Assessment of intracranial vascular flow oscillations in Alzheimer’s disease using real time 4D flow MRI

Cerebral blood flow, arterial pulsation, and vasomotion play important roles in the transport of waste metabolites out of the brain. Impaired vasomotion results in reduced driving force for the perivascular/glymphatic clearance of beta-amyloid. Noninvasive cerebrovascular characteristic features that potentially assess these transport mechanisms are mean blood flow (MBF) and pulsatility index (PI). In this study, 4D flow MRI was used to measure intra-cranial flow features, particularly MBF, PI, resistive index (RI) and cross-sectional area in patients with Alzheimer’s disease (AD), mild cognitive impairment and in age matched and younger cognitively healthy controls. Three-hundred fourteen subjects participated in this study. Volumetric, time-resolved phase contrast (PC) MRI data were used to quantify hemodynamic parameters from 11 vessel segments. Anatomical variants of the Circle of Willis were also cataloged. The AD population reported a statistically significant decrease in MBF and cross-sectional area, and also an increase in PI and RI compared to age matched cognitively healthy control subjects. The 4D flow MRI technique used in this study provides quantitative measurements of intracranial vessel geometry and the velocity of flow. Cerebrovascular characteristics features of vascular health such as pulsatility index can be extracted from the 4D flow MRI data.

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Associations in Alzheimer’s disease between intracranial vascular metrics from 4D‐flow MRI and β‐amyloid and tau PET

Alzheimer s & Dementia ◽

10.1002/alz.056621 ◽

2021 ◽

Vol 17 (S1) ◽

Author(s):

Leonardo A Rivera‐Rivera ◽

Karly Alex Cody ◽

Tobey J Betthauser ◽

Robert V Cadman ◽

Thomas Reher ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

4D Flow Mri ◽

4D Flow ◽

Flow Mri ◽

Β Amyloid ◽

Tau Pet

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Changes in intracranial venous blood flow and pulsatility in Alzheimer’s disease: A 4D flow MRI study

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x16661340 ◽

2016 ◽

Vol 37 (6) ◽

pp. 2149-2158 ◽

Cited By ~ 27

Author(s):

Leonardo A Rivera-Rivera ◽

Tilman Schubert ◽

Patrick Turski ◽

Kevin M Johnson ◽

Sara E Berman ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Blood Flow ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Peak Flow ◽

Superior Sagittal Sinus ◽

4D Flow ◽

Sagittal Sinus ◽

Flow Mri

Cerebral blood flow, arterial pulsation, and vasomotion may be important indicators of cerebrovascular health in aging and diseases of aging such as Alzheimer’s disease. Noninvasive markers that assess these characteristics may be helpful in the study of co-occurrence of these diseases and potential additive and interacting effects. In this study, 4D flow MRI was used to measure intra-cranial flow features with cardiac-gated phase contrast MRI in cranial arteries and veins. Mean blood flow and pulsatility index as well as the transit time of the peak flow from the middle cerebral artery to the superior sagittal sinus were measured in a total of 104 subjects comprising of four groups: (a) subjects with Alzheimer’s disease, (b) age-matched controls, (c) subjects with mild cognitive impairment, and (d) a group of late middle-aged with parental history of sporadic Alzheimer’s disease. The Alzheimer’s disease group exhibited: a significant decrease in mean blood flow in the superior sagittal sinus, transverse sinus, middle cerebral artery, and internal carotid arteries; a significant decrease of the peak and end diastolic blood flow in the middle cerebral artery and superior sagittal sinus; a faster transmission of peak flow from the middle cerebral artery to the superior sagittal sinus and increased pulsatility index along the carotid siphon.

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Aortocaval Fistula at 4D Flow MRI: Visualization and Quantification of Vascular Flow

Radiology ◽

10.1148/radiol.2018181215 ◽

2018 ◽

Vol 289 (3) ◽

pp. 617-617

Author(s):

Annett Lebenatus ◽

Mona Salehi Ravesh

Keyword(s):

Aortocaval Fistula ◽

4D Flow Mri ◽

4D Flow ◽

Vascular Flow ◽

Flow Mri

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4D-Flow MRI: Beyond the Images

Seminars in Thoracic and Cardiovascular Surgery ◽

10.1053/j.semtcvs.2019.09.008 ◽

2020 ◽

Vol 32 (1) ◽

pp. 35

Author(s):

Pietro Sergio ◽

Antonio Miceli

Keyword(s):

4D Flow Mri ◽

4D Flow ◽

Flow Mri

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4D- Flow- MRI After Aortic Valve Surgery

Case Medical Research ◽

10.31525/ct1-nct04223713 ◽

2020 ◽

Author(s):

Keyword(s):

Aortic Valve ◽

Valve Surgery ◽

Aortic Valve Surgery ◽

4D Flow Mri ◽

4D Flow ◽

Flow Mri

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Circulation derived from 4D flow MRI correlates with right ventricular dysfunction in patients with tetralogy of Fallot

Scientific Reports ◽

10.1038/s41598-021-91125-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Nanae Tsuchiya ◽

Michinobu Nagao ◽

Yumi Shiina ◽

Shohei Miyazaki ◽

Kei Inai ◽

...

Keyword(s):

Right Ventricular ◽

Tetralogy Of Fallot ◽

Main Pulmonary Artery ◽

Vortex Formation ◽

Cine Mri ◽

Short Axis ◽

4D Flow Mri ◽

4D Flow ◽

Flow Mri ◽

Rv Function

AbstractWe used 4D-flow MRI to investigate circulation, an area integral of vorticity, in the main pulmonary artery (MPA) as a new hemodynamic parameter for assessing patients with a repaired Tetralogy of Fallot (TOF). We evaluated the relationship between circulation, right ventricular (RV) function and the pulmonary regurgitant fraction (PRF). Twenty patients with a repaired TOF underwent cardiac MRI. Flow-sensitive 3D-gradient sequences were used to obtain 4D-flow images. Vortex formation in the MPA was visualized, with short-axis and longitudinal vorticities calculated by software specialized for 4D flow. The RV indexed end-diastolic/end-systolic volumes (RVEDVi/RVESVi) and RV ejection fraction (RVEF) were measured by cine MRI. The PR fraction (PRF) and MPA area were measured by 2D phase-contrast MRI. Spearman ρ values were determined to assess the relationships between circulation, RV function, and PRF. Vortex formation in the MPA occurred in 15 of 20 patients (75%). The longitudinal circulation (11.7 ± 5.1 m2/s) was correlated with the RVEF (ρ = − 0.85, p = 0.0002), RVEDVi (ρ = 0.62, p = 0.03), and RVESVi (ρ = 0.76, p = 0.003) after adjusting for the MPA size. The short-axis circulation (9.4 ± 3.4 m2/s) in the proximal MPA was positively correlated with the MPA area (ρ = 0.61, p = 0.004). The relationships between the PRF and circulation or RV function were not significant. Increased longitudinal circulation in the MPA, as demonstrated by circulation analysis using 4D flow MRI, was related to RV dysfunction in patients with a repaired TOF.

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Associations between haemodynamics and wall enhancement of intracranial aneurysm

Stroke and Vascular Neurology ◽

10.1136/svn-2020-000636 ◽

2021 ◽

pp. svn-2020-000636

Author(s):

Miaoqi Zhang ◽

Fei Peng ◽

Xin Tong ◽

Xin Feng ◽

Yunduo Li ◽

...

Keyword(s):

Blood Flow ◽

High Resolution ◽

Ordinal Regression ◽

Parent Artery ◽

Black Blood ◽

4D Flow Mri ◽

4D Flow ◽

Unruptured Intracranial Aneurysms ◽

Black Blood Mri ◽

Flow Mri

Background and purposePrevious studies have reported about inflammation processes (IPs) that play important roles in aneurysm formation and rupture, which could be driven by blood flow. IPs can be identified using aneurysmal wall enhancement (AWE) on high-resolution black-blood MRI (BB-MRI) and blood flow haemodynamics can be demonstrated by four-dimensional-flow MRI (4D-flow MRI). Thus, this study investigated the associations between AWE and haemodynamics in unruptured intracranial aneurysms (IA) by combining 4D-flow MRI and high-resolution BB-MRI.Materials and methodsBetween April 2014 and October 2017, 48 patients with 49 unruptured IA who underwent both 4D-flow MRI and high-resolution BB-MRI were retrospectively included in this study. The haemodynamic parameters demonstrated using 4D-flow MRI were compared between different AWE patterns using the Kruskal-Wallis test and ordinal regression.ResultsThe results of Kruskal-Wallis test showed that the average wall shear stress in the IA (WSSavg-IA), maximum through-plane velocity in the adjacent parent artery, inflow jet patterns and the average vorticity in IA (vorticityavg-IA) were significantly associated with the AWE patterns. Ordinal regression analysis identified WSSavg-IA (p=0.002) and vorticityavg-IA (p=0.033) as independent predictors of AWE patterns.ConclusionA low WSS and low average vorticity were independently associated with a high AWE grade for IAs larger than 4 mm. Therefore, WSS and average vorticity could predict AWE and circumferential AWE.

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A pilot study investigating the use of 4D flow MRI for the assessment of splanchnic flow in patients suspected of mesenteric ischaemia

Scientific Reports ◽

10.1038/s41598-021-85315-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Pauline Hall Barrientos ◽

Katrina Knight ◽

Douglas Black ◽

Alexander Vesey ◽

Giles Roditi

Keyword(s):

Blood Flow ◽

Pilot Study ◽

Splenic Vein ◽

Normal Subjects ◽

Mesenteric Ischaemia ◽

4D Flow Mri ◽

4D Flow ◽

Flow Mri ◽

Mesenteric Vessels ◽

Flow Changes

AbstractThe most common cause of chronic mesenteric ischaemia is atherosclerosis which results in limitation of blood flow to the gastrointestinal tract. This pilot study aimed to evaluate 4D flow MRI as a potential tool for the analysis of blood flow changes post-prandial within the mesenteric vessels. The mesenteric vessels of twelve people were scanned; patients and healthy volunteers. A baseline MRI scan was performed after 6 h of fasting followed by a post-meal scan. Two 4D flow datasets were acquired, over the superior mesenteric artery (SMA) and the main portal venous vessels. Standard 2D time-resolved PC-MRI slices were also obtained across the aorta above the coeliac trunk, superior mesenteric vein, splenic vein and portal vein (PV). In the volunteer cohort there was a marked increase in blood flow post-meal within the PV (p = 0.028), not seen in the patient cohort (p = 0.116). Similarly, there were significant flow changes within the SMA of volunteers (p = 0.028) but not for the patient group (p = 0.116). Our pilot data has shown that there is a significant haemodynamic response to meal challenge in the PV and SMA in normal subjects compared to clinically apparent CMI patients. Therefore, the interrogation of mesenteric venous vessels exclusively is a feasible method to measure post-prandial flow changes in CMI patients.

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