Hemodynamic Parameters for Cardiovascular System in 4D Flow MRI: Mathematical Definition and Clinical Applications

Sekine, Tetsuro; Yamagishi, Masaaki; Maeda, Yoshinobu; Higashitani, Norika; Miyazaki, Shohei; Matsuda, Junya; Takehara, Yasuo

doi:10.2463/mrms.rev.2021-0097

Cited by 18 publications

(13 citation statements)

References 97 publications

(142 reference statements)

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“…12,13 As 4D flow MRI can measure the spatio-temporal velocity field in the entire volume of interest, indices reflecting the dissipation of viscous energy such as energy loss (EL) can also be measured using equations based on spatiotemporal velocity data. [13][14][15] EL is the energy loss due to friction between viscous blood and the vessel wall or between blood. Previously, researchers used this indicator as a virtual catheter to fascilitate reproducible automated evaluation of volumetric intra-aortic hemodynamics alterations observed in the bicuspid aortic valve.…”

Section: Atherosclerosis Research Using 4d Flow Mrimentioning

confidence: 99%

Clinical Application of 4D Flow MR Imaging for the Abdominal Aorta

Takehara

2022

magn reson med sci

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Blood vessels can be regarded as autonomous organs. The endothelial cells on the vessel surface serve as mechanosensors or mechanoreceptors for the flow velocity and turbulence of the blood flow in terms of wall shear stress (WSS), thereby monitoring changes in the flow velocity. Accordingly, the endothelial cells regulate the flow velocity by releasing numerous mediators. Such regulatory systems also trigger atherosclerosis, where the WSS decreases or fluctuates to maintain the flow velocity or local WSS. As occurrences of abdominal aortic aneurysms and aortic dissection are closely related to atherosclerosis, understanding the hemodynamics of the abdominal aorta is necessary to obtain useful information concerning the pathogenesis, diagnosis, and interventions. 4D flow MRI is beneficial for measuring the hemodynamics through comprehensive retrospective flowmetry of the entire spatio-temporal distributions of the flow vectors. This section focuses on abdominal aortic aneurysms and aortic dissection as representative examples of abdominal aortic diseases. Their hemodynamic characteristics and how hemodynamics is involved in their progression are described, and how 4D flow MRI can contribute to their assessment is also explained.

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Section: Atherosclerosis Research Using 4d Flow Mrimentioning

confidence: 99%

Clinical Application of 4D Flow MR Imaging for the Abdominal Aorta

Takehara

2022

magn reson med sci

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“…It is currently the only method that can measure 3D blood flow with the vector component in vivo , and as such is a powerful tool in the evaluation of hemodynamics in cardiac disease. 4D flow MRI can even comprehensively capture cardiac structure and hemodynamic function in patients with complex anatomy ( 6 , 20 ). Recently, several commercial tools utilizing this imaging process have become available, leading to an increase in publications and clinical applications regarding 4D flow MRI ( 6 ).…”

Section: How Does Blood Flow Assessment Work?mentioning

confidence: 99%

Blood flow assessment technology in aortic surgery: a narrative review

Hohri,

Chung,

Kandula

et al. 2024

J Thorac Dis

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Background and Objective Blood flow assessment is an emerging technique that allows for assessment of hemodynamics in the heart and blood vessels. Recent advances in cardiovascular imaging technologies have made it possible for this technique to be more accessible to clinicians and researchers. Blood flow assessment typically refers to two techniques: measurement-based flow visualization using echocardiography or four-dimensional flow magnetic resonance imaging (4D flow MRI), and computer-based flow simulation based on computational fluid dynamics modeling. Using these methods, blood flow patterns can be visualized and quantitative measurements of mechanical stress on the walls of the ventricles and blood vessels, most notably the aorta, can be made. Thus, blood flow assessment has been enhancing the understanding of cardiac and aortic diseases; however, its introduction to clinical practice has been negligible yet. In this article, we aim to discuss the clinical applications and future directions of blood flow assessment in aortic surgery. We then provide our unique perspective on the technique’s translational impact on the surgical management of aortic disease. Methods Articles from the PubMed database and Google Scholar regarding blood flow assessment in aortic surgery were reviewed. For the initial search, articles published between 2013 and 2023 were prioritized, including original articles, clinical trials, case reports, and reviews. Following the initial search, additional articles were considered based on manual searches of the references from the retrieved literature. Key Content and Findings In aortic root pathology and ascending aortic aneurysms, blood flow assessment can elucidate postoperative hemodynamic changes after surgical reconfiguration of the aortic valve complex or ascending aorta. In cases of aortic dissection, analysis of blood flow can predict future aortic dilatation. For complicated congenital aortic anomalies, surgeons may use preoperative imaging to perform “virtual surgery”, in which blood flow assessment can predict postoperative hemodynamics for different surgical reconstructions and assist in procedural planning even before entering the operating room. Conclusions Blood flow assessment and computational modeling can evaluate hemodynamics and flow patterns by visualizing blood flow and calculating biomechanical forces in patients with aortic disease. We anticipate that blood flow assessment will become an essential tool in the treatment planning and understanding of the progression of aortic disease.

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“…[9][10][11][12] As an alternative to ultrasound, time-resolved 3D phasecontrast (4D flow) MRI has been used to estimate pressure gradient by applying simplified Bernoulli equation, calculating viscous energy loss (VEL) and turbulent kinetic energy (TKE). [13][14][15][16][17] The estimation of TKE has been difficult even in computational fluid dynamics analysis, but the accurate quantification of TKE from 4D flow MRI has been developed and validated by the group of Linköping and Eidgenössische Technische Hochschule Zürich (ETH). 9,[18][19][20][21] The phase-contrast MRI applies a bipolar gradient, which induces signal dephasing of magnitude images proportional to the heterogeneity of the spin movement (intravoxel velocity standard deviation [IVSD]) in each voxel.…”

Section: Introductionmentioning

confidence: 99%

Measurement of Turbulent Kinetic Energy in Hypertrophic Cardiomyopathy Using Triple-velocity Encoding 4D Flow MR Imaging

et al. 2024

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The turbulent kinetic energy (TKE) estimation based on 4D flow MRI has been currently developed and can be used to estimate the pressure gradient. The objective of this study was to validate the clinical value of 4D flow-based TKE measurement in patients with hypertrophic cardiomyopathy (HCM).Methods: From April 2018 to March 2019, we recruited 28 patients with HCM. Based on echocardiography, they were divided into obstructed HCM (HOCM) and non-obstructed HCM (HNCM). Triplevelocity encoding 4D flow MRI was performed. The volume-of-interest from the left ventricle to the aortic arch was drawn semi-automatically. We defined peak turbulent kinetic energy (TKE peak ) as the highest TKE phase in all cardiac phases.Results: TKE peak was significantly higher in HOCM than in HNCM (14.83 ± 3.91 vs. 7.11 ± 3.60 mJ, P < 0.001). TKE peak was significantly higher in patients with systolic anterior movement (SAM) than in those without SAM (15.60 ± 3.96 vs. 7.44 ± 3.29 mJ, P < 0.001). Left ventricular (LV) mass increased proportionally with TKE peak (P = 0.012, r = 0.466). When only the asymptomatic patients were extracted, a stronger correlation was observed (P = 0.001, r = 0.842).Conclusion: TKE measurement based on 4D flow MRI can detect the flow alteration induced by systolic flow jet and LV outflow tract geometry, such as SAM in patients with HOCM. The elevated TKE is correlated with increasing LV mass. This indicates that increasing cardiac load, by pressure loss due to turbulence, induces progression of LV hypertrophy, which leads to a worse prognosis.

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Hemodynamic Parameters for Cardiovascular System in 4D Flow MRI: Mathematical Definition and Clinical Applications

Cited by 18 publications

References 97 publications

Clinical Application of 4D Flow MR Imaging for the Abdominal Aorta

Clinical Application of 4D Flow MR Imaging for the Abdominal Aorta

Blood flow assessment technology in aortic surgery: a narrative review

Measurement of Turbulent Kinetic Energy in Hypertrophic Cardiomyopathy Using Triple-velocity Encoding 4D Flow MR Imaging

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