Neurovascular 4DFlow MRI (Phase Contrast MRA): emerging clinical applications

Turski, Patrick A.; Scarano, Andrew; Hartman, Eric; Clark, Zachary; Schubert, Tilman; Rivera‐Rivera, Leonardo A.; Wu, Yijing; Wieben, Oliver; Johnson, Kevin M.

doi:10.1186/s40809-016-0019-0

Cited by 23 publications

(29 citation statements)

References 82 publications

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“…The study of hemodynamic alterations in patients with cerebrovascular disease is important to understand the disease, potentially improving diagnostic capabilities and therapeutic planning. There is a demand for noninvasive imaging of cerebrovascular territories; therefore, new emerging techniques for evaluation cerebrovascular hemodynamics and CBF [ 88 ], including four-dimensional (4D) flow MRI [ 89 , 90 , 91 , 92 ]; 2D phase contrast MRI (PC-MRI) [ 93 , 94 , 95 ] and magnetic resonance black-blood thrombus imaging technique (MRBTI) [ 96 ] are being developed.…”

Section: Magnetic Resonance Imaging (Mri) and Other Similar Technimentioning

confidence: 99%

Brain Vascular Imaging Techniques

Laviña

2016

IJMS

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Recent major improvements in a number of imaging techniques now allow for the study of the brain in ways that could not be considered previously. Researchers today have well-developed tools to specifically examine the dynamic nature of the blood vessels in the brain during development and adulthood; as well as to observe the vascular responses in disease situations in vivo. This review offers a concise summary and brief historical reference of different imaging techniques and how these tools can be applied to study the brain vasculature and the blood-brain barrier integrity in both healthy and disease states. Moreover, it offers an overview on available transgenic animal models to study vascular biology and a description of useful online brain atlases.

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Section: Magnetic Resonance Imaging (Mri) and Other Similar Technimentioning

confidence: 99%

Brain Vascular Imaging Techniques

Laviña

2016

IJMS

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“…Several studies have demonstrated the feasibility of 4D flow MRI for the evaluation of intracranial hemodynamics. [25][26][27][28][29] 4D flow MRI, time-resolved 3D PC MRI with 3-directional velocity encoding, allows velocity measurements across the cerebral vasculature with a single scan. 30,31 4D flow MRI has been previously applied for measuring cerebrovascular flow 27,[32][33][34] and shown to be consistent with 2D PC MRI.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have demonstrated the feasibility of 4D flow MRI for the evaluation of intracranial hemodynamics . 4D flow MRI, time‐resolved 3D PC MRI with 3‐directional velocity encoding, allows velocity measurements across the cerebral vasculature with a single scan .…”

Section: Introductionmentioning

confidence: 99%

Semi‐automated analysis of 4D flow MRI to assess the hemodynamic impact of intracranial atherosclerotic disease

Vali

Aristova

Vakil

et al. 2019

Magnetic Resonance in Med

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Purpose This study evaluated the feasibility of using 4D flow MRI and a semi‐automated analysis tool to assess the hemodynamic impact of intracranial atherosclerotic disease (ICAD). The ICAD impact was investigated by evaluating pressure drop (PD) at the atherosclerotic stenosis and changes in cerebral blood flow distribution in patients compared to healthy controls. Methods Dual‐venc 4D flow MRI was acquired in 25 healthy volunteers and 16 ICAD patients (ICA, N = 3; MCA, N = 13) with mild (<50%), moderate (50–69%), or severe (>70%) intracranial stenosis. A semi‐automated analysis tool was developed to quantify velocity and flow from 4D flow MRI and to evaluate cerebral blood flow redistribution. PD at stenosis was estimated using the Bernoulli equation. The PD calculation was examined by an in vitro phantom study against flow simulations. Results Flow analysis in controls indicated symmetry in blood flow rate (FR) and peak velocity (PV) between the brain hemispheres. For patients, PV in the affected hemisphere was significantly (65%) higher than the normal side (P = 0.002). However, FR to both hemispheres of the brain was the same. The PD depicted significant correlation with PV asymmetry in patients (ρ = 0.67 and P = 0.02), and it was significantly higher for severe compared to moderate stenosis (3.73 vs. 2.30 mm Hg, P = 0.02). Conclusion 4D flow MRI quantification enables assessment of the hemodynamic impact of ICAD. The significant difference of the PD between patients with severe and moderate stenosis and its correlation with PV asymmetry suggest that PD may be a pertinent hemodynamic biomarker to evaluate ICAD.

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“…Measuring the relationship between intracranial vessel flow and cerebral perfusion was previously challenging because of practical limitations, including motion artifacts, lengthy scan times, and complex implementation [11]. However, a recently developed 4D‐flow MRI technique termed phase‐contrast vastly undersampled isotropic projection (PC VIPR) imaging uses radial undersampling, allowing for improved temporal and spatial resolution compared with 2D methods in clinically feasible scan times [12,13].…”

Section: Introductionmentioning

confidence: 99%

Macrovascular and microvascular cerebral blood flow in adults at risk for Alzheimer's disease

Clark

Berman

Rivera‐Rivera

et al. 2017

Alz & Dem Diag Ass & Dis Mo

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IntroductionCapillary hypoperfusion is reported in asymptomatic adults at-risk for Alzheimer's disease (AD), but the extent that can be explained by reduced flow in intracranial arteries is unknown.MethodsOne hundred fifty-five asymptomatic adults enriched for AD risk (mean age 61 years) completed arterial spin labeling (pcASL) and 4D-flow MRI sequences. Voxel-wise regression models investigated the relationship between mean flow in bilateral cerebral arteries and capillary perfusion, and tested potential moderators of this relationship.ResultsMean arterial blood flow through middle cerebral arteries (MCAs) and internal carotid arteries was positively associated with perfusion in large cortical clusters (P < .05, false discovery rate corrected). Trends were observed for the interactions MCA flow × age and MCA flow × cardiovascular risk on cerebral perfusion (P < .001, uncorrected).DiscussionThese findings provide evidence that capillary perfusion measured via pseudocontinuous arterial spin labeling is strongly dependent on inflow from larger cerebral arteries. Further studies are warranted to investigate possible alterations between macrovascular and microvascular flow in advanced age and elevated cardiovascular risk in asymptomatic adults at risk for AD.

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Neurovascular 4DFlow MRI (Phase Contrast MRA): emerging clinical applications

Cited by 23 publications

References 82 publications

Brain Vascular Imaging Techniques

Brain Vascular Imaging Techniques

Semi‐automated analysis of 4D flow MRI to assess the hemodynamic impact of intracranial atherosclerotic disease

Macrovascular and microvascular cerebral blood flow in adults at risk for Alzheimer's disease

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