Four‐dimensional phase contrast MRI with accelerated dual velocity encoding

Nett, Elizabeth J; Johnson, Kevin M.; Frydrychowicz, Alex; Río, Alejandro Muñoz del; Schrauben, Eric; François, Christopher J.; Wieben, Oliver

doi:10.1002/jmri.23588

Cited by 85 publications

(23 citation statements)

References 25 publications

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“…Second, it was necessary to repeat 4D-flow MR imaging back-to-back with two different velocity encoding settings to allow for optimal assessment of both slow flow in the portal vein and high flow velocities within the TIPS. The application of recently developed dual-velocity encoding strategies to improve the range of velocity encoding should be used in future studies (25). Four-dimensional– flow MR imaging was also performed at different times of the day, a factor that is known to influence portal flow.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, a reference standard was not available for quantification of blood flow in the portal circulation. However, 4D-flow MR imaging flow measurements were previously and extensively validated in flow phantoms and in vivo compared with two-dimensional phase-contrast MR imaging, Doppler US, and animal studies (25–31). In the human abdomen, 4D-flow MR imaging was validated on the basis of conservation of mass principles (16,27).…”

Section: Discussionmentioning

confidence: 99%

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Longitudinal Monitoring of Hepatic Blood Flow before and after TIPS by Using 4D-Flow MR Imaging

Bannas¹,

Roldán‐Alzate²,

Johnson³

et al. 2016

Radiology

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Purpose To demonstrate the feasibility of four-dimensional (4D)– flow magnetic resonance (MR) imaging for noninvasive longitudinal hemodynamic monitoring of hepatic blood flow before and after transjugular intrahepatic portosystemic shunt (TIPS) placement. Materials and Methods The institutional review board approved this prospective Health Insurance Portability and Accountability Act compliant study with written informed consent. Four-dimensional–flow MR imaging was performed in seven patients with portal hypertension and refractory ascites before and 2 and 12 weeks after TIPS placement by using a time-resolved three-dimensional radial phase-contrast acquisition. Flow and peak velocity measurements were obtained in the superior mesenteric vein (SMV), splenic vein (SV), portal vein (PV), and the TIPS. Flow volumes and peak velocities in each vessel, as well as the ratio of in-stent to PV flow, were compared before and after TIPS placement by using analysis of variance. Results Flow volumes significantly increased in the SMV (0.24 L/ min; 95% confidence interval [CI]: 0.07, 0.41), SV (0.31 L/min; 95% CI: 0.07, 0.54), and PV (0.88 L/min; 95% CI: 0.06, 1.70) after TIPS placement (all P < .05), with no significant difference between the first and second post-TIPS placement acquisitions (all P > .11). Ascites resolved in six of seven patients. In those with resolved ascites, the TIPS-to-PV flow ratio was 0.8 ± 6 0.2 and 0.9 ± 0.2 at the two post-TIPS time points, respectively, while the observed ratios were 4.6 and 4.3 in the patient with refractory ascites at the two post-TIPS time points, respectively. In this patient, 4D-flow MR imaging demonstrated arterio-portal-venous shunting, with draining into the TIPS. Conclusion Four-dimensional–flow MR imaging is feasible for noninvasive longitudinal hemodynamic monitoring of hepatic blood flow before and after TIPS placement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Longitudinal Monitoring of Hepatic Blood Flow before and after TIPS by Using 4D-Flow MR Imaging

Bannas¹,

Roldán‐Alzate²,

Johnson³

et al. 2016

Radiology

Self Cite

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“…However, the bias introduced by aliasing and the attempt to correct it would likely introduce more error than the noise and dynamic range variation. This issue may be overcome by using dual velocity encoding approaches, which are under development [34]. …”

Section: Discussionmentioning

confidence: 99%

4-D flow magnetic resonance imaging: blood flow quantification compared to 2-D phase-contrast magnetic resonance imaging and Doppler echocardiography

et al. 2014

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Background Doppler echocardiography (echo) is the reference standard for blood flow velocity analysis, and two-dimensional (2-D) phase-contrast magnetic resonance imaging (MRI) is considered the reference standard for quantitative blood flow assessment. However, both clinical standard-of-care techniques are limited by 2-D acquisitions and single-direction velocity encoding and may make them inadequate to assess the complex three-dimensional hemodynamics seen in congenital heart disease. Four-dimensional flow MRI (4-D flow) enables qualitative and quantitative analysis of complex blood flow in the heart and great arteries. Objectives The objectives of this study are to compare 4-D flow with 2-D phase-contrast MRI for quantification of aortic and pulmonary flow and to evaluate the advantage of 4-D flow-based volumetric flow analysis compared to 2-D phase-contrast MRI and echo for peak velocity assessment in children and young adults. Materials and methods Two-dimensional phase-contrast MRI of the aortic root, main pulmonary artery (MPA), and right and left pulmonary arteries (RPA, LPA) and 4-D flow with volumetric coverage of the aorta and pulmonary arteries were performed in 50 patients (mean age: 13.1±6.4 years). Four-dimensional flow analyses included calculation of net flow and regurgitant fraction with 4-D flow analysis planes similarly positioned to 2-D planes. In addition, 4-D flow volumetric assessment of aortic root/ascending aorta and MPA peak velocities was performed and compared to 2-D phase-contrast MRI and echo. Results Excellent correlation and agreement were found between 2-D phase-contrast MRI and 4-D flow for net flow (r=0.97, P<0.001) and excellent correlation with good agreement was found for regurgitant fraction (r= 0.88, P<0.001) in all vessels. Two-dimensional phase-contrast MRI significantly underestimated aortic (P= 0.032) and MPA (P<0.001) peak velocities compared to echo, while volumetric 4-D flow analysis resulted in higher (aortic: P=0.001) or similar (MPA: P=0.98) peak velocities relative to echo. Conclusion Excellent flow parameter agreement between 2-D phase-contrast MRI and 4-D flow and the improved volumetric 4-D flow velocity analysis relative to echo suggests that 4-D flow has the potential to become a clinical alternative to 2-D phase-contrast MRI.

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“…This too may have contributed to differences in arterial and portal venous flow comparisons. Of note, dual V enc approaches or dual scanning methods with low and high V enc are a feasible approach to avoid this trade-off, but are time consuming and not clinically practical at this time [28, 31, 32]. …”

Section: Discussionmentioning

confidence: 99%

Comparison of radial 4D Flow-MRI with perivascular ultrasound to quantify blood flow in the abdomen and introduction of a porcine model of pre-hepatic portal hypertension

et al. 2017

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Objectives Objectives of this study were to compare radial time-resolved phase contrast magnetic resonance imaging (4D Flow-MRI) with perivascular ultrasound (pvUS) and to explore a porcine model of acute pre-hepatic portal hypertension (PHTN). Methods Abdominal 4D Flow-MRI and pvUS in portal and splenic vein, hepatic and both renal arteries were performed in 13 pigs of approximately 60 kg. In six pigs, measurements were repeated after partial portal vein (PV) ligature. Inter-and intra-reader comparisons and statistical analysis including Bland–Altman (BA) comparison, paired Student’s t tests and linear regression were performed. Results PvUS and 4D Flow-MRI measurements agreed well; flow before partial PV ligature was 322 ± 30 ml/min in pvUS and 297 ± 27 ml/min in MRI (p = 0.294), and average BA difference was 25 ml/min [−322; 372]. Inter- and intra-reader results differed very little, revealed excellent correlation (R2 = 0.98 and 0.99, respectively) and resulted in BA differences of −5 ml/min [−161; 150] and −2 ml/min [−28; 25], respectively. After PV ligature, PV flow decreased from 356 ± 50 to 298 ± 61 ml/min (p = 0.02), and hepatic arterial flow increased from 277 ± 36 to 331 ± 65 ml/min (p = n.s.). Conclusion The successful in vivo comparison of radial 4D Flow-MRI to perivascular ultrasound revealed good agreement of abdominal blood flow although with considerable spread of results. A model of pre-hepatic PHTN was successfully introduced and acute responses monitored.

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Four‐dimensional phase contrast MRI with accelerated dual velocity encoding

Cited by 85 publications

References 25 publications

Longitudinal Monitoring of Hepatic Blood Flow before and after TIPS by Using 4D-Flow MR Imaging

Longitudinal Monitoring of Hepatic Blood Flow before and after TIPS by Using 4D-Flow MR Imaging

4-D flow magnetic resonance imaging: blood flow quantification compared to 2-D phase-contrast magnetic resonance imaging and Doppler echocardiography

Comparison of radial 4D Flow-MRI with perivascular ultrasound to quantify blood flow in the abdomen and introduction of a porcine model of pre-hepatic portal hypertension

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