Serial Quantitative and Qualitative Measurements of Flow in Vein of Galen Malformations Using 4-Dimensional Flow Magnetic Resonance Imaging (Phase Contrast Vastly undersampled Isotropic PRojection)

Li, Yiping; Ahmed, Raheel; Rivera‐Rivera, Leonardo A.; Stadler, James A.; Turski, Patrick A.; Aagaard‐Kienitz, Beverly

doi:10.1016/j.wneu.2019.02.131

Cited by 9 publications

(10 citation statements)

References 8 publications

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“…UB comes with fewer assumptions, however, still reduces evaluation to an integration line p(s) as per Equation (5). As outlined in Section 2.1, this only holds true when p(s) follows a physiological streamline, 49 and if instead using a user-defined integration line (eg, the vessel centerline) the conversion from Equation (4) to Equation ( 5) is no longer valid.…”

Section: Discussionmentioning

confidence: 99%

“…The onset and manifestation of cerebrovascular disease directly impacts regional hemodynamics. Alterations in pressure through sections of the cerebrovasculature have been highlighted as indicative for a number of pathological scenarios: the risk for recurrent stroke in intracranial atherosclerosis, 1,2 the development of arteriovenous malformations and cerebral aneurysms, 3‐5 and the manifestation of neurodegenerative disorders 6,7 . The cerebrovasculature is, however, characterized by a complex network of narrow, tortuous, and bifurcating vessels, giving rise to intricate hemodynamic behavior 3,8,9 .…”

Section: Introductionmentioning

confidence: 99%

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Noninvasive quantification of cerebrovascular pressure changes using 4D Flow MRI

Marlevi

Schollenberger

Aristova

et al. 2021

Magnetic Resonance in Med

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Purpose Hemodynamic alterations are indicative of cerebrovascular disease. However, the narrow and tortuous cerebrovasculature complicates image‐based assessment, especially when quantifying relative pressure. Here, we present a systematic evaluation of image‐based cerebrovascular relative pressure mapping, investigating the accuracy of the routinely used reduced Bernoulli (RB), the extended unsteady Bernoulli (UB), and the full‐field virtual work‐energy relative pressure (νWERP) method. Methods Patient‐specific in silico models were used to generate synthetic cerebrovascular 4D Flow MRI, with RB, UB, and νWERP performance quantified as a function of spatiotemporal sampling and image noise. Cerebrovascular relative pressures were also derived in 4D Flow MRI from healthy volunteers (n=8), acquired at two spatial resolutions (dx = 1.1 and 0.8 mm). Results The in silico analysis indicate that accurate relative pressure estimations are inherently coupled to spatial sampling: at dx = 1.0 mm high errors are reported for all methods; at dx = 0.5 mm νWERP recovers relative pressures at a mean error of 0.02 ± 0.25 mm Hg, while errors remain higher for RB and UB (mean error of −2.18 ± 1.91 and −2.18 ± 1.87 mm Hg, respectively). The dependence on spatial sampling is also indicated in vivo, albeit with higher correlative dependence between resolutions using νWERP (k = 0.64, R2 = 0.81 for dx = 1.1 vs. 0.8 mm) than with RB or UB (k = 0.04, R2 = 0.03, and k = 0.07, R2 = 0.07, respectively). Conclusion Image‐based full‐field methods such as νWERP enable cerebrovascular relative pressure mapping; however, accuracy is directly dependent on utilized spatial resolution.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Noninvasive quantification of cerebrovascular pressure changes using 4D Flow MRI

Marlevi

Schollenberger

Aristova

et al. 2021

Magnetic Resonance in Med

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“…By measuring the flow velocity field, 4D flow MRI allows the characterisation of haemodynamic parameters including average blood flow rates, PIs, PWV, pressure gradients, wall shear stress, vessel tracking and other parameters. 9 4D flow MRI has been used to detect alterations in intracranial blood flow in multiple types as vascular lesions including aneurysms, 20 21 dural arteriovenous fistulas, 22 vein of Galen malformations 23 and arteriovenous malformations 24 as well as more diffuse neurological disease such as Alzheimer’s disease 10 25 26 ; however, to the best of our knowledge, this is the first case of PHACE syndrome evaluated with this advanced technique. As expected, we found decreased blood flow through the stenotic left ICA and increased blood flow through the prominent left PCOMM artery.…”

Section: Discussionmentioning

confidence: 99%

Utilisation of advanced MRI techniques to understand neurovascular complications of PHACE syndrome: a case of arterial stenosis and dissection

Eisenmenger¹,

Rivera‐Rivera

Johnson³

et al. 2020

BMJ Case Rep

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PHACE syndrome is a rare disorder with posterior fossa brain malformations, segmental infantile haemangiomas, arterial anomalies, cardiac defects and eye anomalies. Cerebral and cervical arterial abnormalities occur commonly in these patients, predisposing subjects with PHACE syndrome to neurovascular complications including migraine-like headaches, moyamoya vasculopathy, arterial dissection and arterial ischaemia stroke. We leveraged institutional MRI protocols developed for adult neurovascular disease to better elucidate the pathogenesis of the arterial alternations observed in PHACE. Using high-resolution vessel wall and 4D flow MRI, we demonstrated enhancement, focal dissection and altered blood flow in a 7-year-old girl with PHACE syndrome. This is the first-time vessel wall imaging has been used to detail the known arterial changes in PHACE, and these findings may indicate that progressive vascular narrowing and vessel wall changes/inflammation are a factor in chronic headaches and other arterial complications seen in subjects with PHACE syndrome.

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“…152 Vein of Galen aneurysmal malformations (VGAMs) are rare congenital cerebral arteriovenous shunts between the choroidal arterial system and a markedly dilated persistent median prosencephalic vein of Markowski (the embryologic precursor of the vein of Galen). 153,154 VGAMs represent less than 1% of all intracranial vascular malformations, but account for 30% of brain vascular malformations in children.…”

Section: Intracranial Arteriovenous Shuntsmentioning

confidence: 99%

“…4D flow MRI demonstrated a marked reduction of arteriovenous shunting and intracranial flow redistribution after staged embolization. 153,154 From baseline to endpoint embolization, total cerebral arterial inflow dropped by 40.2%, corresponding to arteriovenous shunt flow reduction of 73.5%. The pressure gradient change of feeding arteries and venous drainage on 4D flow MRI decreased after embolization, with good correlation with invasive measurement.…”

Section: Intracranial Arteriovenous Shuntsmentioning

confidence: 99%

From2Dto4DPhase‐ContrastMRIin the Neurovascular System: Will It Be a Quantum Jump or a Fancy Decoration?

Youn

Lee

2020

Magnetic Resonance Imaging

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Considering the crosstalk between the flow and vessel wall, hemodynamic assessment of the neurovascular system may offer a well-integrated solution for both diagnosis and management by adding prognostic significance to the standard CT/MR angiography. 4D flow MRI or time-resolved 3D velocity-encoded phase-contrast MRI has long been promising for the hemodynamic evaluation of the great vessels, but challenged in clinical studies for assessing intracranial vessels with small diameter due to long scan times and low spatiotemporal resolution. Current accelerated MRI techniques, including parallel imaging with compressed sensing and radial k-space undersampling acquisitions, have decreased scan times dramatically while preserving spatial resolution. 4D flow MRI visualized and measured 3D complex flow of neurovascular diseases such as aneurysm, arteriovenous shunts, and atherosclerotic stenosis using parameters including flow volume, velocity vector, pressure gradients, and wall shear stress. In addition to the noninvasiveness of the phase contrast technique and retrospective flow measurement through the wanted windows of the analysis plane, 4D flow MRI has shown several advantages over Doppler ultrasound or computational fluid dynamics. The evaluation of the flow status and vessel wall can be performed simultaneously in the same imaging modality. This article is an overview of the recent advances in neurovascular 4D flow MRI techniques and their potential clinical applications in neurovascular disease. Level of Evidence: 5 Technical Efficacy Stage: 3

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Serial Quantitative and Qualitative Measurements of Flow in Vein of Galen Malformations Using 4-Dimensional Flow Magnetic Resonance Imaging (Phase Contrast Vastly undersampled Isotropic PRojection)

Cited by 9 publications

References 8 publications

Noninvasive quantification of cerebrovascular pressure changes using 4D Flow MRI

Noninvasive quantification of cerebrovascular pressure changes using 4D Flow MRI

Utilisation of advanced MRI techniques to understand neurovascular complications of PHACE syndrome: a case of arterial stenosis and dissection

From2Dto4DPhase‐ContrastMRIin the Neurovascular System: Will It Be a Quantum Jump or a Fancy Decoration?

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