regions of interest (ROI): ascending aorta (AAo), aortic arch and descending aorta. 4D flow MRI peak velocities in the AAo were compared to peak velocities recorded by 2D phase contrast MRI (2D PCMRI) in a subcohort of 36 patients and by Doppler echocardiography in a subcohort of 34 patients. 4D flow MRI peak velocities recorded by each observer were compared for all ROIs to test for inter-observer variability. Results 4D flow MRI recorded significantly higher velocities compared to 2D PCMRI (2.04 ± 0.71 m/s vs 1.69 ± 0.79 m/s, 17.2% difference, p < 0.001) and similar velocities compared to Doppler echocardiography. There was excellent agreement between the observers with a mean difference of 0.005 m/s and an intraclass correlation coefficient of 0.98. Conclusion 4D flow MRI velocity MIPs allow for efficient measurement of peak velocities in BAV patients with higher accuracy than 2D PCMRI and similar accuracy to Doppler echocardiography.

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Section: Discussionmentioning

confidence: 99%

Efficient method for volumetric assessment of peak blood flow velocity using 4D flow MRI

Rose

Jarvis

Chowdhary

et al. 2016

J. Magn. Reson. Imaging

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“…Time-resolved (cine) phase contrast (PC) MRI is regularly used for hemodynamic assessment of the thoracic (4) and abdominal aorta (5). Four-dimensional (4D) flow MRI representing time-resolved phase contrast (PC) MRI with tridirectional velocity encoding and three-dimensional (3D) anatomic coverage has recently gained increased attention due to its ability to provide comprehensive 3D flow visualization and quantitative blood flow evaluation (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Previous reports include the application of 4D flow MRI in the thoracic aorta (6,7), pulmonary artery (8,9), and carotid artery (10), which represent high-flow arterial systems.…”

Section: Introductionmentioning

confidence: 99%

Reproducibility study of four‐dimensional flow MRI of arterial and portal venous liver hemodynamics: Influence of spatio‐temporal resolution

Stanković

Jung

Collins

et al. 2013

Magnetic Resonance in Med

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Purpose To evaluate influence of variation in spatio-temporal resolution and scan-rescan reproducibility on 3D visualization and quantification of arterial and portal venous (PV) liver hemodynamics at 4D flow MRI. Methods Scan-rescan reproducibility of 3D hemodynamic analysis of the liver was evaluated in 10 healthy volunteers using 4D flow MRI at 3T with three different spatio-temporal resolutions (2.4×2.0×2.4mm3, 61.2ms; 2.5×2.0×2.4mm3, 81.6ms; 2.6×2.5×2.6mm3, 80ms) and thus different total scan times. Qualitative flow analysis used 3D streamlines and time-resolved particle traces. Quantitative evaluation was based on maximum and mean velocities, flow volume and vessel lumen area in the hepatic arterial and PV systems. Results 4D flow MRI showed good inter-observer variability for assessment of arterial and PV liver hemodynamics. 3D flow visualization revealed limitations for the left intrahepatic PV branch. Lower spatio-temporal resolution resulted in underestimation of arterial velocities (mean 15%, p<0.05). For the PV system hemodynamic analyses showed significant differences in the velocities for intrahepatic portal vein vessels (p<0.05). Scan-rescan reproducibility was good except for flow volumes in the arterial system. Conclusion 4D flow MRI for assessment of liver hemodynamics can be performed with low interobserver variability and good reproducibility. Higher spatio-temporal resolution is necessary for complete assessment of the hepatic blood flow required for clinical applications.

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“…Newer 4D flow-sensitive noncontrast MRA techniques can be used to qualitatively and quantitatively study blood flow (25). However, there is a significant discrepancy between these techniques and Doppler US for several indices used to quantity flow (26), and so these methods are not widely used in the clinical setting. In spite of the major advantage of lack of exposure to ionizing radiation, MRA of PSMV system is remains as a useful option only in special circumstances due to a several reasons-high cost, limited availability, longer scan times compared to MDCT, artifacts, and contraindications of MRI (19).…”

Section: Imaging Techniques To Assess Psmv Systemmentioning

confidence: 99%

Utility of cone-beam computed tomography in the assessment of the porto-spleno-mesenteric venous system

Karuppasamy

2016

Cardiovasc. Diagn. Ther.

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The common diagnostic tools available to evaluate the porto-spleno-mesenteric venous (PSMV) system provide either good hemodynamic information with limited morphological details [e.g., ultrasonography (US)] or excellent tomographic display of the anatomy with limited information about flow patterns [e.g., multidetector computed tomography (MDCT) and magnetic resonance imaging]. Although catheter-directed selective digital subtraction angiography (DSA) can provide excellent information about flow at a high temporal resolution and can generate images at a high spatial resolution, this technique is often limited by a lack of cross-sectional detail. In the assessment of the PSMV system, DSA is also limited by dilution of contrast and motion artefacts. Combining venous phase cone-beam computed tomography (CBCT) with DSA can generate high-quality tomographic data, which allows detailed evaluation of venous tributaries and flow patterns within the splenic, superior mesenteric, and inferior mesenteric venous systems individually. This enables clinicians to better understand the impact of nonobstructive resistance to flow (e.g., as in patients with cirrhosis) and obstructive resistance to flow (e.g., as in patients with thrombosis) within each system and plan treatment accordingly. In this review, we discuss the limitations of common diagnostic methods and the role venous CBCT in combination with DSA can play in assessing the PSMV system.

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A feasibility study to evaluate splanchnic arterial and venous hemodynamics by flow-sensitive 4D MRI compared with Doppler ultrasound in patients with cirrhosis and controls

Abstract: Flow-sensitive 4D MRI is feasible for profound evaluation of arterial and portal venous hemodynamics in liver cirrhosis patients, providing additional information on the pathophysiology of the altered splanchnic system.

Cited by 41 publications

References 22 publications

Efficient method for volumetric assessment of peak blood flow velocity using 4D flow MRI

Efficient method for volumetric assessment of peak blood flow velocity using 4D flow MRI

Reproducibility study of four‐dimensional flow MRI of arterial and portal venous liver hemodynamics: Influence of spatio‐temporal resolution

Utility of cone-beam computed tomography in the assessment of the porto-spleno-mesenteric venous system

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