Flow‐sensitive four‐dimensional cine magnetic resonance imaging for offline blood flow quantification in multiple vessels: A validation study

Abstract

Purpose:To further validate the quantitative use of flowsensitive four-dimensional velocity encoded cine magnetic resonance imaging (4D VEC MRI) for simultaneously acquired venous and arterial blood flow in healthy volunteers and for abnormal flow in patients with congenital heart disease.Materials and Methods: Stroke volumes (SV) obtained in arterial and venous thoracic vessels were compared between standard two-dimensional (2D), 4D VEC MRI with and without respiratory navigator gating (gated/nongated) in volunteers (n ¼ 7). In addition, SV and regurgitation fractions (RF) measured in aorta or pulmonary trunk of patients with malformed and/or insufficient valves (n ¼ 10) were compared between 2D and nongated 4D VEC MRI methods. Results:In volunteers and patients, Bland-Altman tests showed excellent agreement between 2D, gated, and nongated 4D VEC MRI obtained quantitative blood flow measurements. The bias between 2D and gated 4D VEC MRI was <0.5 mL for SV; between 2D and nongated 4D VEC MRI the bias was <0.7 mL for SV and <1% for RF.Conclusion: Blood flow can be quantified accurately in arterial, venous, and pathological flow conditions using 4D VEC MRI. Nongated 4D VEC MRI has the potential to be suited for clinical use in patients with congenital heart disease who require flow acquisitions in multiple vessels.

Towards highly accelerated Cartesian time-resolved 3D flow cardiovascular magnetic resonance in the clinical setting

“…In volunteers, flow curves compared well between accelerated time-resolved 3D flow data and time-resolved 2D flow data with stroke volume deviations of 2.5 ± 8.4 ml in line with previous studies [2,30]. …”

“…This results in trade-offs between spatial and temporal resolutions and/or tolerating potential breathing motion artefact when acquiring the data in a clinical routine setting [2]. However, the ability of time-resolved 3D CMR to assess flow volumes, pulse wave velocities [3], pressure gradients [4], wall shear stress [5-7] and turbulent kinetic energy [8,9] requires high spatial and temporal resolution.…”

Whole-heart four-dimensional flow can be acquired with preserved quality without respiratory gating, facilitating clinical use: a head-to-head comparison

“…Nordmeyer et al [20] have previously investigated the effect of respiratory gating in 4D flow and found a large reduction in scan time for 4D flow without respiratory gating compared to with respiratory gating, and no significant differences for stroke volume (SV) quantifications in greater vessels. However, intracardiac 4D flow was not investigated.…”

4D FLOW: Una nueva herramienta de diagnóstico para cardiopatías congénitas

“…La automatización en la definición de regiones de interés de los grandes vasos y cavidades cardíacas podría reducir considerablemente este tiempo, haciendo que los tiempos de 4D flow y 2D de contraste de fase sean comparables. Con esto la secuencia 4D flow podría reemplazar las secuencias 2D, y por lo tanto se podría disminuir el tiempo total del examen (22) . La aplicación de 4D flow en distintas CC podría ayudar a entender la relación entre la hemodinamia y el comportamiento de las paredes vasculares.…”