Assessment of flow distribution in the mouse fetal circulation at late gestation by high-frequency Doppler ultrasound

2014 ◽  
Vol 46 (16) ◽  
pp. 602-614 ◽  
Author(s):  
Yu-Qing Zhou ◽  
Lindsay S. Cahill ◽  
Michael D. Wong ◽  
Mike Seed ◽  
Christopher K. Macgowan ◽  
...  
Keyword(s):  
High Frequency ◽  
Superior Vena ◽  
Ductus Arteriosus ◽  
Main Pulmonary Artery ◽  
Vena Cava ◽  
Flow Distribution ◽  
Late Gestation ◽  
Ductus Venosus ◽  
Mouse Fetus ◽  
Fetal Circulation

This study used high-frequency ultrasound to evaluate the flow distribution in the mouse fetal circulation at late gestation. We studied 12 fetuses (embryonic day 17.5) from 12 pregnant CD1 mice with 40 MHz ultrasound to assess the flow in 11 vessels based on Doppler measurements of blood velocity and M-mode measurements of diameter. Specifically, the intrahepatic umbilical vein (UVIH), ductus venosus (DV), foramen ovale (FO), ascending aorta (AA), main pulmonary artery (MPA), ductus arteriosus (DA), descending thoracic aorta (DTA), common carotid artery (CCA), inferior vena cava (IVC), and right and left superior vena cavae (RSVC, LSVC) were examined, and anatomically confirmed by micro-CT. The mouse fetal circulatory system was found to be similar to that of the humans in terms of the major circuit and three shunts, but characterized by bilateral superior vena cavae and a single umbilical artery. The combined cardiac output (CCO) was 1.22 ± 0.05 ml/min, with the left ventricle (flow in AA) contributing 47.8 ± 2.3% and the right ventricle (flow in MPA) 52.2 ± 2.3%. Relative to the CCO, the flow percentages were 13.6 ± 1.0% for the UVIH, 10.4 ± 1.1% for the DV, 35.6 ± 2.4% for the DA, 41.9 ± 2.6% for the DTA, 3.8 ± 0.3% for the CCA, 29.5 ± 2.2% for the IVC, 12.7 ± 1.0% for the RSVC, and 9.9 ± 0.9% for the LSVC. The calculated flow percentage was 16.6 ± 3.4% for the pulmonary circulation and 31.2 ± 5.3% for the FO. In conclusion, the flow in mouse fetal circulation can be comprehensively evaluated with ultrasound. The baseline data of the flow distribution in normal mouse fetus serve as the reference range for future studies.

scholarly journals Volumetric Fetal Flow Imaging with Magnetic Resonance Imaging

2021 ◽  
Author(s):  
Datta Singh Goolaub ◽  
Jiawei Xu ◽  
Eric Schrauben ◽  
Davide Marini ◽  
John Kingdom ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Main Pulmonary Artery ◽  
Vena Cava ◽  
Late Gestation ◽  
Ductus Venosus ◽  
Cardiac Gating ◽  
Resonance Imaging ◽  
Limits Of Agreement ◽  
Fetal Circulation

Fetal development relies on a complex circulatory network and accurately assessing the flow distribution is important for understanding pathologies and potential therapies. In this paper, we demonstrate a method for volumetric multidimensional imaging of fetal flow with magnetic resonance imaging (MRI). Fetal application of MRI faces several challenges such as small vascular structures, unpredictable motion, and lack of traditional cardiac gating methods. Here, orthogonal multislice stacks are acquired with accelerated multidimensional radial phase contrast (PC) MRI. Each slice is reconstructed into flow sensitive time-series images (CINEs) with retrospective intraslice motion correction and image-based fetal cardiac gating. CINEs are then combined into a dynamic 3D volume using slice-to-volume reconstruction (SVR) while accounting for interslice spatiotemporal coregistration. Validation of the technique is demonstrated in adult volunteers by comparing mean flows from SVR with 4D radial PCMRI with bias and limits of agreement being -1.1 ml/s and [-12.5 10.2] ml/s. Feasibility is demonstrated in late gestation fetuses by comparing SVR with 2D Cartesian PCMRI with bias and limits of agreement being -0.9 ml/min/kg and [-39.7 37.8] ml/min/kg for mean flows. With SVR, we also demonstrate complex flow pathways (such as parallel flow streams in the proximal inferior vena cava, preferential shunting of blood from the ductus venosus into the left side of the heart, and blood returning from the brain leaving the heart through the main pulmonary artery) for the first time in human fetal circulation. This method allows for comprehensive evaluation of the fetal circulation and enables future studies of fetal physiology.

scholarly journals Volumetric Fetal Flow Imaging with Magnetic Resonance Imaging

2021 ◽  
Author(s):  
Datta Singh Goolaub ◽  
Jiawei Xu ◽  
Eric Schrauben ◽  
Davide Marini ◽  
John Kingdom ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Main Pulmonary Artery ◽  
Vena Cava ◽  
Late Gestation ◽  
Ductus Venosus ◽  
Cardiac Gating ◽  
Resonance Imaging ◽  
Limits Of Agreement ◽  
Fetal Circulation

Fetal development relies on a complex circulatory network and accurately assessing the flow distribution is important for understanding pathologies and potential therapies. In this paper, we demonstrate a method for volumetric multidimensional imaging of fetal flow with magnetic resonance imaging (MRI). Fetal application of MRI faces several challenges such as small vascular structures, unpredictable motion, and lack of traditional cardiac gating methods. Here, orthogonal multislice stacks are acquired with accelerated multidimensional radial phase contrast (PC) MRI. Each slice is reconstructed into flow sensitive time-series images (CINEs) with retrospective intraslice motion correction and image-based fetal cardiac gating. CINEs are then combined into a dynamic 3D volume using slice-to-volume reconstruction (SVR) while accounting for interslice spatiotemporal coregistration. Validation of the technique is demonstrated in adult volunteers by comparing mean flows from SVR with 4D radial PCMRI with bias and limits of agreement being -1.1 ml/s and [-12.5 10.2] ml/s. Feasibility is demonstrated in late gestation fetuses by comparing SVR with 2D Cartesian PCMRI with bias and limits of agreement being -0.9 ml/min/kg and [-39.7 37.8] ml/min/kg for mean flows. With SVR, we also demonstrate complex flow pathways (such as parallel flow streams in the proximal inferior vena cava, preferential shunting of blood from the ductus venosus into the left side of the heart, and blood returning from the brain leaving the heart through the main pulmonary artery) for the first time in human fetal circulation. This method allows for comprehensive evaluation of the fetal circulation and enables future studies of fetal physiology.

Assessment of superior vena cava flow and cardiac output in different patterns of patent ductus arteriosus shunt

2021 ◽  
Author(s):  
Adrianne Rahde Bischoff ◽  
Regan E. Giesinger ◽  
Amy H. Stanford ◽  
Ravi Ashwath ◽  
Patrick J. McNamara
Keyword(s):  
Cardiac Output ◽  
Patent Ductus Arteriosus ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Ductus Arteriosus ◽  
Vena Cava ◽  
Patent Ductus

ANOMALIES OF THE PULMONARY VEINS AND THEIR SURGICAL SIGNIFICANCE

PEDIATRICS ◽  
1952 ◽  
Vol 9 (2) ◽  
pp. 152-166
Author(s):  
HARRY G. PARSONS ◽  
ANN PURDY ◽  
BRUCE JESSUP
Keyword(s):  
Superior Vena Cava ◽  
Clinical Symptoms ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Ductus Venosus ◽  
Return Flow ◽  
Right Heart ◽  
Surgical Measures ◽  
The Right

The successful operations upon abnormalities of the outflow tracts of the heart suggest that surgical measures may also be applied to the correction of abnormal inflow tracts. Technically the anastomosis of veins to the auricle has been proved feasible in the experimental animal. Therefore, it should be possible to correct abnormally placed pulmonary veins in man. A wide variety of such anomalies occur. In 55 of 136 reported cases, all the oxygenated blood from the lungs was returned to the right heart through anomalous vessels. Thirty-five per cent of these cases of complete diversion were accompanied by other major cardiac defects. It is estimated that 50% or more of the return flow from the lungs must reach the right heart to produce clinical symptoms. Two cases are presented of persistence of the left superior vena cava which transmitted all the freshly oxygenated blood to the right auricle, by way of the left innominate and the right superior vena cava. The clinical picture was that of growth retardation, minimal cyanosis, a huge hyperactive heart, a loud left mesocardial systolic murmur, pulsating shadows in both upper pulmonary fields, and nearly identical oxygen-saturation of blood obtained from the right heart and femoral artery. One case is reported in which all the oxygenated blood from the lungs is carried to the right auricle by way of the ductus venosus. Surgical correction of the abnormality of these cases by transplantation of one or more of the veins would have been possible. However, no case known to the authors has yet been successfully corrected.

Comprehensive transthoracic cardiac imaging in mice using ultrasound biomicroscopy with anatomical confirmation by magnetic resonance imaging

2004 ◽  
Vol 18 (2) ◽  
pp. 232-244 ◽  
Author(s):  
Yu-Qing Zhou ◽  
F. Stuart Foster ◽  
Brian J. Nieman ◽  
Lorinda Davidson ◽  
X. Josette Chen ◽  
...  
Keyword(s):  
Cardiac Imaging ◽  
Superior Vena ◽  
Main Pulmonary Artery ◽  
Vena Cava ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
High Frequency Ultrasound ◽  
The Right

High-frequency ultrasound biomicroscopy (UBM) has recently emerged as a high-resolution means of phenotyping genetically altered mice and has great potential to evaluate the cardiac morphology and hemodynamics of mouse mutants. However, there is no standard procedure of in vivo transthoracic cardiac imaging using UBM to comprehensively phenotype the adult mice. In this paper, the characteristic mouse thoracic anatomy is elucidated using magnetic resonance (MR) imaging on fixed mice. Besides the left parasternal and apical windows commonly used for transthoracic ultrasound cardiac imaging, a very useful right parasternal window is found. We present strategies for optimal visualization using UBM of key cardiac structures including: 1) the right atrial inflow channels such as the right superior vena cava; 2) the right ventricular inflow tract via the tricuspid orifice; 3) the right ventricular outflow tract to the main pulmonary artery; 4) the left atrial inflow channel, e.g., pulmonary vein; 5) the left ventricular inflow tract via the mitral orifice; 6) the left ventricular outflow tract to the ascending aorta; 7) the left coronary artery; and 8) the aortic arch and associated branches. Two-dimensional ultrasound images of these cardiac regions are correlated to similar sections in the three-dimensional MR data set to verify anatomical details of the in vivo UBM imaging. Dimensions of the left ventricle and ascending aorta are measured by M-mode. Flow velocities are recorded using Doppler at six representative intracardiac locations: right superior vena cava, tricuspid orifice, main pulmonary artery, pulmonary vein, mitral orifice, and ascending aorta. The methodologies and baseline measurements of inbred mice provide a useful guide for investigators applying the high-frequency ultrasound imaging to mouse cardiac phenotyping.

A Computational Pulsatile Model of the Bidirectional Cavopulmonary Anastomosis: The Influence of Pulmonary Forward Flow

1996 ◽  
Vol 118 (4) ◽  
pp. 520-528 ◽  
Author(s):  
Francesco Migliavacca ◽  
Marc R. de Leval ◽  
Gabriele Dubini ◽  
Riccardo Pietrabissa
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Main Pulmonary Artery ◽  
Vena Cava ◽  
Similar Distribution ◽  
Pulsatile Blood Flow ◽  
Cavopulmonary Anastomosis ◽  
Bidirectional Cavopulmonary Anastomosis

The bidirectional cavopulmonary anastomosis (BCPA or bidirectional Glenn) is an operation to treat congenital heart diseases of the right heart by diverting the systemic venous return from the superior vena cava to both lungs. The main goal is to provide the correct perfusion to both lungs avoiding an excessive increase in systemic venous pressure. One of the factors which can affect the clinical outcome of the surgically reconstructed circulation is the amount of pulsatile blood flow coming from the main pulmonary artery. The purpose of this work is to analyse the influence of this factor on the BCPA hemodynamics. A 3-D finite element model of the BCPA has been developed to reproduce the flow of the surgically reconstructed district. Geometry and hemodynamic data have been taken from angiocardiogram and catheterization reports, respectively. On the basis of the developed 3-D model, four simulations have been performed with increasing pulsatile blood flow rate from the main pulmonary artery. The results show that hemodynamics in the pulmonary arteries are greatly influenced by the amount of flow through the native main pulmonary artery and that the flow from the superior vena cava allows to have a similar distribution of the blood to both lungs, with a little predilection for the left side, in agreement with clinical postoperative data.

scholarly journals The Methodology of Doppler-Derived Central Blood Flow Measurements in Newborn Infants

2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
Koert A. de Waal
Keyword(s):  
Blood Flow ◽  
Doppler Ultrasound ◽  
Superior Vena ◽  
Ductus Arteriosus ◽  
Newborn Infants ◽  
Vena Cava ◽  
Left Ventricular ◽  
Flow Measurements ◽  
General Guide ◽  
Blood Flow Measurements

Central blood flow (CBF) measurements are measurements in and around the heart. It incorporates cardiac output, but also measurements of cardiac input and assessment of intra- and extracardiac shunts. CBF can be measured in the central circulation as right or left ventricular output (RVO or LVO) and/or as cardiac input measured at the superior vena cava (SVC flow). Assessment of shunts incorporates evaluation of the ductus arteriosus and the foramen ovale. This paper describes the methodology of CBF measurements in newborn infants. It provides a brief overview of the evolution of Doppler ultrasound blood flow measurements, basic principles of Doppler ultrasound, and an overview of all used methodology in the literature. A general guide for interpretation and normal values with suggested cutoffs of CBFs are provided for clinical use.

scholarly journals Pharmacological management of low blood flow state in less than 28weeks neonate.

2021 ◽  
Author(s):  
Femi Adeniyi ◽  
Kunle Oyedokun ◽  
Adeniyi Ajiboye ◽  
Sanjeev Rath
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Pharmacological Treatment ◽  
Superior Vena ◽  
Ductus Arteriosus ◽  
Vena Cava ◽  
Low Flow ◽  
Systemic Resistance ◽  
Preterm Neonates ◽  
Flow State

low blood flow state is defined as insufficient cardiac output to maintain adequate cellular metabolism at the organ level. A low blood flow state can be measured by reduced organ perfusion, such as reduced superior vena cava flow[1,2] or high resistance flow in superior mesenteric doppler scan [3]. The combination of capillary refill time of greater than 4 seconds and serum lactate greater than 4 mmol/litre has 97% sensitivity of identifying low blood flow state [4]. In the presence of the above markers of a low blood flow state, the blood pressure may be normal or high in the first 48hours of life due to high systemic resistance [5]. Therefore, high, or normal blood pressure should be interpreted with great caution. CONCLUSIONThe pharmacological treatment of a low blood flow state should be guided by thorough clinical assessment. The prophylaxis or stress dose hydrocortisone treatment of low flow state is gaining grounds mainly when there is evidence of adrenal insufficiency. The choice and titration of pharmacological treatment should be guided by functional echocardiography. The use of Dobutamine as first-line treatment is advised when myocardia dysfunction on echocardiography is noted.Milrinone use is reserved for extreme preterm neonates with myocardia dysfunction before patent ductus arteriosus ligation. Dopamine and noradrenaline remain the commonly used first and second-line vasopressors, respectively, to manage low blood flow states secondary to poor vasomotor resistance.

scholarly journals Feasibility of phase-contrast cine magnetic resonance imaging for measuring blood flow in the sheep fetus

2019 ◽  
Vol 317 (6) ◽  
pp. R780-R792 ◽  
Author(s):  
An Qi Duan ◽  
Jack R. T. Darby ◽  
Jia Yin Soo ◽  
Mitchell C. Lock ◽  
Meng Yuan Zhu ◽  
...  
Keyword(s):  
Blood Flow ◽  
Phase Contrast ◽  
Interobserver Agreement ◽  
Main Pulmonary Artery ◽  
Ductus Venosus ◽  
Cine Mri ◽  
Flow Measurements ◽  
Fetal Sheep ◽  
Fetal Circulation ◽  
Arterial Blood

Phase-contrast cine MRI (PC-MRI) is the gold-standard noninvasive technique for measuring vessel blood flow and has previously been applied in the human fetal circulation. We aimed to assess the feasibility of using PC-MRI to define the distribution of the fetal circulation in sheep. Fetuses were catheterized at 119–120 days of gestation (term, 150 days) and underwent MRI at ∼123 days of gestation under isoflurane anesthesia, ventilated at a [Formula: see text] of 1.0. PC-MRI was performed using a fetal arterial blood pressure catheter signal for cardiac triggering. Blood flows were measured in the major fetal vessels, including the main pulmonary artery, ascending and descending aorta, superior vena cava, ductus arteriosus, left and right pulmonary arteries, umbilical vein, ductus venosus, and common carotid artery and were indexed to estimated fetal weight. The combined ventricular output, pulmonary blood flow, and flow across the foramen ovale were calculated from vessel flows. Intraobserver and interobserver agreement and reproducibility was assessed. Blood flow measurements were successfully obtained in 61 out of 74 vessels (82.4%) interrogated in 9 fetuses. There was good intraobserver [ R = 0.998, P < 0.0001; intraclass correlation (ICC) = 0.997] and interobserver agreement ( R = 0.996, P < 0.0001; ICC = 0.996). Repeated MRI measurements showed good reproducibility ( R = 0.989, P = 0.0002; ICC = 0.990). We conclude that PC-MRI using fetal catheters for gating triggers is feasible in the major vessels of late gestation fetal sheep. This approach may provide a useful new tool for assessing the circulatory characteristics of fetal sheep models of human disease, including fetal growth restriction and congenital heart disease.

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