Magnetic Resonance Assessment of Pulmonary (QP) to Systemic (QS) Flows Using 4D Phase-contrast Imaging

Hanneman, Kate; Sivagnanam, Milani; Nguyen, Elsie T.; Wald, Rachel M.; Greiser, Andreas; Crean, Andrew M.; Ley, Sebastian; Wintersperger, Bernd J.

doi:10.1016/j.acra.2014.04.012

Cited by 55 publications

(46 citation statements)

References 30 publications

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“…As previously reported (Table 4), we found that flow volume [14–16, 21, 25, 26] and peak flow [14] were lower and that peak velocities were higher [18] when estimated using 4D flow in comparison with 2D measurements. Of note, our net volume measurements were lower than those previously reported both at 3T (2D-1dir = 89 ± 10 ml [18] or 100.6 ± 27.8 ml [16] and 4D flow = 88 ± 10 ml [18] or 95.9 ± 19.1 ml [16] in the AA).…”

Section: Discussionsupporting

confidence: 81%

“…Several previous works have focused on the comparison of 2D and 4D flow MRI for flow quantification, involving in vitro experiments [13] and in vivo in healthy subjects [13–22] or patients with congenital heart disease [17, 20, 22–24], dilated cardiomyopathy [15], valve stenosis [18], suspected intracardiac shunts [25], and other miscellaneous populations [26]. However, in these latter studies, either 2D-1dir or 2D-3dir measurements were used.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of 4D flow and 2D velocity-encoded phase contrast MRI sequences for the evaluation of aortic hemodynamics

Bollache

Ooij

Powell

et al. 2016

Int J Cardiovasc Imaging

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The purpose of this study was to compare aortic flow and velocity quantification using 4D flow MRI and 2D CINE phase-contrast (PC)-MRI with either one-directional (2D-1dir) or three-directional (2D-3dir) velocity encoding. 15 healthy volunteers (51 ± 19 years) underwent MRI including (1) breath-holding 2D-1dir and (2) free breathing 2D-3dir PC-MRI in planes orthogonal to the ascending (AA) and descending (DA) aorta, as well as (3) free breathing 4D flow MRI with full thoracic aorta coverage. Flow quantification included the co-registration of the 2D PC acquisition planes with 4D flow MRI data, AA and DA segmentation, and calculation of AA and DA peak systolic velocity, peak flow and net flow volume for all sequences. Additionally, the 2D-3dir velocity taking into account the through-plane component only was used to obtain results analogous to a free breathing 2D-1dir acquisition. Good agreement was found between 4D flow and 2D-3dir peak velocity (differences = −3 to 6 %), peak flow (−7 %) and net volume (−14 to −9 %). In contrast, breath-holding 2D-1dir measurements exhibited indices significantly lower than free breathing 2D-3dir and 2D-1dir (differences = −35 to −7 %, p < 0.05). Finally, high correlations (r ≥ 0.97) were obtained for indices estimated with or without eddy current correction, with the lowest correlation observed for net volume. 4D flow and 2D-3dir aortic hemodynamic indices were in concordance. However, differences between respiration state and 2D-1dir and 2D-3dir measurements indicate that reference values should be established according to the PC-MRI sequence, especially for the widely used net flow (e.g. stroke volume in the AA).

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Comparison of 4D flow and 2D velocity-encoded phase contrast MRI sequences for the evaluation of aortic hemodynamics

Bollache

Ooij

Powell

et al. 2016

Int J Cardiovasc Imaging

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“…The volumetric nature of 4D flow acquisitions allows for separation of the processes of image acquisition and interpretation, which may improve clinical workflow and reduce total scan times compared with traditional multi-sequence approaches. The clinical utility of 4D flow MRI was previously limited by prohibitively long image acquisition times (13). However, with the implementation of under-sampling methods including parallel imaging and compressed sensing, near-isotropic images can now be acquired in a scan time practical for clinical practice (9).…”

Section: Discussionmentioning

confidence: 99%

“…However, until the recent implementation of under-sampling methods, including parallel imaging, the clinical utility of 4D flow MRI had been largely limited by prohibitively long image acquisition times (12). To date, although flow and function assessment have been described with 4D flow imaging (9, 13–15), assessment of ventricular mass quantification has not yet been reported to our knowledge. Left ventricular (LV) mass quantification is commonly performed in the setting of congenitally corrected transposition of the great arteries after pulmonary arterial banding to assess feasibility of an arterial switch operation (16).…”

Section: Introductionmentioning

confidence: 99%

Assessment of the precision and reproducibility of ventricular volume, function, and mass measurements with ferumoxytol‐enhanced 4D flow MRI

Hanneman

Kino

Cheng

et al. 2016

Magnetic Resonance Imaging

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Purpose To compare the precision and inter-observer agreement of ventricular volume, function and mass quantification by three-dimensional time-resolved (4D) flow MRI relative to cine steady state free precession (SSFP). Materials and Methods With research board approval, informed consent, and HIPAA compliance, 22 consecutive patients with congenital heart disease (CHD) (10 males, 6.4±4.8 years) referred for 3T ferumoxytol-enhanced cardiac MRI were prospectively recruited. Complete ventricular coverage with standard 2D short-axis cine SSFP and whole chest coverage with axial 4D flow were obtained. Two blinded radiologists independently segmented images for left ventricular (LV) and right ventricular (RV) myocardium at end systole (ES) and end diastole (ED). Statistical analysis included linear regression, ANOVA, Bland-Altman (BA) analysis, and intra-class correlation (ICC). Results Significant positive correlations were found between 4D flow and SSFP for ventricular volumes (r = 0.808–0.972, p<0.001), ejection fraction (EF) (r = 0.900–928, p<0.001), and mass (r = 0.884–0.934, p<0.001). BA relative limits of agreement for both ventricles were between −52% to 34% for volumes, −29% to 27% for EF, and −41% to 48% for mass, with wider limits of agreement for the RV compared to the LV. There was no significant difference between techniques with respect to mean square difference of ED-ES mass for either LV (F=2.05, p=0.159) or RV (F=0.625, p=0.434). Inter-observer agreement was moderate to good with both 4D flow (ICC 0.523–0.993) and SSFP (ICC 0.619–0.982), with overlapping confidence intervals. Conclusion Quantification of ventricular volume, function and mass can be accomplished with 4D flow MRI with precision and inter-observer agreement comparable to that of cine SSFP.

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“…A few studies have evaluated the use of 4D flow MRI for visualization and quantification of cardiac shunts [15–17]. It is not yet clear, however, whether this technique is robust across the range of imaging parameters that might be used in the clinical environment because of differences in body habitus or equipment.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of atrial septal defects with 4D flow MRI—multilevel and inter-reader reproducibility for quantification of shunt severity

Chelu

Horowitz

Sucha

et al. 2018

Magn Reson Mater Phy

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Magnetic Resonance Assessment of Pulmonary (QP) to Systemic (QS) Flows Using 4D Phase-contrast Imaging

Cited by 55 publications

References 30 publications

Comparison of 4D flow and 2D velocity-encoded phase contrast MRI sequences for the evaluation of aortic hemodynamics

Comparison of 4D flow and 2D velocity-encoded phase contrast MRI sequences for the evaluation of aortic hemodynamics

Assessment of the precision and reproducibility of ventricular volume, function, and mass measurements with ferumoxytol‐enhanced 4D flow MRI

Evaluation of atrial septal defects with 4D flow MRI—multilevel and inter-reader reproducibility for quantification of shunt severity

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