Four-Dimensional Flow Magnetic Resonance Imaging for Cardiovascular Imaging: from Basic Concept to Clinical Application

Ota, Hideki; Higuchi, Satoshi; Sun, Wenyu; Ueda, Toshihisa; Takase, Kei; Tamura, H.

doi:10.22468/cvia.2018.00045

Cited by 6 publications

(4 citation statements)

References 86 publications

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“…Additionally, there is a limited literature on the assessment of 4D-flow-based pressure drop and relative pressures in rTOF patients. On the other hand, numerous studies demonstrated an elevated ventricular kinetic energy (KE), vorticity, wall shear stress (WSS), and turbulent KE in the patient cohort [47][48][49]. A study by Hirtler et al reported a significantly higher intracardiac vorticity in patients with rTOF, as well as the association of a higher right vorticity with the regurgitant flow in the MPA [50].…”

Section: Discussionmentioning

confidence: 99%

Repaired Tetralogy of Fallot Pressure Assessment: Insights from 4D-Flow Pressure Mapping

Ali

Patton

Myers

et al. 2023

Fluids

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Tetralogy of Fallot (TOF) is the most prevalent cyanotic congenital heart defect (CHD) that alters normal blood flow through the heart and accounts for 10% of all CHD. Pulmonary stenosis and regurgitation are common in adults who have undergone TOF repair (rTOF) and can impact the load on the right ventricle, blood flow pressure, and pulmonary hemodynamics. Pressure mapping, obtained through 4D-flow magnetic resonance imaging (4D-flow MRI), has been applied to identify abnormal heart hemodynamics in CHD. Hence, the aim of this research was to compare pressure drop and relative pressures between patients with repaired TOF (rTOF) and healthy volunteers. An in vitro validation was performed, followed by an in vivo validation. We hypothesized that pressure drop is a more stable pressure mapping method than relative pressures to detect altered hemodynamics. A total of 36 subjects, 18 rTOF patients and 18 controls underwent cardiac MRI scans and 4D-flow MRI. Pressure drops and relative pressures in the MPA were higher in rTOF patients compared to the controls (p < 0.05). Following the in vitro validation, pressure drops proved to be a more stable pressure mapping method than relative pressures, as the flow loses its laminarity and becomes more turbulent. In conclusion, this study demonstrated that flow hemodynamics in rTOF can exhibit altered pressure maps. Pressure mapping can help provide further insight into rTOF patients’ hemodynamics to improve patient care and clinical decisions.

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Section: Discussionmentioning

confidence: 99%

Repaired Tetralogy of Fallot Pressure Assessment: Insights from 4D-Flow Pressure Mapping

Ali

Patton

Myers

et al. 2023

Fluids

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“…Diagnostics of the operation of mechanical valves in vivo are carried out using diagnostic complexes of Doppler echocardiography, magnetic resonance imaging, electrocardiography, ultrasound tomographic velocity measurement, phonocardiography, seismocardiography, and a number of other techniques and devices [23][24][25][26]. This equipment uses various principles and mechanisms for recording hemodynamics inside the heart and in general throughout the entire cardiovascular system.…”

Section: Methodsmentioning

confidence: 99%

Hydrodynamic Noise of Pulsating Jets through Bileaflet Mechanical Mitral Valve

Voskoboinick

Voskoboinyk

Chertov

et al. 2020

BioMed Research International

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Experimental research results of hydrodynamic noise of pulsating flow through a bileaflet mechanical mitral valve are presented. The pulsating flow of pure water corresponds to the diastolic mode of the cardiac rhythm heart. The valve was located between the model of the left atrium and the model of the left ventricle of the heart. A coordinate device, on which a block of miniature sensors of absolute pressure and pressure fluctuations was installed, was located inside the model of the left ventricle. It is found that the hydrodynamic noise of the pulsating side jet of the semiclosed valve is higher than for the open valve. The pressure fluctuation levels gradually decrease with the removal from the mitral valve. It is established that at the second harmonic of the pulsating flow frequency, the spectral levels of the hydrodynamic noise of the semiclosed bileaflet mechanical mitral valve are almost 5 times higher than the open valve. With the removal from the mitral valve, spectral levels of hydrodynamic noise are decreased, especially strongly at the frequency of the pulsating water flow and its higher harmonics.

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“…Одной из таких новых магнитно-резонансных (МР) методик является МР-программа 4D обработки изображений-«4D Flow» для оценки кровотока. Неудивительно, что ее клиническое использование вызывает нарастающий интерес в мире [6][7][8][9][10].…”

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“…Методика позволяет ретроспективно наглядно представить 3D-геометрию кровотока с цветовым картированием скоростей, направления потока в произвольно выбранных участках сосудистого русла и рассчитывать количественные показатели потока. Сканирование осуществляется на свободном дыхании, без введения контрастных препаратов и может использоваться на различных этапах динамического наблюдения, что делает методику особенно привлекательной для обследования детей [2,5,6,8].…”

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4D FLOW Magnetic Resonance Imaging in the Study of Blood Flow in Patients With Aortic Coarctation in the Long-Term After Surgery

et al. 2020

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Aim Comprehensive evaluation of blood flow in the thoracic aorta using a software for 4D processing of magnetic resonance (MR) images of the heart and blood vessels (4D Flow) in patients with aortic coarctation in the late postoperative period.Materials and methods The MR study of the heart was performed for 10 patients (7 boys and 3 girls) aged 8 to 13 years (median, 9.5 [8.3; 10.8] years) who underwent resection with end-to-end anastomosis for aortic coarctation at age of 2 weeks to 10 months. MR tomography was performed on a 1.5 T MR scanner using a multichannel surface coil for scanning, electrocardiographic synchronization, and a specialized package of pulse sequences for scanning of the heart. Blood flow was evaluated with a 4D data handling software for processing of MR images of heart and blood vessels (4D Flow). The following blood flow parameters were analyzed: blood flow volume per second, peak blood flow velocity, peak and minimum blood flow area at the levels of ascending aorta, arch, isthmus, and descending aorta, and pressure gradient at the level of maximum narrowing of the aorta. 3D-MR images were used for evaluation of aortic geometry. Blood flow formation, distribution, and trajectories were analyzed by maps of vectors, particle trace, and stream lines. Statistical analysis was performed with a Statistica (v. 6.0 StatSoft Inc.) package.Results Accelerated flow in the region of residual aortic stenosis in systole was observed in all patients; 4 patients had an additional vortex flow below the aortic stenosis and a spiral flow in the descending aorta. The pressure gradient on the aortic isthmus was directly correlated with the left ventricular myocardial mass index (r=0.65; р=0.04) and indexes of blood flow in the ascending and descending aorta (р=0.03; р=0.026). No significant correlation was found for blood flow indexes and geometry of the aortic arch (H / L). Delayed contrast enhancement MR imaging did not detect any fibrotic changes in the myocardium in only one patient. The fibrosis severity inversely correlated with the right ventricular ejection fraction (r=0.65; р=0.04) and directly correlated with the pressure gradient at the aortic isthmus (r=0.63; p=0.05).Conclusion The 4D MR image processing software for the heart and blood vessels allows studying the blood flow in detail under natural conditions, provides potential advantages in comprehensive evaluation of patients with aortic coarctation during a dynamic follow-up. For a definitive conclusion about the relationship between the altered blood flow in the thoracic aorta and markers of residual, post-correction pathology, larger studies are required as well as long-term follow-up of patients with documented pathological patterns of blood flow (changes in blood flow velocity and volume throughout the entire thoracic aorta in combination with disorders in the normal flow geometry during the cardiac cycle).

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Four-Dimensional Flow Magnetic Resonance Imaging for Cardiovascular Imaging: from Basic Concept to Clinical Application

Cited by 6 publications

References 86 publications

Repaired Tetralogy of Fallot Pressure Assessment: Insights from 4D-Flow Pressure Mapping

Repaired Tetralogy of Fallot Pressure Assessment: Insights from 4D-Flow Pressure Mapping

Hydrodynamic Noise of Pulsating Jets through Bileaflet Mechanical Mitral Valve

4D FLOW Magnetic Resonance Imaging in the Study of Blood Flow in Patients With Aortic Coarctation in the Long-Term After Surgery

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