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

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.

Abstract 14534: In vitro Assessment of Transvalvular Peak Velocity Measurement for Various Orifice Shapes: Comparison Between 4D Flow MRI vs. Doppler Echocardiography

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jeesoo Lee ◽  
Nadia El hangouche ◽  
Liliana Ma ◽  
Michael Scott ◽  
Michael Markl ◽  
...  
Keyword(s):  
Temporal Resolution ◽  
Continuous Wave ◽  
Peak Velocity ◽  
Left Ventricular ◽  
Patient Specific ◽  
Maximal Velocity ◽  
4D Flow Mri ◽  
4D Flow ◽  
Flow Phantom ◽  
Flow Mri

Introduction: 4D flow MRI can assess transvalvular velocity, but validation against continuous wave (CW) Doppler echo is limited in high-velocity regurgitation and stenosis situations. We sought to compare 4D flow MRI and echo peak velocity using a pulsatile echo-MRI flow phantom. Materials and Methods: An MRI-compatible flow phantom with restrictive orifice situated was driven by a left ventricular assist device at 50 bpm (figure 1A). Three orifice shapes were tested: circular, elliptical and 3D-printed patient-specific mitral regurgitant orifice model of prolapse with areas of 0.5, 0.41 and 0.35 cm 2 , respectively. CW Doppler was acquired with peak velocity extracted from the profile. Retrospectively-gated 4D flow MRI was performed (spatial resolution = 2 mm isotropic, temporal resolution = 36 ms, encoding velocity = 400 cm/s). Maximal velocity magnitude was extracted volumetrically (figure 1B). An echo-mimicking profile was also obtained with a “virtual” ultrasound beam in the 4D flow data to simulate CW Doppler (figure 1C). Bland-Altman analysis was used to assess the agreement of temporal peak velocities. Results: 4D flow MRI demonstrated a centrally directed jet for the circular and elliptical orifices and an oblique jet for the prolapse orifice (figure 1B). Peak velocities were in excellent agreement between 4D flow MRI vs. echo for the circular (peak: 5.13 vs. 5.08 m/s, bias = 0.06 ± 0.66 m/s, figure 1D) and the elliptical orifice (peak: 4.95 vs. 4.79 m/s, bias = 0.07 ± 0.87 m/s, figure 1E). The prolapse orifice velocity was underestimated somewhat by MRI by ~10% (peak: 4.41 vs. 4.90 m/s, bias=0.26±1.18, figure 1F). Conclusion: 4D flow MRI can quantify high velocities like echo for simple geometries while underestimating for more complex geometry, likely due to partial volume effects. Further investigation is warranted to systematically investigate the effects of 4D flow MRI spatial and temporal resolution as well as the jet angle on velocity quantification accuracy.

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

2013 ◽  
Vol 61 (10) ◽  
pp. E950
Author(s):  
Kenichiro Suwa ◽  
Takeji Saito ◽  
Makoto Sano ◽  
Mamoru Nobuhara ◽  
Masao Saotome ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Phase Contrast ◽  
4D Flow ◽  
Phase Contrast Mri ◽  
Cine Phase Contrast

scholarly journals 4D-Flow MRI: Technique and Applications

2018 ◽  
Vol 190 (11) ◽  
pp. 1025-1035 ◽  
Author(s):  
Alexandra Sträter ◽  
Armin Huber ◽  
Jan Rudolph ◽  
Maria Berndt ◽  
Michael Rasper ◽  
...  
Keyword(s):  
Blood Flow ◽  
Phase Contrast ◽  
Relevant Information ◽  
Flow Quantification ◽  
Current Status ◽  
4D Flow Mri ◽  
4D Flow ◽  
Advantages And Disadvantages ◽  
Pubmed Database ◽  
Flow Mri

Background Blood flow through the cavities of the heart and great vessels is pulsatile and is subject to time and multidirectional variations. To date, the recording of blood flow in multiple directions and phases has been limited. 4D-flow MRI offers advantages for the recording, visualization and analysis of blood flow. Method The status quo of the method was summarized through analysis with the PubMed database using the keywords “4D-flow MRI, phase-contrast magnetic resonance imaging, MR flow imaging/visualization, MR flow quantification, 3 D cine (time-resolved) phase-contrast CMR, three-directional velocity-encoding MRI”. Results/Conclusion This review summarizes the current status of the technical development of 4D-flow MRI, discusses its advantages and disadvantages and describes clinical applications. Finally, the most important principles and parameters are explained to give the reader relevant information about clinical indications, postprocessing methods and limitations of the method. Key Points:  Citation Format

scholarly journals Associations between haemodynamics and wall enhancement of intracranial aneurysm

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.

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

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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