4D cardiovascular magnetic resonance velocity mapping of alterations of right heart flow patterns and main pulmonary artery hemodynamics in tetralogy of Fallot

François, Christopher J.; Srinivasan, Shardha; Schiebler, Mark L.; Reeder, Scott B.; Niespodzany, Eric; Landgraf, Benjamin R; Wieben, Oliver; Frydrychowicz, Alex

doi:10.1186/1532-429x-14-16

Cited by 133 publications

(133 citation statements)

References 32 publications

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“…Recently developed time-resolved 3-or 4-dimensional PC-MRI may soon resolve this problem. [34][35][36] The retrospective design also limited our study. We expect a prospective study with longitudinal observations would strengthen the conclusions of our study.…”

Section: Magnetic Resonance In Medical Sciencesmentioning

confidence: 99%

MR-based Measurements of Portal Vein Flow and Liver Stiffness for Predicting Gastroesophageal Varices

et al. 2013

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Objectives: We evaluated ‰ow parameters measured by phase-contrast magnetic resonance (MR) imaging (PC-MRI) of the portal venous system and liver stiŠness measured by MR elastography (MRE) to determine the usefulness of these methods in predicting gastroesophageal varices (GEV) in patients with chronic liver disease (CLD).Methods: In patients with CLD and controls, we performed PC-MRI on the portal (PV) and superior mesenteric veins; calculated mean velocity (V, cm/s), cross-sectional area (S, mm 2 ), and ‰ow volume (Q, mL/min); and determined markers of liverˆbrosis (liver stiŠ-ness [kPa]) and aspartate aminotransferase (AST) platelet ratio index [APRI]). We visually assessed GEV and development of collateral pathways of the PV on routine contrast-enhanced dynamic MR imaging and compared patient characteristics, ‰ow parameters, liver stiŠness markers, and visual analysis among 3GEV groups, those with mild, severe, or no GEV with reference to endoscopicˆndings.Results: Child-Pugh grade, V PV , S PV , liver stiŠness, APRI, and visually identiˆed GEV (visible GEV) diŠered signiˆcantly among the 3 groups (Pº0.05). We investigated V PV , S PV , liver stiŠness, and visible GEV as independent markers to distinguish patients with and without GEV and examined V PV and visible GEV to predict severe GEV. Visible GEV showed low sensitivity (14 to 30z) and high speciˆcity (98z) for predicting GEV in patients with CLD. A subgroup analysis that excluded cases with collateral pathway demonstrated slightly improved diagnostic performance of V PV and liver stiŠness.Conclusions: Portal vein ‰ow parameters and liver stiŠness can be useful markers for predicting GEV in patients with CLD.

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Section: Magnetic Resonance In Medical Sciencesmentioning

confidence: 99%

MR-based Measurements of Portal Vein Flow and Liver Stiffness for Predicting Gastroesophageal Varices

et al. 2013

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“…Three-dimensional (3D) time-resolved phase-contrast MRI with three-dimensional motion encoding permits flow assessment of the true 3D nature of intracardiac blood flow over the cardiac cycle (12)(13)(14)(15)(16)(17). A recent 4D (3D + time) flow MRI study of the normal RV described patterns and energetics of RV flow with a special emphasis on RV diastolic inflow passing directly to ensuing outflow (Direct Flow).…”

Section: Introductionmentioning

confidence: 99%

4D flow MRI can detect subtle right ventricular dysfunction in primary left ventricular disease

Fredriksson

Svalbring

Eriksson

et al. 2015

Magnetic Resonance Imaging

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Methods4D flow and morphological 3T MRI data were acquired in 22 patients with mild ischemic heart disease, that were stratified into two groups based on LV end-diastolic volume index (EDVI): lower-LVEDVI and higher-LVEDVI, as well as in 11 healthy controls. The RV volume was segmented at end-diastole (ED) and end-systole (ES).Pathlines were emitted from the ED volume and traced forwards and backwards in time to ES. The blood volume was separated into flow components. The Direct Flow (DF) component was defined as RV inflow passing directly to outflow. The kinetic energy (KE) of the DF component was calculated. Echocardiographic conventional RV indices were also assessed. ResultsThe higher-LVEDVI group had larger LVEDVI and lower LV ejection fraction (98±32 ml/m 2 ; 48±13 %) compared to the healthy (67±12, P=0.002; 64±7, P<0.001) and lower-LVEDI group (62±10; 68±7, both P<0.001). The RV 4D flow specific measures "DF/EDV volume-ratio" and "DF/EDV KE-ratio at ED" were lower in the higher-LVEDVI group (38±5 %; 52±6 %) compared to the healthy (44±6; 65±7, P=0.018 and P<0.001) and lower-LVEDVI groups (44±6; 64±7, P=0.011 and P<0.001). There was no difference in any of the conventional MRI and echocardiographic RV indices between the three groups.4 ConclusionWe found that in primary LV disease, mild impairment of RV function can be detected by 4D flow specific measures, but not by the conventional MRI and echocardiographic indices.

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“…Increased vortex flow was observed in the right ventricle as well as the pulmonary artery in such cases compared to healthy volunteers. [8] • Due to a stenosis in the pulmonary artery, the mixed blood from both ventricles is preferably pumped through the aorta. This behavior is called right-to-left shunt.…”

Section: Tetralogy Of Fallotmentioning

confidence: 99%

Semi-Automatic Vortex Extraction in 4D PC-MRI Cardiac Blood Flow Data using Line Predicates

Köhler¹,

Gasteiger²,

Preim³

et al. 2013

IEEE Trans. Visual. Comput. Graphics

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This indicates an improperly closing aortic valve and supports the decision whether or not to implant an artificial valve.Abstract-Cardiovascular diseases (CVD) are the leading cause of death worldwide. Their initiation and evolution depends strongly on the blood flow characteristics. In recent years, advances in 4D PC-MRI acquisition enable reliable and time-resolved 3D flow measuring, which allows a qualitative and quantitative analysis of the patient-specific hemodynamics. Currently, medical researchers investigate the relation between characteristic flow patterns like vortices and different pathologies. The manual extraction and evaluation is tedious and requires expert knowledge. Standardized, (semi-)automatic and reliable techniques are necessary to make the analysis of 4D PC-MRI applicable for the clinical routine. In this work, we present an approach for the extraction of vortex flow in the aorta and pulmonary artery incorporating line predicates. We provide an extensive comparison of existent vortex extraction methods to determine the most suitable vortex criterion for cardiac blood flow and apply our approach to ten datasets with different pathologies like coarctations, Tetralogy of Fallot and aneurysms. For two cases we provide a detailed discussion how our results are capable to complement existent diagnosis information. To ensure real-time feedback for the domain experts we implement our method completely on the GPU.

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4D cardiovascular magnetic resonance velocity mapping of alterations of right heart flow patterns and main pulmonary artery hemodynamics in tetralogy of Fallot

Cited by 133 publications

References 32 publications

MR-based Measurements of Portal Vein Flow and Liver Stiffness for Predicting Gastroesophageal Varices

MR-based Measurements of Portal Vein Flow and Liver Stiffness for Predicting Gastroesophageal Varices

4D flow MRI can detect subtle right ventricular dysfunction in primary left ventricular disease

Semi-Automatic Vortex Extraction in 4D PC-MRI Cardiac Blood Flow Data using Line Predicates

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