Dual-VENC 4D Flow MRI Can Detect Abnormal Blood Flow in the Left Atrium That Potentially Causes Thrombosis Formation after Left Upper Lobectomy

Nakaza, Masatoki; Maeda, Mitsuo; Sekine, Tetsuro; Inoue, Tatsuya; Ando, Takahiro; Ogawa, Masashi; Obara, Makoto; Leonowicz, Olgierd; Kumita, Shin‐ichiro; Usuda, Jitsuo

doi:10.2463/mrms.mp.2020-0170

Cited by 22 publications

(21 citation statements)

References 39 publications

(114 reference statements)

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“…This figure was reused from a published paper with permission. 58 had a higher likelihood of PVST. 53 As one of the promoters of PVST, cancer-related coagulation has been considered.…”

Section: D Flow Mri Assessment Of Post-lung Surgerymentioning

confidence: 92%

4D Flow MR Imaging of the Left Atrium: What is Non-physiological Blood Flow in the Cardiac System?

et al. 2022

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Most cardiac diseases cause a non-physiological blood flow pattern known as turbulence around the heart and great vessels, which further worsen the disease itself. However, there is no consensus on how blood flow can be defined in disease conditions. Especially, in the left atrium, the fact that vortex flow already exists makes this debate more complicated. 3D time-resolved phase-contrast (4D flow) MRI is expected to be able to capture blood flow patterns from multiple aspects, such as blood flow velocity, stasis, and vortex quantification. Previous studies have confirmed that physiological vortex flow is predominantly induced by the higher-volume flow from the superior left pulmonary vein. In atrial fibrillation, 4D flow MRI reveals a non-physiological blood flow pattern, which information may add value to well-established clinical risk factors. Currently, the research target of LA analysis has also widened to lung surgeons, pulmonary vein stump thrombosis after left upper lobectomy. 4D flow MRI is expected to be utilized for many more variable diseases that are currently unimaginable.

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“…This figure was reused from a published paper with permission. 58 had a higher likelihood of PVST. 53 As one of the promoters of PVST, cancer-related coagulation has been considered.…”

Section: D Flow Mri Assessment Of Post-lung Surgerymentioning

confidence: 92%

4D Flow MR Imaging of the Left Atrium: What is Non-physiological Blood Flow in the Cardiac System?

et al. 2022

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“…To accurately capture both the high-and low-velocity blood flow, multivelocity encoding (multi-VENC) 4D flow MRI with a wide dynamic range of target blood flow velocity has been proposed. 63,[65][66][67][68]…”

Section: Aortic Dissectionmentioning

confidence: 99%

Utility of 4D Flow MRI in Thoracic Aortic Diseases: A Literature Review of Clinical Applications and Current Evidence

Takahashi

Sekine

Ando

et al. 2022

MRMS

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Despite the recent technical developments, surgery on the thoracic aorta remains challenging and is associated with significant mortality and morbidity. Decisions about when and if to operate are based on a balance between surgical risk and the hazard of aortic rupture. These decisions are sometimes difficult in elective cases of thoracic aortic diseases, including aneurysms and dissections. Abnormal wall stress derived from flow alterations influences disease progression. Therefore, a better understanding of the complex hemodynamic environment inside the aortic lumen will facilitate patient-specific risk assessments of complications, which enable clinicians to provide timely prophylactic interventions. Time-resolved 3D phase-contrast (4D flow) MRI has many advantages for the in vivo assessment of flow dynamics. Recent developments in 4D flow imaging techniques has led to significant advances in our understanding of physiological flow dynamics in healthy subjects and patients with thoracic aortic diseases. In this clinically focused review of thoracic aortic diseases, we demonstrate the clinical advances acquired with 4D flow MRI from published studies. We provide a systematic overview of key evidences and considerations regarding normal thoracic aortas, thoracic aortic aneurysms, aortic dissections, and thoracic aortas with prosthetic graft replacement.

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“…With such a multi-venc sequence, a comprehensive, simultaneous assessment of portal, arterial, and venous flow in the upper abdomen should be possible, and promising approaches are emerging. [79][80][81][82] However,…”

Section: Unmet Needs For Implementation In Clinical Routinementioning

confidence: 99%

Clinical Applications of 4D Flow MRI in the Portal Venous System

et al. 2022

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Evaluation of the hemodynamics in the portal venous system plays an essential role in many hepatic pathologies. Changes in portal flow and vessel morphology are often indicative of disease. Routinely used imaging modalities, such as CT, ultrasound, invasive angiography, and MRI, often focus on either hemodynamics or anatomical imaging. In contrast, 4D flow MRI facilitiates a more comprehensive understanding of pathophysiological mechanisms by simultaneously and noninvasively acquiring time-resolved flow and anatomical information in a 3D imaging volume.Though promising, 4D flow MRI in the portal venous system is especially challenging due to small vessel calibers, slow flow velocities, and breathing motion. In this review article, we will discuss how to account for these challenges when planning and conducting 4D flow MRI acquisitions in the upper abdomen. We will address patient preparation, sequence acquisition, postprocessing, quality control, and analysis of 4D flow data.In the second part of this article, we will review potential clinical applications of 4D flow MRI in the portal venous system. The most promising area for clinical utilization is the diagnosis and grading of liver cirrhosis and its complications. Relevant parameters acquired by 4D flow MRI include the detection of reduced or reversed flow in the portal venous system, characterization of portosystemic collaterals, and impaired response to a meal challenge. In patients with cirrhosis, 4D flow MRI has the potential to address the major unmet need of noninvasive detection of gastroesophageal varices at high risk for bleeding. This could replace many unnecessary, purely diagnostic, and invasive esophagogastroduodenoscopy procedures, thereby improving patient compliance with follow-up. Moreover, 4D flow MRI offers unique insights and added value for surgical planning and follow-up of multiple hepatic interventions, including transjugular intrahepatic portosystemic shunts, liver transplantation, and hepatic disease in children. Lastly, we will discuss the path to clinical implementation and remaining challenges.

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Dual-VENC 4D Flow MRI Can Detect Abnormal Blood Flow in the Left Atrium That Potentially Causes Thrombosis Formation after Left Upper Lobectomy

Cited by 22 publications

References 39 publications

4D Flow MR Imaging of the Left Atrium: What is Non-physiological Blood Flow in the Cardiac System?

4D Flow MR Imaging of the Left Atrium: What is Non-physiological Blood Flow in the Cardiac System?

Utility of 4D Flow MRI in Thoracic Aortic Diseases: A Literature Review of Clinical Applications and Current Evidence

Clinical Applications of 4D Flow MRI in the Portal Venous System

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