Wall shear stress estimation in the aorta: Impact of wall motion, spatiotemporal resolution, and phase noise

Zimmermann, Judith; Demedts, Daniel; Mirzaee, Hanieh; Ewert, Peter; Stern, Heiko; Meierhofer, Christian; Menze, Bjoern; Hennemuth, Anja

doi:10.1002/jmri.26007

Cited by 27 publications

(40 citation statements)

References 30 publications

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“…This increased underestimation of WSS is likely related to its dependence on spatiotemporal undersampling and regularization. [45][46][47] The evaluation of the relative changes in regional WSS did not show any significant difference between the conventional and CS 4D flows, except with R = 10.2 CS, which showed a trend toward underestimation of the higher WSS at the inner curvature more than the lower WSS at the outer curvature of the aorta. A detailed comparison of measurements derived from the conventional and CS 4D flow MRIs for each patient are attached as Supporting Information Figure S1, which is available online.…”

Section: F I G U R Ementioning

confidence: 80%

Highly accelerated aortic 4D flow MRI using compressed sensing: Performance at different acceleration factors in patients with aortic disease

Pathrose

Berhane

et al. 2020

Magnetic Resonance in Med

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Purpose: To systematically assess the feasibility and performance of a highly accelerated compressed sensing (CS) 4D flow MRI framework at three different acceleration factors (R) for the quantification of aortic flow dynamics and wall shear stress (WSS) in patients with aortic disease. Methods: Twenty patients with aortic disease (58 ± 15 y old; 19 M) underwent four 4D flow scans: one conventional (GRAPPA, R = 2) and three CS 4D flows with R = 5.7, 7.7, and 10.2. All scans were acquired with otherwise equivalent imaging parameters on a 1.5T scanner. Peak-systolic velocity (V max), peak flow (Q max), and net flow (Q net) were quantified at the ascending aorta (AAo), arch, and descending aorta (DAo). WSS was calculated at six regions within the AAo and arch. Results: Mean scan times for the conventional and CS 4D flows with R =

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Section: F I G U R Ementioning

confidence: 80%

Highly accelerated aortic 4D flow MRI using compressed sensing: Performance at different acceleration factors in patients with aortic disease

Pathrose

Berhane

et al. 2020

Magnetic Resonance in Med

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“…First, the study has inherent bias as a retrospective study with a limited number of patients. Second, spatial resolution of 4D flow MRI is a limiting factor for WSS estimation . Improving the spatiotemoral resolution of 4D flow MRI sequences is a field of ongoing technical development.…”

Section: Discussionmentioning

confidence: 99%

“…Second, spatial resolution of 4D flow MRI is a limiting factor for WSS estimation. 29 Improving the spatiotemoral resolution of 4D flow MRI sequences is a field of ongoing technical development. Although this may influence the absolute WSS value, it does not affect the finding of relatively elevated WSS using the same imaging parameters.…”

Section: Discussionmentioning

confidence: 99%

“…WSS was estimated based on the algorithm described by Stalder et al with adaptations previously described . The WSS vector was projected along the local vessel surface tangent plane (WSS tang ).…”

Section: Methodsmentioning

confidence: 99%

“…WSS was estimated based on the algorithm described by Stalder et al 28 with adaptations previously described. 29 The WSS vector was projected along the local vessel surface tangent plane (WSS tang ). Estimated WSS was also decomposed into both axial (WSS axial ) and circumferential (WSS circ ) components; WSS axial is defined as the component of WSS along the flow direction (through-plane) and WSS circ as the component along the vessel circumference (in-plane).…”

Section: Wss Estimationmentioning

confidence: 99%

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Elevated diastolic wall shear stress in regurgitant semilunar valvular lesions

Rizk

Latus

Shehu

et al. 2019

Magnetic Resonance Imaging

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Background Alterations in wall shear stress (WSS) assessed using 4D flow MRI have been shown to play a role in various vascular pathologies, such as bicuspid aortic valve aortopathy. Most studies have focused on systolic WSS, whereas altered diastolic hemodynamics in regurgitant semilunar valvular lesions have not so far been well characterized. Purpose To investigate diastolic WSS in aortic and pulmonary regurgitation. Study Type Retrospective data analysis. Population Thirty tetralogy of Fallot patients, 19 bicuspid aortic valve patients, 11 healthy volunteers. Field Strength/Sequence 5 T, 3D time‐resolved phase‐contrast MRI with 3D velocity encoding. Assessment Estimation of WSS and its axial and circumferential vector components along cardiac cycle timeframes in the proximal main pulmonary artery in pulmonary regurgitation (PR) and in the proximal ascending aorta in aortic regurgitation (AR) as well as in healthy volunteers. Statistical Tests Wilcoxon matched pairs test was used for intra‐group comparisons and Mann–Whitney test for intergroup comparisons. Correlations were assessed using Spearman correlation. Results WSS along the entire cardiac cycle was higher in PR and AR in comparison with controls (mean WSS 0.381 ± 0.070 vs. 0.220 ± 0.018, P < 0.0001; 0.361 ± 0.099 vs. 0.212 ± 0.030, P < 0.0001; respectively). Peak diastolic WSS was significantly higher than the mean WSS in AR and PR (P < 0.0001–0.005). The severity of PR correlated with the peak diastolic axial WSS (Spearman's r s = 0.454, P = 0.018), whereas the severity of AR correlated with both peak systolic and diastolic tangential WSS (Spearman's r s = 0.458, P = 0.049; r s = 0.539, P = 0.017, respectively). Data Conclusion Elevated diastolic WSS is a component of the altered flow hemodynamics in AR and PR. This may give more insight into the pathophysiologic role of WSS in vascular remodeling in AR and PR. Level of Evidence: 4 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2019;50:763–770.

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Traveling Volunteers: A Multi‐Vendor, Multi‐Center Study on Reproducibility and Comparability of 4D Flow Derived Aortic Hemodynamics in Cardiovascular Magnetic Resonance

Demir

Wiesemann

Erley

et al. 2021

Magnetic Resonance Imaging

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Background Implementation of four‐dimensional flow magnetic resonance (4D Flow MR) in clinical routine requires awareness of confounders. Purpose To investigate inter‐vendor comparability of 4D Flow MR derived aortic hemodynamic parameters, assess scan‐rescan repeatability, and intra‐ and interobserver reproducibility. Study Type Prospective multicenter study. Population Fifteen healthy volunteers (age 24.5 ± 5.3 years, 8 females). Field Strength/Sequence 3 T, vendor‐provided and clinically used 4D Flow MR sequences of each site. Assessment Forward flow volume, peak velocity, average, and maximum wall shear stress (WSS) were assessed via nine planes (P1–P9) throughout the thoracic aorta by a single observer (AD, 2 years of experience). Inter‐vendor comparability as well as scan‐rescan, intra‐ and interobserver reproducibility were examined. Statistical Tests Equivalence was tested setting the 95% confidence interval of intraobserver and scan‐rescan difference as the limit of clinical acceptable disagreement. Intraclass correlation coefficient (ICC) and Bland–Altman plots were used for scan‐rescan reproducibility and intra‐ and interobserver agreement. A P‐value <0.05 was considered statistically significant. ICCs ≥ 0.75 indicated strong correlation (>0.9: excellent, 0.75–0.9: good). Results Ten volunteers finished the complete study successfully. 4D flow derived hemodynamic parameters between scanners of three different vendors are not equivalent exceeding the equivalence range. P3–P9 differed significantly between all three scanners for forward flow (59.1 ± 13.1 mL vs. 68.1 ± 12.0 mL vs. 55.4 ± 13.1 mL), maximum WSS (1842.0 ± 190.5 mPa vs. 1969.5 ± 398.7 mPa vs. 1500.6 ± 247.2 mPa), average WSS (1400.0 ± 149.3 mPa vs. 1322.6 ± 211.8 mPa vs. 1142.0 ± 198.5 mPa), and peak velocity between scanners I vs. III (114.7 ± 12.6 cm/s vs. 101.3 ± 15.6 cm/s). Overall, the plane location at the sinotubular junction (P1) presented most inter‐vendor stability (forward: 78.5 ± 15.1 mL vs. 80.3 ± 15.4 mL vs. 79.5 ± 19.9 mL [P = 0.368]; peak: 126.4 ± 16.7 cm/s vs. 119.7 ± 13.6 cm/s vs. 111.2 ± 22.6 cm/s [P = 0.097]). Scan‐rescan reproducibility and intra‐ and interobserver variability were good to excellent (ICC ≥ 0.8) with best agreement for forward flow (ICC ≥ 0.98). Data Conclusion The clinical protocol used at three different sites led to differences in hemodynamic parameters assessed by 4D flow. Level of Evidence 2 Technical Efficacy Stage 2

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Wall shear stress estimation in the aorta: Impact of wall motion, spatiotemporal resolution, and phase noise

Abstract: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.

Cited by 27 publications

References 30 publications

Highly accelerated aortic 4D flow MRI using compressed sensing: Performance at different acceleration factors in patients with aortic disease

Highly accelerated aortic 4D flow MRI using compressed sensing: Performance at different acceleration factors in patients with aortic disease

Elevated diastolic wall shear stress in regurgitant semilunar valvular lesions

Traveling Volunteers: A Multi‐Vendor, Multi‐Center Study on Reproducibility and Comparability of 4D Flow Derived Aortic Hemodynamics in Cardiovascular Magnetic Resonance

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