4D phase contrast MRI at 3 T: Effect of standard and blood‐pool contrast agents on SNR, PC‐MRA, and blood flow visualization

Bock, Jelena; Frydrychowicz, Alex; Stalder, Aurélien F.; Bley, Thorsten Alexander; Burkhardt, Hans; Hennig, Jürgen; Markl, Michael

doi:10.1002/mrm.22199

Cited by 154 publications

(117 citation statements)

References 40 publications

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“…Data analysis included the calculation of a 3D phase contrast (PC) MR angiogram (MRA) from 4D-MRI data combined with 3D blood-flow visualization (EnSight, CEI, Apex, NC) (27).…”

Section: Discussionmentioning

confidence: 99%

Aortic flow patterns in patients with Marfan syndrome assessed by flow‐sensitive four‐dimensional MRI

Geiger

Markl

Herzer

et al. 2011

Magnetic Resonance Imaging

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Purpose: To apply time-resolved three-dimensional (3D) phase contrast MRI with three-directional velocity encoding (flow-sensitive 4D MRI) for the characterization of flow pattern changes in patients with Marfan syndrome (MFS) compared with normal controls.Materials and Methods: Flow-sensitive 4D MRI of the thoracic aorta (temporal resolution $45 ms, spatial resolution $2.4 Â 2.1 Â 2.8 mm 3 ) was performed in 24 MFS patients and 10 volunteers. Aortic flow patterns were visualized by 3D particle traces and streamlines. Global (affecting the complete lumen) and local (parts of the vessel lumen) helix and vortex flow in the ascending aorta (AAo), aortic arch, and descending aorta (DAo) were graded in 3 categories (blinded reading, two observers): none ¼ 0, moderate ¼ 1, pronounced ¼ 2.Results: Flow grading revealed similar global helix and vortex flow in the AAo and arch for MFS patients and controls. Local helix flow in the AAo was significantly (P ¼ 0.011) increased in patients and was associated with aortic sinus dilatation. The incidence of global helix and vortex flow in the DAo was increased in patients (77% and 50% of subjects) compared with controls (none and 10%). Conclusion:The 4D flow analysis revealed marked differences of the aortic flow patterns between Marfan patients and controls: Local helix flow in the patients' AAo may be associated with the increased incidence of aortic root dilatation. The flow alterations in the proximal DAo could explain the occurrence of Type-B dissection originating from this site.

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“…Data analysis included the calculation of a 3D phase contrast (PC) MR angiogram (MRA) from 4D-MRI data combined with 3D blood-flow visualization (EnSight, CEI, Apex, NC) (27).…”

Section: Discussionmentioning

confidence: 99%

Aortic flow patterns in patients with Marfan syndrome assessed by flow‐sensitive four‐dimensional MRI

Geiger

Markl

Herzer

et al. 2011

Magnetic Resonance Imaging

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“…3D phase contrast MR angiograms were computed based on the 4D flow data and used to obtain a 3D segmentation of the aorta using a commercial software package (Mimics; Materialise, Leuven, Belgium) 21. To quantify degree of AS in patients, peak velocity during systole was quantified at the aortic root using an oblique sagittal maximum intensity projection of the absolute velocity 22.…”

Section: Methodsmentioning

confidence: 99%

Aortic Valve Stenosis Alters Expression of Regional Aortic Wall Shear Stress: New Insights From a 4‐Dimensional Flow Magnetic Resonance Imaging Study of 571 Subjects

Ooij

Markl

Collins

et al. 2017

JAHA

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BackgroundWall shear stress (WSS) is a stimulus for vessel wall remodeling. Differences in ascending aorta (AAo) hemodynamics have been reported between bicuspid aortic valve (BAV) and tricuspid aortic valve patients with aortic dilatation, but the confounding impact of aortic valve stenosis (AS) is unknown.Methods and ResultsFive hundred seventy‐one subjects underwent 4‐dimensional flow magnetic resonance imaging in the thoracic aorta (210 right‐left BAV cusp fusions, 60 right‐noncoronary BAV cusp fusions, 245 tricuspid aortic valve patients with aortic dilatation, and 56 healthy controls). There were 166 of 515 (32%) patients with AS. WSS atlases were created to quantify group‐specific WSS patterns in the AAo as a function of AS severity. In BAV patients without AS, the different cusp fusion phenotypes resulted in distinct differences in eccentric WSS elevation: right‐left BAV patients exhibited increased WSS by 9% to 34% (P<0.001) at the aortic root and along the entire outer curvature of the AAo whereas right‐noncoronary BAV patients showed 30% WSS increase (P<0.001) at the distal portion of the AAo. WSS in tricuspid aortic valve patients with aortic dilatation patients with no AS was significantly reduced by 21% to 33% (P<0.01) in 4 of 6 AAo regions. In all patient groups, mild, moderate, and severe AS resulted in a marked increase in regional WSS (P<0.001). Moderate‐to‐severe AS further increased WSS magnitude and variability in the AAo. Differences between valve phenotypes were no longer apparent.Conclusions AS significantly alters aortic hemodynamics and WSS independent of aortic valve phenotype and over‐rides previously described flow patterns associated with BAV and tricuspid aortic valve with aortic dilatation. Severity of AS must be considered when investigating valve‐mediated aortopathy.

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“…Both contrast agents used (Multihance and Ablavar) are well suited for contrast-enhanced MRA and 4D flow MRI as previously shown, 43,44 with no difference in quantification results between the two agents.…”

Section: Study Limitationsmentioning

confidence: 62%

Altered aortic shape in bicuspid aortic valve relatives influences blood flow patterns

Schnell

Smith²,

Barker

et al. 2016

Eur Heart J Cardiovasc Imaging

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AimsBicuspid aortic valve (BAV) is known to exhibit familial inheritance and is associated with aortopathy and altered aortic haemodynamics. However, it remains unclear whether BAV-related aortopathy can be inherited independently of valve morphology. Methods and resultsFour-dimensional flow magnetic resonance imaging for the in vivo assessment of thoracic aortic 3D blood flow was performed in 24 BAV relatives with trileaflet aortic valves (age ¼ 40 + 14 years) and 15 healthy controls (age ¼ 37 + 10 years). Data analysis included aortic dimensions, shape (round/gothic/cubic), and 3D blood flow characteristics (semiquantitative vortex/helix grading and peak velocities). Cubic and gothic aortic shapes were markedly more prevalent in BAV relatives compared with controls (38 vs. 7%). Ascending aorta (AAo) vortex flow in BAV relatives was significantly increased compared with controls (grading ¼ 1.5 + 1.0 vs. 0.6 + 0.9, P ¼ 0.015). Aortic haemodynamics were influenced by aortic shape: peak velocities were reduced for gothic aortas vs. round aortas (P ¼ 0.003); vortex flow was increased for cubic aortas in the AAo (P , 0.001) and aortic arch (P ¼ 0.004); vortex and helix flows were elevated for gothic aortas in the AAo and descending aorta (P ¼ 0.003, P ¼ 0.029). Logistic regression demonstrated significant associations of shape with severity of vortex flow in AAo (P , 0.001) and aortic arch (P ¼ 0.016) in BAV relatives. ConclusionBAV relatives expressed altered aortic shape and increased vortex flow despite the absence of valvular disease or aortic dilatation. These data suggest a heritable component of BAV-related aortopathy affecting aortic shape and aberrant blood flow, independent of valve morphology.--

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4D phase contrast MRI at 3 T: Effect of standard and blood‐pool contrast agents on SNR, PC‐MRA, and blood flow visualization

Cited by 154 publications

References 40 publications

Aortic flow patterns in patients with Marfan syndrome assessed by flow‐sensitive four‐dimensional MRI

Aortic flow patterns in patients with Marfan syndrome assessed by flow‐sensitive four‐dimensional MRI

Aortic Valve Stenosis Alters Expression of Regional Aortic Wall Shear Stress: New Insights From a 4‐Dimensional Flow Magnetic Resonance Imaging Study of 571 Subjects

Altered aortic shape in bicuspid aortic valve relatives influences blood flow patterns

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