MR Measurement of Blood Flow in the True and False Channel in Chronic Aortic Dissection

Chang, Jinn-Ming; Friese, K.; Caputo, Gary R.; Kondo, Chisato; Higgins, Charles B.

doi:10.1097/00004728-199105000-00013

Cited by 60 publications

(21 citation statements)

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“…It is not surprising, then, that considerable effort has been expended in the development of NMR techniques for the measurement of blood flow. [8][9][10][11][12][13] Direct comparisons of aortic flow measurements performed by NMR techniques with those obtained by ultrasound have been performed by several groups.14"15 In all of these studies, however, the time course of the velocity during the heart cycle had to be constructed as a composite from data acquired over many heart cycles. Information on flow in dysrhythmia cases cannot be obtained using these techniques.…”

Section: Resultsmentioning

confidence: 99%

Real-time NMR beam-directed velocity mapping. V-mode NMR.

1992

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Section: Resultsmentioning

confidence: 99%

Real-time NMR beam-directed velocity mapping. V-mode NMR.

1992

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“…23,24 Time-resolved 3D MR velocity mapping did not visualize the entire blood ‰ow in the patent false lumen, possibly because of the sudden changes in ‰ow velocity and retrograde or multidirectional blood ‰ow in the dilated false lumen. 25,26 Two-dimensional phase-contrast imaging detects an abnormal ‰ow pattern in the false lumen at any slice level, [25][26][27] but this technique cannot comprehensively visualize the 3D blood ‰ow patterns. Extensive visualization of the blood ‰ow in the false lumen requires more attention to the loca-tions where``seeding particles'' are placed.…”

Section: Discussionmentioning

confidence: 99%

Time-resolved Three-dimensional Magnetic Resonance Velocity Mapping of Chronic Thoracic Aortic Dissection: A Preliminary Investigation

Amano

Sekine

Suzuki³

et al. 2011

MRMS

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Purpose: The blood ‰ow patterns of chronic thoracic aortic dissection are complicated, and their clinical signiˆcance remains unknown. We evaluated the technical and clinical potentials of time-resolved 3-dimensional (3D) magnetic resonance (MR) velocity mapping for assessing these patterns.Methods: We used data collected from time-resolved 3D phase-contrast MR imaging of 16 patients with chronic thoracic aortic dissection to generate time-resolved 3D MR velocity mapping that included 3D streamline and path line. We investigated blood ‰ow patterns of this disease in the mapping and compared them with the morphological changes of the patent false lumen.Results: Time-resolved 3D MR velocity mapping visualized rapid ‰ow at the entry and in the true lumen immediately distal to the entry. We observed slower helical or laminar ‰ow in the patent false lumen. In patients with disease progression, slower helical ‰ow following rapid entry jet collided with the outer wall of the false lumen and was also observed in a growing ulcer-like projection.Conclusion: We showed the potential of time-resolved 3D MR velocity mapping for visualizing pathologic ‰ow patterns related to chronic thoracic aortic dissection.

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“…8 -10 Magnetic resonance angiography and imaging enables identification of the entry tear and the extent of dissection, defines the anatomy of the vessels arising from the aortic arch, visceral vessels and the iliac and common femoral arteries, [11][12][13] and measurement of blood flow velocities in both the true and false lumens. 14,15 When the false lumen is thrombosed, the dissection may be overlooked and give the appearance of an intact aneurysm. 5 Other shortcomings are inaccessibility of the patient for 30 to 60 minutes during image acquisition and unsuitability of the method for those with implanted electronic devices.…”

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confidence: 99%

Acute Aortic Dissection

Olin

Fuster

2003

ATVB

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A ortic dissection may be fatal without early diagnosis and appropriate medical, surgical, or endovascular treatment. The presenting symptoms and signs are so myriad and nonspecific that dissection may be overlooked initially in up to 40% of cases. In addition, the diagnosis is established only postmortem in a substantial number of cases. 1 Few other conditions demand such prompt diagnosis and treatment, because the mortality rate of untreated dissection approaches 1%/h during the first 48 hours, 80% at 14 days, and 90% at three months. 2 If unrecognized and untreated, fewer than 10% of patients with proximal aortic dissection survive a year. Most patients succumb within the first 3 months, 3 usually of acute aortic insufficiency, major branch vessel occlusion, or rupture into the pericardium, mediastinum, or left hemithorax. In 20 years of follow-up of 527 patients with aortic dissection, nearly 30% of late deaths were due to ruptured aortic aneurysm. 4 See page 1839The most frequently used modalities to identify dissection and define the sites of origin and termination are computerized tomography (CT), transesophageal echocardiography (TEE), and magnetic resonance (MR) imaging. The primary diagnostic criterion for diagnosis of aortic dissection by CT is demonstration of two contrast-filled lumens separated by an intimal flap. 5 The sensitivity of CT ranges from 93% to 100% and specificity from 87% to 100%. 5,6 Inaccuracy may result from inadequate contrast opacification, nonvisualization of the intimal flap, artifacts extending across the aortic lumen that simulate an intimal flap, misinterpretation of adjacent vessels or prominent sinus of Valsalva as the flap, atelectasis, pleural thickening, or thrombosis of the false lumen. Multidetector-row CT scanners offer more rapid image acquisition, variable section thickness, 3-dimensional rendering, diminished helical artifacts, and smaller contrast requirements, overcoming many of the limitations discussed above. 7 The sensitivity and specificity of MR imaging for diagnosis of aortic dissection has been reported between 95% and 100%. 8 -10 Magnetic resonance angiography and imaging enables identification of the entry tear and the extent of dissection, defines the anatomy of the vessels arising from the aortic arch, visceral vessels and the iliac and common femoral arteries, 11-13 and measurement of blood flow velocities in both the true and false lumens. 14,15 When the false lumen is thrombosed, the dissection may be overlooked and give the appearance of an intact aneurysm. 5 Other shortcomings are inaccessibility of the patient for 30 to 60 minutes during image acquisition and unsuitability of the method for those with implanted electronic devices.TEE provides rapid multiplane imaging of the aorta and heart as well as assessment of flow dynamics. The examination can be performed soon after the patient presents to the emergency department and has a sensitivity of 95% to 98% and specificity of 63% to 96%. 16 -19 Limitations are that the coronary arteries and the ...

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MR Measurement of Blood Flow in the True and False Channel in Chronic Aortic Dissection

Cited by 60 publications

References 0 publications

Real-time NMR beam-directed velocity mapping. V-mode NMR.

Real-time NMR beam-directed velocity mapping. V-mode NMR.

Time-resolved Three-dimensional Magnetic Resonance Velocity Mapping of Chronic Thoracic Aortic Dissection: A Preliminary Investigation

Acute Aortic Dissection

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