Four-dimensional flow MRI for evaluation of post-stenotic turbulent flow in a phantom: comparison with flowmeter and computational fluid dynamics

Kweon, Jihoon; Yang, Dong Hyun; Kim, Guk Bae; Kim, Namkug; Paek, MunYoung; Stalder, Aurélien F.; Greiser, Andreas; Kim, Young‐Hak

doi:10.1007/s00330-015-4181-6

Cited by 21 publications

(19 citation statements)

References 25 publications

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“…To optimise long-term outcome, the valve prostheses should provide unobstructed central laminar blood flow without substantial energy loss and shear stress on the aortic wall comparable to energy loss and shear stress on the native aortic valve. In our study, although the peak velocity presented is elevated and comparable to that of a phantom with severe stenosis, the native velocity, WSS and EL pattern was best resembled by the stentless prosthesis [ 18 ]. Additional evidence of the obstruction that is still present in both prostheses is provided by a comparison with results of 4D flow MRI of the ascending aorta of healthy volunteers in recent literature [ 8 , 19 ].…”

Section: Discussionmentioning

confidence: 83%

Four-dimensional flow MRI of stented versus stentless aortic valve bioprostheses

et al. 2017

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ObjectivesTo evaluate aortic velocity, wall shear stress (WSS) and viscous energy loss (EL) of stented and stentless bioprostheses using 4D flow MRI 1 year after surgical aortic valve replacement.MethodsFor this cross-sectional study 28 patients with stented (n = 14) or stentless (n = 14) bioprosthesis underwent non-contrast-enhanced 4D-flow MRI at 1.5 T. Analyses included a comparison of velocity, WSS and EL in the ascending aorta during peak systole for both spatially averaged values and a comparison of local differences using per-voxel analysis.ResultsNo significant differences were found in peak and mean velocity (stented vs. stentless: 2.45 m/s vs. 2.11 m/s; p = 0.09 and 0.60 m/s vs. 0.62 m/s; p = 0.89), WSS (0.60 Pa vs. 0.59 Pa; p = 0.55) and EL (10.17 mW vs. 7.82 mW; p = 0.10). Per-voxel analysis revealed significantly higher central lumen velocity, and lower outer lumen velocity, WSS and EL for stentless versus stented prostheses.ConclusionOne year after aortic valve implantation with stented and stentless bioprostheses, velocity, WSS and EL were comparable when assessed for averaged values in the ascending aorta. However, the flow profile described with local analysis for stentless prosthesis is potentially favourable with a significantly higher central velocity profile and lower values for outer lumen velocity, WSS and EL.Key Points• Stentless bioprostheses can be implanted instead of stented aortic valve bioprostheses.• Haemodynamic performance of valve prosthesis can be assessed using 4D flow MRI.• Averaged ascending aorta PSV, WSS and EL are comparable 1 year post-implantation.• Centreline velocity is highest, WSS and EL is lowest for stentless prosthesis.

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Section: Discussionmentioning

confidence: 83%

Four-dimensional flow MRI of stented versus stentless aortic valve bioprostheses

et al. 2017

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“…According to previous studies, the velocity of the jet flow usually reaches a maximum at around 10 mm distal to the valve as the flow converges at the post-valve region, and retains more than 85% of the peak velocity at 30 mm distal to the valve [45]. Meanwhile, turbulence production usually occurs distal to the valve, reaching a maximum at the aortic root and ascending aorta [14,42,46,47]. Considering that the length of signal loss behind the outlet orifice of the valve is less than half of the total signal void of the valves (Figure 3), the Tilting disc, STJM and SAPIEN 3 valves should be relatively free from significant underestimation of peak velocity and turbulence production.…”

Section: Discussionmentioning

confidence: 92%

4D Flow MRI quantification of blood flow patterns, turbulence and pressure drop in normal and stenotic prosthetic heart valves

Kvitting

Dyverfeldt

et al. 2019

Magnetic Resonance Imaging

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The self-archived postprint version of this journal article is available at Linköping University Institutional Repository (DiVA): http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-153497 N.B.: When citing this work, cite the original publication.Ha, H., Escobar Kvitting, J., Dyverfeldt, P., Ebbers, T., (2019), 4D Flow MRI quantification of blood flow patterns, turbulence and pressure drop in normal and stenotic prosthetic heart valves, Magnetic Resonance Imaging, 55, 118-127. https://doi. AbstractPurpose -To assess valvular flow characteristics and pressure drop in a variety of normal and stenotic prosthetic heart valves (PHVs) using 4D Flow MRI. Materials and methods-In-vitro flow phantoms with four different PHVs were studied: Medtronic-Hall tilting disc, St. Jude Medical standard bileaflet (STJM), Medtronic CoreValve Evolut R and Edwards SAPIEN 3. The valvular flow characteristics were investigated in normal and stenotic PHVs by using 4D Flow MRI.Results -The results showed that each valve provided a different amount of signal loss in the 4D Flow MRI. The defect size of the signal loss from each valve was 37.5 mm, 39.0 mm, 37.5 mm and 51.0 mm for the Tilting disk, STJM, SAPIEN 3 and CoreValve, respectively.The 4D Flow MRI-based estimation of the elevation of the pressure drop through the stenotic PHV using both Bernoulli-based and turbulence-based methods correlated well with the true values for the Tilting disc, STJM and SAPIEN 3 valve. However, the obstructive hemodynamics in the stenotic CoreValve was not clearly identified due to the large signal void from the long struts, resulting in a severe underestimation of the pressure drop using 4D Flow MRI.Conclusion -The Tilting disc, STJM and SAPIEN 3 valves provided reasonable estimates of peak velocity, turbulence production and the corresponding pressure drop. In contrast, the large strut of the CoreValve and corresponding signal void prevented accurate measurements of the velocity and turbulence production; therefore, 4D Flow MRI prediction of the pressure drop through the CoreValve was not feasible.

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“…The validity of 4D flow MRI measurements has been investigated in several studies [11,12,15,[29][30][31][32][33][34]. In vivo reference methods include Doppler ultrasound, 2D PCMRI and computational fluid dynamics [33,35].…”

Section: Validation Of 4d Flow Mrimentioning

confidence: 99%

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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Four-dimensional flow MRI for evaluation of post-stenotic turbulent flow in a phantom: comparison with flowmeter and computational fluid dynamics

Abstract: • 4D flow MRI accurately measures the flow rate in axial scan. • The peak velocity was underestimated by 4D flow MRI. •4D flow MRI demonstrates the principal pattern of post-stenotic flow.

Cited by 21 publications

References 25 publications

Four-dimensional flow MRI of stented versus stentless aortic valve bioprostheses

Four-dimensional flow MRI of stented versus stentless aortic valve bioprostheses

4D Flow MRI quantification of blood flow patterns, turbulence and pressure drop in normal and stenotic prosthetic heart valves

Abdominal Applications of 4D Flow MRI

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