Congenital heart disease assessment with 4D flow MRI

Vasanawala, Shreyas S.; Hanneman, Kate; Alley, Marcus T.; Hsiao, Albert

doi:10.1002/jmri.24856

Cited by 108 publications

(83 citation statements)

References 70 publications

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“…Several studies provide evidence for this mechanism and demonstrated that more evenly distributed delivery of hepatic venous blood directed to the left and right lung through the IVC results in decreased Fontan complications [6–9]. Blood flow at the Fontan connection has previously been studied in vivo by multiple techniques [10–15], including whole-heart 4-D flow MRI data [16–21] and computational fluid dynamics.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of blood flow distribution asymmetry and vascular geometry in patients with Fontan circulation using 4-D flow MRI

et al. 2016

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Background Asymmetrical caval to pulmonary blood flow is suspected to cause complications in patients with Fontan circulation. The aim of this study was to test the feasibility of 4-D flow MRI for characterizing the relationship between 3-D blood flow distribution and vascular geometry. Objective We hypothesized that both flow distribution and geometry can be calculated with low interobserver variability and will detect a direct relationship between flow distribution and Fontan geometry. Materials and methods Four-dimensional flow MRI was acquired in 10 Fontan patients (age: 16±4 years [mean ± standard deviation; range 9–21 years]). The Fontan connection was isolated by 3-D segmentation to evaluate flow distribution from the inferior vena cava (IVC) and superior vena cava (SVC) to the left and right pulmonary arteries (LPA, RPA) and to characterize geometry (cross-sectional area, caval offset, vessel angle). Results Flow distribution results indicated SVC flow tended toward the RPA while IVC flow was more evenly distributed (SVC to RPA: 78%±28 [9–100], IVC to LPA: 54%±28 [4–98]). There was a significant relationship between pulmonary artery cross-sectional area and flow distribution (IVC to RPA: R2=0.50, P=0.02; SVC to LPA: R2=0.81, P=0.0004). Good agreement was found between observers and for flow distribution when compared to net flow values. Conclusion Four-dimensional (4-D) flow MRI was able to detect relationships between flow distribution and vessel geometry. Future studies are warranted to investigate the potential of patient specific hemodynamic analysis to improve diagnostic capability.

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Section: Introductionmentioning

confidence: 99%

Evaluation of blood flow distribution asymmetry and vascular geometry in patients with Fontan circulation using 4-D flow MRI

et al. 2016

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“…In some cases, even blood pool agents are used [20, 21]. Also in this study, the 4D flow CMR acquisition was preceded by an injection of an extracellular contrast agent for delayed contrast-enhaced CMR.…”

Section: Discussionmentioning

confidence: 99%

Improving visualization of 4D flow cardiovascular magnetic resonance with four-dimensional angiographic data: generation of a 4D phase-contrast magnetic resonance CardioAngiography (4D PC-MRCA)

Bustamante

Gupta

Carlhäll

et al. 2016

Journal of Cardiovascular Magnetic Resonance

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Magnetic Resonance Angiography (MRA) and Phase-Contrast MRA (PC-MRA) approaches used for assessment of cardiovascular morphology typically result in data containing information from the entire cardiac cycle combined into one 2D or 3D image. Information specific to each timeframe of the cardiac cycle is, however, lost in this process. This study proposes a novel technique, called Phase-Contrast Magnetic Resonance CardioAngiography (4D PC-MRCA), that utilizes the full potential of 4D Flow CMR when generating temporally resolved PC-MRA data to improve visualization of the heart and major vessels throughout the cardiac cycle. Using non-rigid registration between the timeframes of the 4D Flow CMR acquisition, the technique concentrates information from the entire cardiac cycle into an angiographic dataset at one specific timeframe, taking movement over the cardiac cycle into account. Registration between the timeframes is used once more to generate a time-resolved angiography. The method was evaluated in ten healthy volunteers. Visual comparison of the 4D PC-MRCAs versus PC-MRAs generated from 4D Flow CMR using the traditional approach was performed by two observers using Maximum Intensity Projections (MIPs). The 4D PC-MRCAs resulted in better visibility of the main anatomical regions of the cardiovascular system, especially where cardiac or vessel motion was present. The proposed method represents an improvement over previous PC-MRA generation techniques that rely on 4D Flow CMR, as it effectively utilizes all the information available in the acquisition. The 4D PC-MRCA can be used to visualize the motion of the heart and major vessels throughout the entire cardiac cycle.Electronic supplementary materialThe online version of this article (doi:10.1186/s12968-017-0360-8) contains supplementary material, which is available to authorized users.

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“…It shows pathophysiological conditions. The physiological consequences of congenital heart defects expressed as abnormal flows and abnormal functioning of the ventricles and heart valves can also be detected [35]. Patients often require lifelong monitoring.…”

Section: Congenital Heart Defectsmentioning

confidence: 99%

4D-Flow MRI: Technique and Applications

Sträter

Huber

Rudolph

et al. 2018

Fortschr Röntgenstr

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ABSTR AC TBackground 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, threedirectional velocity-encoding MRI". Methode Basierend auf einer Literaturrecherche in der PubMed-Datenbank mit den Begriffen "4D-Flow-MRI, Phasecontrast magnetic-resonance-imaging, MR-flow-imaging/-visualization, MR-Flow-quantification, 3D-cine (time-resolved) phase-contrast CMR, three-directional velocity-encoding MR" wurde der aktuelle Stand der Methode in dieser Über-sichtsarbeit zusammengefasst.Ergebnisse/Schlussfolgerung Diese Übersichtsarbeit fasst den aktuellen Stand der technischen Entwicklung der 4D-Flussmessung zusammen, diskutiert ihre Vor-und Nachteile und zeigt Anwendungsmöglichkeiten auf. Schließlich werden die wichtigsten Prinzipien und Parameter erklärt, sodass der Leser über die Anwendung der Methode, die möglichen klinischen Indikationen, die Auswertung verschiedener Parameter durch Post-processing-Methoden und die Limitationen des Verfahrens relevante Informationen erhält. Review 1025Sträter A et al. 4D-Flow

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Congenital heart disease assessment with 4D flow MRI

Cited by 108 publications

References 70 publications

Evaluation of blood flow distribution asymmetry and vascular geometry in patients with Fontan circulation using 4-D flow MRI

Evaluation of blood flow distribution asymmetry and vascular geometry in patients with Fontan circulation using 4-D flow MRI

Improving visualization of 4D flow cardiovascular magnetic resonance with four-dimensional angiographic data: generation of a 4D phase-contrast magnetic resonance CardioAngiography (4D PC-MRCA)

4D-Flow MRI: Technique and Applications

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