Fast Contrast-Enhanced 4D MRA and 4D Flow MRI Using Constrained Reconstruction (HYPRFlow): Potential Applications for Brain Arteriovenous Malformations

Chang, Warren; Wu, Yijing; Johnson, Kevin M.; Loecher, Michael; Wieben, Oliver; Edjlali, Myriam; Oppenheim, Catherine; Roca, Pauline; Hald, John; Aagaard-Kienitz, B.; Niemann, David; Mistretta, Charles A.; Turski, Patrick A.

doi:10.3174/ajnr.a4245

Cited by 32 publications

(29 citation statements)

References 36 publications

(37 reference statements)

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“…increased WSS in AVM feeding arteries was more prevalent with severe patient symptoms. Another study (55) demonstrated the utility of 4D flow MRI combined with contrast-enhanced 4D MRA (HYPRFlow) to obtain high-resolution angiography and quantitative flow assessment of the entire AVM vasculature. Additional studies explored the comprehensive evaluation of cerebral 3D blood flow patterns, regional flow characteristics and post-embolization induced hemodynamic changes in patients with cerebral AVMs (27, 56, 57), providing an individualized assessment of AVM hemodynamics and longitudinal evaluation of treatment-induced flow redistribution.…”

Section: Evaluation Of Cerebral Vascular Malformationsmentioning

confidence: 99%

Four-dimensional MRI flow examinations in cerebral and extracerebral vessels – ready for clinical routine?

Schnell

Ansari

2016

Current Opinion in Neurology

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Purpose of review To evaluate the feasibility of 4D flow MRI for the clinical assessment of cerebral and extracerebral vascular hemodynamics in patients with neurovascular disease. Recent findings 4D flow MRI has been applied in multiple studies to qualitatively and quantitatively study intracranial aneurysm blood flow for potential risk stratification and to assess treatment efficacy of various neurovascular lesions, including intra-aneurysmal and parent artery blood flow after flow diverter stent placement and staged embolizations of arteriovenous malformations and vein of Galen aneurysmal malformations. Recently, the technique has been utilized to characterize age-related changes of normal cerebral hemodynamics in healthy subjects over a broad age range. Summary 4D flow MRI is a useful tool for the non-invasive, volumetric and quantitative hemodynamic assessment of neurovascular disease without the need for gadolinium contrast agents. Further improvements are warranted to overcome technical limitations before broader clinical implementation. Current developments, such as advanced acceleration techniques (parallel imaging and compressed sensing) for faster data acquisition, dual or multiple velocity encoding strategies for more accurate arterial and venous flow quantification, ultra-high field strengths to achieve higher spatial resolution, and streamlined post-processing workflow for more efficient and standardized flow analysis, are promising advancements in 4D flow MRI.

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Section: Evaluation Of Cerebral Vascular Malformationsmentioning

confidence: 99%

Four-dimensional MRI flow examinations in cerebral and extracerebral vessels – ready for clinical routine?

Schnell

Ansari

2016

Current Opinion in Neurology

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“…This technique has been used with success to characterize AVMs, which similarly to DAVFs requires high spatial and temporal resolution due to their rapid arteriovenous shunting and small feeding vessels. (18, 19) HYPRFlow is well suited for characterizing AVMs and DAVFs because whole brain coverage allows the whole lesion to be characterized which is possible because the relative sparsity of vessels in 3D space allows for the use of undersampling techniques such as radial acquisition (VIPR). Previous work has demonstrated that use of the HYPR reconstruction method provides improved SNR compared to radially sampling k -space with a sliding window reconstruction method (33)…”

Section: Discussionmentioning

confidence: 99%

Accelerated Time-Resolved Contrast-Enhanced Magnetic Resonance Angiography of Dural Arteriovenous Fistulas Using Highly Constrained Reconstruction of Sparse Cerebrovascular Data Sets

Clark

Johnson

Wu³

et al. 2016

Investigative Radiology

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Objective Time resolved contrast enhanced magnetic resonance angiography (TR CEMRA) is commonly used to non-invasively characterize vascular malformations. However, the spatial and temporal resolution of current methods often compromises the clinical value of the exams. Constrained reconstruction is a temporal spatial correlation strategy that exploits the relative sparsity of vessels in space to dramatically reduce the amount of data required to generate fast high resolution TR CEMRA studies. In this report we use a novel temporal spatial acceleration method termed HYPRFLow to diagnose and classify dural arteriovenous fistulas (DAVFs). Our hypothesis is that HYPRFLow images are of adequate diagnostic image quality to delineate the arterial and venous components of DAVFs and allow correct classification using the Cognard system. Subjects and Methods 8 patients with known DAVFs underwent HYPRFlow imaging with isotropic resolution of 0.68 mm and temporal resolution of 0.75 s and 3D Time of Flight MRA (3DTOF). 3DTOF images and HYPRFLow images were evaluated by 2 readers and scored for arterial anatomic image quality. DSA was available for comparison in seven subjects and for these patients each DAVF was classified according to the Cognard system using HYPRFlow and DSA exams. DSA was considered the reference exam or gold standard. Results HYPRFlow imaging classification was concordant with DSA in all but one case. There was no difference in the arterial image quality scores between HYPRFlow and 3DTOF MRA (95% CI). Arterial to venous separation was rated excellent (n=3), good (n=4) or poor (n=1)and arteriovenous shunting was easily appreciated. Undersampling artifacts were reduced by using a low pass filter and did not interfere with the diagnostic quality of the exams. Conclusion HYPRFlow is a novel acquisition and reconstruction technique that exploits the relative sparsity of intracranial vessels in space to increase temporal and spatial resolution and provides accurate delineation of DAVF vasculature.

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“…To date, there are only a few studies investigating the diagnostic value of 4D flow MRI for the assessment of AVM flow characteristics. Recent reports include the quantification of flow and WSS in patients using a highly optimised radial 4D flow technique 203,204 . Additional studies demonstrated the potential of 4D flow MRI for the evaluation of global and regional AVM flow characteristics as illustrated in Fig.…”

Section: Applicationsmentioning

confidence: 99%

Advanced flow MRI: emerging techniques and applications

et al. 2016

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Magnetic resonance imaging (MRI) techniques provide non-invasive and non-ionising methods for the highly accurate anatomical depiction of the heart and vessels throughout the cardiac cycle. In addition, the intrinsic sensitivity of MRI to motion offers the unique ability to acquire spatially registered blood flow simultaneously with the morphological data, within a single measurement. In clinical routine, flow MRI is typically accomplished using methods that resolve two spatial dimensions in individual planes and encode the time-resolved velocity in one principal direction, typically oriented perpendicular to the two-dimensional (2D) section. This review describes recently developed advanced MRI flow techniques, which allow for more comprehensive evaluation of blood flow characteristics, such as real-time flow imaging, 2D multiple-venc phase contrast MRI, four-dimensional (4D) flow MRI, quantification of complex haemodynamic properties, and highly accelerated flow imaging. Emerging techniques and novel applications are explored. In addition, applications of these new techniques for the improved evaluation of cardiovascular (aorta, pulmonary arteries, congenital heart disease, atrial fibrillation, coronary arteries) as well as cerebrovascular disease (intra-cranial arteries and veins) are presented.

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Fast Contrast-Enhanced 4D MRA and 4D Flow MRI Using Constrained Reconstruction (HYPRFlow): Potential Applications for Brain Arteriovenous Malformations

Cited by 32 publications

References 36 publications

Four-dimensional MRI flow examinations in cerebral and extracerebral vessels – ready for clinical routine?

Four-dimensional MRI flow examinations in cerebral and extracerebral vessels – ready for clinical routine?

Accelerated Time-Resolved Contrast-Enhanced Magnetic Resonance Angiography of Dural Arteriovenous Fistulas Using Highly Constrained Reconstruction of Sparse Cerebrovascular Data Sets

Advanced flow MRI: emerging techniques and applications

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