Intracardiac 4D Flow MRI in Congenital Heart Disease: Recommendations on Behalf of the ISMRM Flow &amp; Motion Study Group

Zhong, Liang; Schrauben, Eric; García, Julio; Uribe, Sergio; Grieve, Stuart M.; Elbaz, Mohammed; Barker, Alex J.; Geiger, Julia; Nordmeyer, Sarah; Marsden, Alison L.; Carlsson, Marcus; Tan, Ru San; Garg, Pankaj; Westenberg, Jos J.M.; Markl, Michael; Ebbers, Tino

doi:10.1002/jmri.26858

Cited by 33 publications

(17 citation statements)

References 14 publications

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“…In addition, Gadolinium contrast agent, used in approximately 1 in 3 MRI scans to increase the image clarity, is toxic and may lead to the development of Nephrogenic Systemic Fibrosis in patients with severe renal failure ( Kuo et al, 2007 ; Paterson et al, 2013 ). However, 4D flow MRI is an emerging technology to allow comprehensive assessment of cardiac function, vascular and valvular function ( Zhong et al, 2019 ). Most importantly, although use MRI is limited in patients with implanted medical devices as they remain a major risk during the examination ( Orwat et al, 2014 ), some devices [e.g., MRI-conditional pacemakers; Saunderson et al (2020) and ( Saunderson et al, 2020 )] may be used in MRI environment if certain conditions are fulfilled.…”

Section: Discussionmentioning

confidence: 99%

Effects of Choice of Medical Imaging Modalities on a Non-invasive Diagnostic and Monitoring Computational Framework for Patients With Complex Valvular, Vascular, and Ventricular Diseases Who Undergo Transcatheter Aortic Valve Replacement

Baiocchi

Barsoum

Khodaei

et al. 2021

Front. Bioeng. Biotechnol.

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Due to the high individual differences in the anatomy and pathophysiology of patients, planning individualized treatment requires patient-specific diagnosis. Indeed, hemodynamic quantification can be immensely valuable for accurate diagnosis, however, we still lack precise diagnostic methods for numerous cardiovascular diseases including complex (and mixed) valvular, vascular, and ventricular interactions (C3VI) which is a complicated situation made even more challenging in the face of other cardiovascular pathologies. Transcatheter aortic valve replacement (TAVR) is a new less invasive intervention and is a growing alternative for patients with aortic stenosis. In a recent paper, we developed a non-invasive and Doppler-based diagnostic and monitoring computational mechanics framework for C3VI, called C3VI-DE that uses input parameters measured reliably using Doppler echocardiography. In the present work, we have developed another computational-mechanics framework for C3VI (called C3VI-CT). C3VI-CT uses the same lumped-parameter model core as C3VI-DE but its input parameters are measured using computed tomography and a sphygmomanometer. Both frameworks can quantify: (1) global hemodynamics (metrics of cardiac function); (2) local hemodynamics (metrics of circulatory function). We compared accuracy of the results obtained using C3VI-DE and C3VI-CT against catheterization data (gold standard) using a C3VI dataset (N = 49) for patients with C3VI who undergo TAVR in both pre and post-TAVR with a high variability. Because of the dataset variability and the broad range of diseases that it covers, it enables determining which framework can yield the most accurate results. In contrast with C3VI-CT, C3VI-DE tracks both the cardiac and vascular status and is in great agreement with cardiac catheter data.

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Section: Discussionmentioning

confidence: 99%

Effects of Choice of Medical Imaging Modalities on a Non-invasive Diagnostic and Monitoring Computational Framework for Patients With Complex Valvular, Vascular, and Ventricular Diseases Who Undergo Transcatheter Aortic Valve Replacement

Baiocchi

Barsoum

Khodaei

et al. 2021

Front. Bioeng. Biotechnol.

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“…Generally agreed-upon recommendations for acquisition of 4-D flow MRI have been published in a consensus statement written by international experts [ 40 ]. More specific recommendations for intracardiac application in CHD are reported by the International Society for Magnetic Resonance in Medicine flow and motion study group in a more recent publication [ 41 ]. In addition to these guidelines, one should keep in mind that the physiological specifics of small children require appropriate adaptions.…”

Section: Four-dimensional Flow Magnetic Resonance Imaging — Acquisitionmentioning

confidence: 99%

Additional value and new insights by four-dimensional flow magnetic resonance imaging in congenital heart disease: application in neonates and young children

et al. 2020

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Cardiovascular MRI has become an essential imaging modality in children with congenital heart disease (CHD) in the last 15–20 years. With use of appropriate sequences, it provides important information on cardiovascular anatomy, blood flow and function for initial diagnosis and post-surgical or -interventional monitoring in children. Although considered as more sophisticated and challenging than CT, in particular in neonates and infants, MRI is able to provide information on intra- and extracardiac haemodynamics, in contrast to CT. In recent years, four-dimensional (4-D) flow MRI has emerged as an additional MR technique for retrospective assessment and visualisation of blood flow within the heart and any vessel of interest within the acquired three-dimensional (3-D) volume. Its application in young children requires special adaptations for the smaller vessel size and faster heart rate compared to adolescents or adults. In this article, we provide an overview of 4-D flow MRI in various types of complex CHD in neonates and infants to demonstrate its potential indications and beneficial application for optimised individual cardiovascular assessment. We focus on its application in clinical routine cardiovascular workup and, in addition, show some examples with pathologies other than CHD to highlight that 4-D flow MRI yields new insights in disease understanding and therapy planning. We shortly review the essentials of 4-D flow data acquisition, pre- and post-processing techniques in neonates, infants and young children. Finally, we conclude with some details on accuracy, limitations and pitfalls of the technique.

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“…Recent developments enable full 4D mapping (3 spatial dimensions plus time) of intravascular flow. 4D Flow provides a promising clinical utility to assess the hemodynamics of the blood inside the heart chambers and the great vessels for patients with cardiovascular disease [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

4DFlowNet: Super-Resolution 4D Flow MRI Using Deep Learning and Computational Fluid Dynamics

et al. 2020

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4D flow magnetic resonance imaging (MRI) is an emerging imaging technique where spatiotemporal 3D blood velocity can be captured with full volumetric coverage in a single non-invasive examination. This enables qualitative and quantitative analysis of hemodynamic flow parameters of the heart and great vessels. An increase in the image resolution would provide more accuracy and allow better assessment of the blood flow, especially for patients with abnormal flows. However, this must be balanced with increasing imaging time. The recent success of deep learning in generating super resolution images shows promise for implementation in medical images. We utilized computational fluid dynamics simulations to generate fluid flow simulations and represent them as synthetic 4D flow MRI data. We built our training dataset to mimic actual 4D flow MRI data with its corresponding noise distribution. Our novel 4DFlowNet network was trained on this synthetic 4D flow data and was capable in producing noise-free super resolution 4D flow phase images with upsample factor of 2. We also tested the 4DFlowNet in actual 4D flow MR images of a phantom and normal volunteer data, and demonstrated comparable results with the actual flow rate measurements giving an absolute relative error of 0.6-5.8% and 1.1-3.8% in the phantom data and normal volunteer data, respectively.

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Intracardiac 4D Flow MRI in Congenital Heart Disease: Recommendations on Behalf of the ISMRM Flow & Motion Study Group

Abstract: Level of Evidence: 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2019;50:677–681.

Cited by 33 publications

References 14 publications

Effects of Choice of Medical Imaging Modalities on a Non-invasive Diagnostic and Monitoring Computational Framework for Patients With Complex Valvular, Vascular, and Ventricular Diseases Who Undergo Transcatheter Aortic Valve Replacement

Effects of Choice of Medical Imaging Modalities on a Non-invasive Diagnostic and Monitoring Computational Framework for Patients With Complex Valvular, Vascular, and Ventricular Diseases Who Undergo Transcatheter Aortic Valve Replacement

Additional value and new insights by four-dimensional flow magnetic resonance imaging in congenital heart disease: application in neonates and young children

4DFlowNet: Super-Resolution 4D Flow MRI Using Deep Learning and Computational Fluid Dynamics

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