Automated Quantitative Extraction and Analysis of 4D flow Patterns in the Ascending Aorta: An intraindividual comparison at 1.5 T and 3 T

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Abstract

4D flow MRI enables quantitative assessment of helical flow. Current methods are susceptible to noise. To evaluate helical flow patterns in healthy volunteers and patients with bicuspid aortic valves (BAV) at 1.5 T and 3 T using pressure-based helix-extraction in 4D flow MRI. Two intraindividual 4D flow MRI examinations were performed at 1.5 T and 3 T in ten healthy volunteers (5 females, 32 ± 3 years) and 2 patients with BAV using different acceleration techniques (kt-GRAPPA and centra). Several new quantitative parameters for the evaluation of volumes [ml], lengths [mm] as well as temporal parameters [ms] of helical flow were introduced and analyzed using the software tool Bloodline. We found good correlations between measurements in volunteers at 1.5 T and 3 T regarding helical flow volumes (R = 0.98) and temporal existence (R = 0.99) of helices in the ascending aorta. Furthermore, we found significantly larger (11.7 vs. 77.6 ml) and longer lasting (317 vs. 769 ms) helices in patients with BAV than in volunteers. The assessed parameters do not depend on the magnetic field strength used for the acquisition. The technique of pressure-based extraction of 4D flow MRI pattern is suitable for differentiation of normal and pathological flow.

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Myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement

James Moon, Daniel R Messroghli, Peter Kellman … (2013)

Rapid innovations in cardiovascular magnetic resonance (CMR) now permit the routine acquisition of quantitative measures of myocardial and blood T1 which are key tissue characteristics. These capabilities introduce a new frontier in cardiology, enabling the practitioner/investigator to quantify biologically important myocardial properties that otherwise can be difficult to ascertain clinically. CMR may be able to track biologically important changes in the myocardium by: a) native T1 that reflects myocardial disease involving the myocyte and interstitium without use of gadolinium based contrast agents (GBCA), or b) the extracellular volume fraction (ECV)–a direct GBCA-based measurement of the size of the extracellular space, reflecting interstitial disease. The latter technique attempts to dichotomize the myocardium into its cellular and interstitial components with estimates expressed as volume fractions. This document provides recommendations for clinical and research T1 and ECV measurement, based on published evidence when available and expert consensus when not. We address site preparation, scan type, scan planning and acquisition, quality control, visualisation and analysis, technical development. We also address controversies in the field. While ECV and native T1 mapping appear destined to affect clinical decision making, they lack multi-centre application and face significant challenges, which demand a community-wide approach among stakeholders. At present, ECV and native T1 mapping appear sufficiently robust for many diseases; yet more research is required before a large-scale application for clinical decision-making can be recommended.

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Normal human left and right ventricular dimensions for MRI as assessed by turbo gradient echo and steady-state free precession imaging sequences.

Holger Thiele, Khaled Alfakih, Jessica Ridgway … (2003)

To establish normal ranges of left ventricular (LV) and right ventricular (RV) dimensions as determined by the current pulse sequences in cardiac magnetic resonance imaging (MRI). Sixty normal subjects (30 male and 30 female; age range, 20-65) were examined; both turbo gradient echo (TGE) and steady-state free precession (SSFP) pulse sequences were used to obtain contiguous short-axis cine data sets from the ventricular apex to the base of the heart. The LV and RV volumes and LV mass were calculated by modified Simpson's rule. Normal ranges were established and indexed to both body surface area (BSA) and height. There were statistically significant differences in the measurements between the genders and between TGE and SSFP pulse sequences. For TGE the LV end-diastolic volume (EDV)/BSA (mL/m(2)) in males was 74.4 +/- 14.6 and in females was 70.9 +/- 11.7, while in SSFP in males it was 82.3 +/- 14.7 and in females it was 77.7 +/- 10.8. For the TGE the LV mass/BSA (g/m(2)) in males was 77.8 +/- 9.1 and in females it was 61.5 +/- 7.5, while in SSFP in males it was 64.7 +/- 9.3 and in females it was 52.0 +/- 7.4. For TGE the RV EDV/BSA (mL/m(2)) in males was 78.4 +/- 14.0 and in females it was 67.5 +/- 12.7, while in SSFP in males it was 86.2 +/- 14.1 and in females it was 75.2 +/- 13.8. We have provided normal ranges that are gender specific as well as data that can be used for age-specific normal ranges for both SSFP and TGE pulse sequences. Copyright 2003 Wiley-Liss, Inc.

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Aortic dilation in bicuspid aortic valve disease: flow pattern is a major contributor and differs with valve fusion type.

Malenka M Bissell, Aaron T Hess, Luca Biasiolli … (2013)

Ascending aortic dilation is important in bicuspid aortic valve (BAV) disease, with increased risk of aortic dissection. We used cardiovascular MR to understand the pathophysiology better by examining the links between 3-dimensional flow abnormalities, aortic function, and aortic dilation. A total of 142 subjects underwent cardiovascular MR (mean age, 40 years; 95 with BAV, 47 healthy volunteers). Patients with BAV had predominantly abnormal right-handed helical flow in the ascending aorta, larger ascending aortas (18.3±3.3 versus 15.2±2.2 mm/m²; P<0.001), and higher rotational (helical) flow (31.7±15.8 versus 2.9±3.9 mm²/s; P<0.001), systolic flow angle (23.1°±12.5° versus 7.0°±4.6°; P<0.001), and systolic wall shear stress (0.85±0.28 versus 0.59±0.17 N/m²; P<0.001) compared with healthy volunteers. BAV with right-handed flow and right-non coronary cusp fusion (n=31) showed more severe flow abnormalities (rotational flow, 38.5±16.5 versus 27.8±12.4 mm²/s; P<0.001; systolic flow angle, 29.4°±10.9° versus 19.4°±11.4°; P<0.001; in-plane wall shear stress, 0.64±0.23 versus 0.47±0.22 N/m²; P<0.001) and larger aortas (19.5±3.4 versus 17.5±3.1 mm/m²; P<0.05) than right-left cusp fusion (n=55). Patients with BAV with normal flow patterns had similar aortic dimensions and wall shear stress to healthy volunteers and younger patients with BAV showed abnormal flow patterns but no aortic dilation, both further supporting the importance of flow pattern in the pathogenesis of aortic dilation. Aortic function measures (distensibility, aortic strain, and pulse wave velocity) were similar across all groups. Flow abnormalities may be a major contributor to aortic dilation in BAV. Fusion type affects the severity of flow abnormalities and may allow better risk prediction and selection of patients for earlier surgical intervention.

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Author and article information

Contributors

Sebastian Ebel:

ORCID: http://orcid.org/0000-0001-6856-6455

sebastian.ebel@icloud.com

Journal

Journal ID (nlm-ta): Sci Rep

Journal ID (iso-abbrev): Sci Rep

Title: Scientific Reports

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2045-2322

Publication date (Electronic): 19 February 2020

Publication date PMC-release: 19 February 2020

Publication date Collection: 2020

Volume: 10

Electronic Location Identifier: 2949

Affiliations

[1 ]ISNI 0000 0001 2230 9752, GRID grid.9647.c, Department of Diagnostic and Interventional Radiology, University of Leipzig – Heart Centre, ; Leipzig, Germany

[2 ]ISNI 0000 0001 2230 9752, GRID grid.9647.c, Department of Diagnostic and Interventional Radiology, University of Leipzig, ; Leipzig, Germany

[3 ]ISNI 0000 0001 1018 4307, GRID grid.5807.a, Department of Simulation and Graphics, University of Magdeburg, ; Magdeburg, Germany

[4 ]ISNI 0000 0001 0726 5157, GRID grid.5734.5, Department of Diagnostic, Interventional and paediatric Radiology, University of Bern, ; Bern, Switzerland

[5 ]Philips Clinical Science, Amsterdam, Netherlands

[6 ]ISNI 0000 0001 1018 4307, GRID grid.5807.a, Institute for Biometrics and Medical Informatics, University of Magdeburg, ; Magdeburg, Germany

Author information

Sebastian Ebel http://orcid.org/0000-0001-6856-6455

Article

Publisher ID: 59826

DOI: 10.1038/s41598-020-59826-2

PMC ID: 7031260

PubMed ID: 32076060

SO-VID: 2463f9d7-95e0-4689-b669-f5c0551bb30b

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Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 6 August 2019

Date accepted : 29 January 2020

Funding

Funded by: FundRef https://doi.org/10.13039/501100001659, Deutsche Forschungsgemeinschaft (German Research Foundation);

Award ID: GR 4617/2-1 – AOBJ 629069

Award ID: GU 777/4-1 – AOBJ 629068

Award Recipient : Matthias Grothoff Matthias Gutberlet

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ScienceOpen disciplines: Uncategorized

Keywords: aneurysm,aortic diseases,cardiovascular genetics

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ScienceOpen disciplines: Uncategorized

Keywords: aneurysm, aortic diseases, cardiovascular genetics

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Automated Quantitative Extraction and Analysis of 4D flow Patterns in the Ascending Aorta: An intraindividual comparison at 1.5 T and 3 T

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Most cited references 26

Myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement

Normal human left and right ventricular dimensions for MRI as assessed by turbo gradient echo and steady-state free precession imaging sequences.

Aortic dilation in bicuspid aortic valve disease: flow pattern is a major contributor and differs with valve fusion type.

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