HELICAL BLOOD FLOW IN PULMONARY ARTERY VISUALIZED WITH PHASE-RESOLVED 3D CINE PHASE CONTRAST MRI (4D-FLOW)

Abstract BackgroundIdentifying elevated intracranial pressure (ICP) and decreased intracranial compliance (ICC) is imperative for optimizing patient management in neurocritical care settings. Intra-abdominal hypertension (IAH) and intrathoracic hypertension (ITH) is common in trauma patients, which affects homeostasis of ICP/ICC. Knowledge of this effects is little and monitoring this effect is difficult. In the current study, we examined whether the indices generated from 2D cine phase contrast MRI (2D cine PC-MRI) could reflect ICC/ICP alterations induced by elevated IAH/ITH during VM.MethodsA total of 50 healthy young volunteers participated in this study (male: female = 24:26), and took a 2D cine PC-MRI during normal breath and VM respectively. Cross-section area (CSA) of dominant IJV and ipsilateral ICA, the maximum blood flow (Fmax), minimum blood flow (Fmin), mean blood flow (MBF), pulsatility index (PI), arteriovenous delay (AVD) and time to peak of arterial pulse (TTP) were gauged from images or calculated from the blood flow curves generated from 2D cine PC-MRI. ResultsDuring VM state, in comparison to NB, CSAIJV increased significantly (p<0.0001), indicating an elevation of cerebral venous outflow resistance; Fmax_ICA, Fmax_IJV, Fmean_ICA and Fmean_IJV decreased significantly (p<0.0001, p<0.0001, p<0.001, p<0.0001, respectively); PI_ICA and PI_IJV decreased significantly (p<0.0001, p<0.0001); both absolute and normalized AVD decreased significantly (p<0.0001, p<0.0001), while absolute and normalized TTP increased significantly (p=0.0329, p=0.0376).Conclusions Indices generated from 2D cine PC-MRI, especially AVD and TTP, can reveal the ICC/ICP dynamics induced by elevated IAP/ITP. These indices have potential clinical application in ICC/ICP monitoring in patients who was speculated with an IAH or ITH.

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Assessment of left ventricular diastolic flow in hypertrophic cardiomyopathy by 4D FLOW MRI

Medical Visualization ◽

10.24835/1607-0763-2019-4-42-49 ◽

2019 ◽

pp. 42-49

Author(s):

E. Yu. Glazkova ◽

O. Yu. Dariy ◽

S. A. Aleksandrova ◽

V. N. Makarenko ◽

M. I. Berseneva ◽

...

Keyword(s):

Blood Flow ◽

Hypertrophic Cardiomyopathy ◽

Phase Contrast ◽

Peak Velocity ◽

Left Ventricular ◽

Vortical Flow ◽

4D Flow ◽

Phase Contrast Mri ◽

Flow Phase ◽

Flow Mri

Objective. To assess phase-contrast MRI in the evaluation of left ventricular hemodynamics changes in various forms of hypertrophic cardiomyopathy.Materials and methods. 11 patients were examined: without pathology of the cardiovascular system (n = 3), with apical (n = 3), diffuse-septal (n = 2) and focal-basal (n = 3) types of hypertrophic cardiomyopathy. All patients underwent MRI of the heart with an additional phase-contrast sequence of the left ventricular area. Postprocessing carried out in the 4D FLOW application (Siemens).Results. Data were obtained on the geometry and dynamics of vortex diastolic flows in the left ventricular of all patients. In patients with hypertrophic cardiomyopathy, an increase in the distance to the center of the vortex and a decrease in the normalized area and peak velocity of the vortex is determined. The diffuse-septal type is characterized by a minimal vortex peak velocity; apical type - by the maximum vortex sphericity index. For patients with a focalbasal type of hypertrophic cardiomyopathy the maximum changes in blood flow are determined in late diastole (absence of vortexes).Conclusion. 4D FLOW Phase-contrast MRI allows identifying and assessing LV vortical flow. Quantitative analysis can be used to characterize the remodeling of LV blood flow of various types of hypertrophic cardiomyopathy.

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