Quantification of peak blood flow velocity at the cardiac valve and great thoracic vessels by four-dimensional flow and two-dimensional phase-contrast MRI compared with echocardiography: a systematic review and meta-analysis

Xu, Kan; Wang, X.D.; Yang, Zhonghua; Xu, Huayan; Xu, Rong; Xie, Linjun; Wen, Lingyi; Fu, Hang; Yan, Wei‐Feng; Guo, Ying

doi:10.1016/j.crad.2021.07.011

Cited by 8 publications

(7 citation statements)

References 45 publications

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Section: Discussionsupporting

confidence: 92%

“…We also demonstrated no significant difference between 2D PC and CS 4D flow MRI peak velocity measurements with a minimal bias; this agrees with the published literature, which also reports that 4D flow MRI is comparable to 2D PC and Doppler echocardiography. 26,31 A systematic review by Doyle et al 32 reported agreement of 4D flow MRI to the reference standard methods of flow assessment (2D PC MRI or echocardiography) in just 55% of manuscripts. However, the review did not comment on the use of contrast agent.…”

Section: Discussionmentioning

confidence: 99%

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Comprehensive Neonatal Cardiac, Feed and Wrap, Non‐contrast, Non‐sedated, Free‐breathing Compressed Sensing 4D Flow MRI Assessment

Panayiotou

Mills

Broadbent

et al. 2022

Magnetic Resonance Imaging

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Background Cardiac MRI is an important imaging tool in congenital cardiac disease, but its use has been limited in the neonatal population as general anesthesia has been needed for breath‐holding. Technological advances in four‐dimensional (4D) flow MRI have now made nonsedated free‐breathing acquisition protocols a viable clinical option, but the method requires prospective validation in neonates. Purpose To test the feasibility of compressed sensing (CS) 4D flow MRI in the neonatal population and to compare with standard previously validated two‐dimensional (2D) phase‐contrast (PC) flow MRI. Study type Prospective, cohort, image quality. Population A total of 14 healthy neonates (median [range] age: 2.5 [0–80] days; 8 male). Field Strength and Sequence Noncontrast 2D cine gradient echo sequence with through‐plane velocity encoding (PC) sequence and compressed sensing (CS) three‐dimensional (3D), time‐resolved, cine phase‐contrast MRI with 3D velocity‐encoding (4D flow MRI) at 3 T. Assessment Aortic 2D PC, and aortic, pulmonary trunk and superior vena cava CS 4D flow MRI were acquired using the feed and wrap technique (nonsedated) and quantified using commercially available software. Aortic flow and peak velocity were compared between methods. Internal consistency of 4D flow MRI was determined by comparing mean forward flow of the main pulmonary artery (MPA) vs. the sum of left and right pulmonary artery flows (LPA and RPA) and by comparing mean ascending aorta forward flow (AAo) vs. the sum of superior vena cava (SVC) and descending aorta flows (DAo). Statistical Tests Flow and peak‐velocity comparisons were assessed using paired t‐tests, with P < 0.05 considered significant, and Bland–Altman analysis. Interobserver and intraobserver agreement and internal consistency were analyzed by intraclass correlation co‐efficient (ICC). Results There was no statistically significant difference between ascending aortic forward flow between 2D PC and CS 4D Flow MRI (P = 0.26) with a bias of 0.11 mL (−0.59 to 0.82 mL) nor peak velocity (P = 0.11), with a bias of −5 cm/sec and (−26 to 16 cm/sec). There was excellent interobserver and intraobserver agreement for each vessel (interobserver ICC: AAo 1.00; DAo 0.94, SVC 0.90, MPA 0.99, RPA 0.98, LPA 0.96; intraobserver ICC: AAo 1.00; DAo 0.99, SVC 0.98, MPA 1.00, RPA 1.00, LPA 0.99). Internal consistency measures showed excellent agreement for both mean forward flow of main pulmonary artery vs. the sum of left and right pulmonary arteries (ICC: 0.95) and mean ascending aorta forward flow vs. the sum of superior vena cava and descending aorta flows (ICC: 1.00). Conclusion Sedation‐free neonatal feed and wrap MRI is well tolerated and feasible. CS 4D flow MRI quantification is similar to validated 2D PC free‐breathing imaging with excellent interobserver and intraobserver agreement. Evidence Level 1 Technical Efficacy Stage 2

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Comprehensive Neonatal Cardiac, Feed and Wrap, Non‐contrast, Non‐sedated, Free‐breathing Compressed Sensing 4D Flow MRI Assessment

Panayiotou

Mills

Broadbent

et al. 2022

Magnetic Resonance Imaging

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“…Accurate measurement of absolute peak E and peak A inflow velocities presents challenges for both echo and CMR methods, relating to the site of measurement, rapid acceleration, and alignment with flow. Peak inflow velocities occur at the site of the vena contracta distal to the leaflet tips; annular-focused methods have been shown, in this and prior studies, to underestimate velocities relative to vena contracta measurement sites [11] , [12] . The better performance of the LVvel method, where the peak velocities are measured with three directional velocities and without constraint to location, likely reflects the ability to measure peak E and A at their maximal sites.…”

Section: Discussionmentioning

confidence: 47%

“…The mitral inflow can be quantified according to volume, velocity, or even kinetic energy [10] . A recent meta-analysis demonstrated that 4D Flow was superior to 2D PC-CMR in measuring peak velocity values at multiple sites in comparison to echo [11] . An important feature of 4D Flow in the clinical setting is the ability to retrospectively position analysis planes at regions of interest to measure flow volumes through valves, vessels, and shunts.…”

Section: Introductionmentioning

confidence: 99%

Diastolic function assessment with four-dimensional flow cardiovascular magnetic resonance using automatic deep learning E/A ratio analysis

Viola,

Bustamante,

Bolger

et al. 2024

Journal of Cardiovascular Magnetic Resonance

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“…A number of cardiovascular 4D Flow CMR reviews were published in recent years. These focused on different aspects of 4D Flow CMR, such as kinetic energy assessment of LV blood flow [ 48 ], technical aspects of 4D Flow acquisition and application of 4D Flow CMR in various cardiac and vascular pathologies [ 49 , 50 ], congenital heart disease applications [ 51 ] as well as structural heart disease [ 52 ] and peak velocity assessment [ 53 ]. Other reviews evaluated 4D Flow CMR in mitral valve disease [ 23 , 54 ], left-sided VHD [ 22 ] and in various cardiovascular pathologies with a limited focus on VHD [ 32 , 38 , 55 , 56 ].…”

Section: Introductionmentioning

confidence: 99%

Rationale and clinical applications of 4D flow cardiovascular magnetic resonance in assessment of valvular heart disease: a comprehensive review

Gorecka

Bissell

Higgins

et al. 2022

Journal of Cardiovascular Magnetic Resonance

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Background Accurate evaluation of valvular pathology is crucial in the timing of surgical intervention. Whilst transthoracic echocardiography is widely available and routinely used in the assessment of valvular heart disease, it is bound by several limitations. Although cardiovascular magnetic resonance (CMR) imaging can overcome many of the challenges encountered by echocardiography, it also has a number of limitations. Main text 4D Flow CMR is a novel technique, which allows time-resolved, 3-dimensional imaging. It enables visualisation and direct quantification of flow and peak velocities of all valves simultaneously in one simple acquisition, without any geometric assumptions. It also has the unique ability to measure advanced haemodynamic parameters such as turbulent kinetic energy, viscous energy loss rate and wall shear stress, which may add further diagnostic and prognostic information. Although 4D Flow CMR acquisition can take 5–10 min, emerging acceleration techniques can significantly reduce scan times, making 4D Flow CMR applicable in contemporary clinical practice. Conclusion 4D Flow CMR is an emerging CMR technique, which has the potential to become the new reference-standard method for the evaluation of valvular lesions. In this review, we describe the clinical applications, advantages and disadvantages of 4D Flow CMR in the assessment of valvular heart disease.

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Quantification of peak blood flow velocity at the cardiac valve and great thoracic vessels by four-dimensional flow and two-dimensional phase-contrast MRI compared with echocardiography: a systematic review and meta-analysis

Cited by 8 publications

References 45 publications

Comprehensive Neonatal Cardiac, Feed and Wrap, Non‐contrast, Non‐sedated, Free‐breathing Compressed Sensing 4D Flow MRI Assessment

Comprehensive Neonatal Cardiac, Feed and Wrap, Non‐contrast, Non‐sedated, Free‐breathing Compressed Sensing 4D Flow MRI Assessment

Diastolic function assessment with four-dimensional flow cardiovascular magnetic resonance using automatic deep learning E/A ratio analysis

Rationale and clinical applications of 4D flow cardiovascular magnetic resonance in assessment of valvular heart disease: a comprehensive review

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