51
|
Sui B, Gao P. High-resolution vessel wall magnetic resonance imaging of carotid and intracranial vessels. Acta Radiol 2019; 60:1329-1340. [PMID: 30727746 DOI: 10.1177/0284185119826538] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Binbin Sui
- Radiology Department, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China
- Radiology Department, Beijing Neurosurgical Institute, Beijing, PR China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, PR China
| | - Peiyi Gao
- Radiology Department, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China
- Radiology Department, Beijing Neurosurgical Institute, Beijing, PR China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, PR China
| |
Collapse
|
52
|
Fischer J, Abels T, Özen AC, Echternach M, Richter B, Bock M. Magnetic resonance imaging of the vocal fold oscillations with sub‐millisecond temporal resolution. Magn Reson Med 2019; 83:403-411. [DOI: 10.1002/mrm.27982] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Johannes Fischer
- Department of Radiology Medical Physics Medical Center University of Freiburg Faculty of Medicine University of Freiburg Freiburg Germany
| | - Timo Abels
- Department of Radiology Medical Physics Medical Center University of Freiburg Faculty of Medicine University of Freiburg Freiburg Germany
| | - Ali Caglar Özen
- Department of Radiology Medical Physics Medical Center University of Freiburg Faculty of Medicine University of Freiburg Freiburg Germany
- German Consortium for Translational Cancer Research Partner Site Freiburg German Cancer Research Center (DKFZ) Heidelberg Germany
| | - Matthias Echternach
- Division of Phoniatrics and Pediatric Audiology Department of Otorhinolaryngology, Head and Neck Surgery Ludwig‐Maximilians‐University Munich Germany
| | - Bernhard Richter
- Freiburg Institute for Musicians' Medicine Freiburg University Medical Center Faculty of Medicine University of Freiburg Freiburg Germany
| | - Michael Bock
- Department of Radiology Medical Physics Medical Center University of Freiburg Faculty of Medicine University of Freiburg Freiburg Germany
| |
Collapse
|
53
|
Borup DD, Elkins CJ, Eaton JK. Effects of motion on MRI signal decay from micron-scale particles. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2019; 305:152-161. [PMID: 31284169 DOI: 10.1016/j.jmr.2019.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 06/09/2023]
Abstract
Transverse decay rate (R2∗) mapping is an established method for measuring iron overload in various biological tissues. Recently, R2∗ mapping was used to measure the mean 3D concentration distribution of micron-size particles dispersed in turbulent flows. However, some discrepancy was observed between the measured R2∗ and the expected decay based on existing theory. The present paper examines three flow-related mechanisms that could be responsible for this discrepancy. Computational simulations were used to study the effects of relative particle-fluid motion and preferential concentration by turbulence, while the effect of enhanced proton dispersion due to turbulence was examined via the existing MRI relaxation theory. Each flow phenomenon was shown to produce a different effect on the signal-time curve, as well as the extracted R2∗. Comparison to experimental data in a square channel flow showed that relative motion between the particles and fluid was the most likely cause of the discrepancy in the previous experiments; however, all three effects may be present in both medical and non-medical flows, and their differing effects on the MRI signal may eventually allow for their identification from MRI data.
Collapse
Affiliation(s)
- Daniel D Borup
- Department of Mechanical Engineering, 488 Escondido Mall, Building 500, Stanford, CA 94305, USA.
| | - Christopher J Elkins
- Department of Mechanical Engineering, 488 Escondido Mall, Building 500, Stanford, CA 94305, USA
| | - John K Eaton
- Department of Mechanical Engineering, 488 Escondido Mall, Building 500, Stanford, CA 94305, USA
| |
Collapse
|
54
|
Wang Y, Joannic D, Juillion P, Monnet A, Delassus P, Lalande A, Fontaine JF. Validation of the Strain Assessment of a Phantom of Abdominal Aortic Aneurysm: Comparison of Results Obtained From Magnetic Resonance Imaging and Stereovision Measurements. J Biomech Eng 2019; 140:2666616. [PMID: 29238828 DOI: 10.1115/1.4038743] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Indexed: 11/08/2022]
Abstract
Predicting aortic aneurysm ruptures is a complex problem that has been investigated by many research teams over several decades. Work on this issue is notably complex and involves both the mechanical behavior of the artery and the blood flow. Magnetic resonance imaging (MRI) can provide measurements concerning the shape of an organ and the blood that flows through it. Measuring local distortion of the artery wall is the first essential factor to evaluate in a ruptured artery. This paper aims to demonstrate the feasibility of this measure using MRI on a phantom of an abdominal aortic aneurysm (AAA) with realistic shape. The aortic geometry is obtained from a series of cine-MR images and reconstructed using Mimics software. From 4D flow and MRI measurements, the field of velocity is determined and introduced into a computational fluid dynamic (CFD) model to determine the mechanical boundaries applied on the wall artery (pressure and ultimately wall shear stress (WSS)). These factors are then converted into a solid model that enables wall deformations to be calculated. This approach was applied to a silicone phantom model of an AAA reconstructed from a patient's computed tomography-scan examination. The calculated deformations were then compared to those obtained in identical conditions by stereovision. The results of both methods were found to be close. Deformations of the studied AAA phantom with complex shape were obtained within a gap of 12% by modeling from MR data.
Collapse
Affiliation(s)
- Yufei Wang
- Laboratoire D'électronique, Informatique et Image, FRE CNRS 2005 UBFC CNRS Art et Métiers Paristech, Université de Bourgogne-France-Comté, Site d'Auxerre, Route des Plaines de l'Yonne, Auxerre 89 000, France e-mail:
| | - David Joannic
- IUT Dijon-Auxerre, Laboratoire D'électronique, Informatique et Image, FRE CNRS 2005 UBFC CNRS Art et Métiers Paristech, Université de Bourgogne-France-Comté, , Auxerre 89 000, France e-mail:
| | - Patrick Juillion
- Laboratoire D'électronique, Informatique et Image, FRE CNRS 2005 UBFC CNRS Art et Métiers Paristech, Université de Bourgogne-France-Comté, Site d'Auxerre, Route des Plaines de l'Yonne, Auxerre 89 000, France e-mail:
| | - Aurélien Monnet
- Siemens Healthcare France, , Saint-Denis 93527, France e-mail:
| | - Patrick Delassus
- GMedTech, Galway-Mayo Institute of Technology, Galway H91 T8NW, Ireland e-mail:
| | - Alain Lalande
- Laboratoire D'électronique, Informatique et Image, FRE CNRS 2005, UBFC CNRS Art et Métiers Paristech, Faculté de Médecine, Université de Bourgogne-Franche-Comté, , Dijon 21 079, Cedex, France e-mail:
| | - Jean-François Fontaine
- IUT Dijon-Auxerre, Laboratoire D'électronique, Informatique et Image, FRE CNRS 2005 UBFC CNRS Art et Métiers Paristech, Université de Bourgogne-France-Comté, , Auxerre 89 000, France e-mail:
| |
Collapse
|
55
|
Evaluation of 4D flow MRI-based non-invasive pressure assessment in aortic coarctations. J Biomech 2019; 94:13-21. [PMID: 31326119 DOI: 10.1016/j.jbiomech.2019.07.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 06/12/2019] [Accepted: 07/04/2019] [Indexed: 12/20/2022]
Abstract
Severity of aortic coarctation (CoA) is currently assessed by estimating trans-coarctation pressure drops through cardiac catheterization or echocardiography. In principle, more detailed information could be obtained non-invasively based on space- and time-resolved magnetic resonance imaging (4D flow) data. Yet the limitations of this imaging technique require testing the accuracy of 4D flow-derived hemodynamic quantities against other methodologies. With the objective of assessing the feasibility and accuracy of this non-invasive method to support the clinical diagnosis of CoA, we developed an algorithm (4DF-FEPPE) to obtain relative pressure distributions from 4D flow data by solving the Poisson pressure equation. 4DF-FEPPE was tested against results from a patient-specific fluid-structure interaction (FSI) simulation, whose patient-specific boundary conditions were prescribed based on 4D flow data. Since numerical simulations provide noise-free pressure fields on fine spatial and temporal scales, our analysis allowed to assess the uncertainties related to 4D flow noise and limited resolution. 4DF-FEPPE and FSI results were compared on a series of cross-sections along the aorta. Bland-Altman analysis revealed very good agreement between the two methodologies in terms of instantaneous data at peak systole, end-diastole and time-averaged values: biases (means of differences) were +0.4 mmHg, -1.1 mmHg and +0.6 mmHg, respectively. Limits of agreement (2 SD) were ±0.978 mmHg, ±1.06 mmHg and ±1.97 mmHg, respectively. Peak-to-peak and maximum trans-coarctation pressure drops obtained with 4DF-FEPPE differed from FSI results by 0.75 mmHg and -1.34 mmHg respectively. The present study considers important validation aspects of non-invasive pressure difference estimation based on 4D flow MRI, showing the potential of this technology to be more broadly applied to the clinical practice.
Collapse
|
56
|
Galea N, Piatti F, Sturla F, Weinsaft JW, Lau C, Chirichilli I, Carbone I, Votta E, Catalano C, De Paulis R, Girardi LN, Redaelli A, Gaudino M. Novel insights by 4D Flow imaging on aortic flow physiology after valve-sparing root replacement with or without neosinuses. Interact Cardiovasc Thorac Surg 2019; 26:957-964. [PMID: 29401262 DOI: 10.1093/icvts/ivx431] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 12/09/2017] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES This study was undertaken to evaluate the flow dynamics in the aortic root after valve-sparing root replacement with and without neosinuses of Valsalva reconstruction, by exploiting the capability of 4D Flow imaging to measure in vivo blood velocity fields and 3D geometric flow patterns. METHODS Ten patients who underwent valve-sparing root replacement utilizing grafts with neosinuses or straight tube grafts (5 cases each) were evaluated by 4D Flow imaging at a mean of 46.5 months after surgery. We used in-house processing tools to quantify relevant bulk flow variables (flow rate, stroke volume, peak velocity and mean velocity), wall shear stresses and the amount of flow rotation characterizing the region enclosed by the graft and the aortic valve leaflets. RESULTS Despite bulk flows with similar peak velocities, flow rates and stroke volumes (P = 0.31-1.00), the neosinuses graft was associated with a lower mean velocity (P < 0.03) and magnitude of wall shear stress along the axial direction of the vessel wall (P < 0.05) at the proximal root level but remained comparable along the circumferential direction (P = 0.22-1.0) to the straight tube graft. Flow rotation was evidently and systematically higher in the neosinuses grafts, characterized by streamline rotations higher than 270°, nearly triple that of tubular grafts (10.3 ÷ 14.0% of all aortic streamline vs 2.2 ÷ 5.7%, P = 0.008). CONCLUSIONS Recreation of the sinuses of Valsalva during valve-sparing root replacement is associated with significantly lower wall shear stress and organized vortical flows at the level of the sinus that are not evident using the straight tube graft. These findings need confirmation in larger studies and could have important implications in terms of aortic valve durability.
Collapse
Affiliation(s)
- Nicola Galea
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Filippo Piatti
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Francesco Sturla
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.,3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Jonathan W Weinsaft
- Departments of Medicine (Cardiology), Weill Cornell Medicine, New York, NY, USA
| | - Christopher Lau
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Ilaria Chirichilli
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Iacopo Carbone
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Emiliano Votta
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Leonard N Girardi
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Alberto Redaelli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | | |
Collapse
|
57
|
Abstract
In children with congenital heart defects, Doppler ultrasound is the standard, bedside imaging modality. However, precise characterization of blood flow is challenging due to angle-dependent and one-dimensional velocity estimation. Contrast agent free Vector Flow Imaging is a new ultrasound technology that enables angle-independent visualization of the detailed flow field. Two piglets, one with normal cardiac anatomy and one with congenital heart disease comprised of valvular pulmonary stenosis, a dilated main pulmonary artery, and an incomplete atrioventricular canal defect, were imaged transthoracically and epicardially using a BK Ultrasound bk5000 with built-in vector flow imaging and a 5MHz linear probe. Subsequently, two children, one with normal cardiac anatomy and one with congenital heart disease comprised of aortic valve stenosis and coarctation of the aorta were imaged transthoracically. Transthoracic two-dimensional echocardiography and vector flow imaging were readily performed in both animals and were limited only by the geometry of the porcine thorax. In addition, transthoracic vector flow imaging was successfully performed in both children, and abnormal flow secondary to cardiac anomalies was visible. Adequate penetration was obtained to a depth of 6.5 cm. Our group has previously demonstrated for the first time that transthoracic vector flow imaging echocardiography is feasible and practicable in pediatric-sized patients, and this paper describes examples of these concepts and in-depth comparisons with traditional imaging modalities. This paper demonstrates that commercially available vector flow imaging technology can be utilized in pediatric cardiac applications as a bedside transthoracic imaging modality, providing advanced detail of blood flow patterns within the cardiac chambers, across valves, and in the great arteries.
Collapse
|
58
|
Kauhanen SP, Hedman M, Kariniemi E, Jaakkola P, Vanninen R, Saari P, Liimatainen T. Aortic dilatation associates with flow displacement and increased circumferential wall shear stress in patients without aortic stenosis: A prospective clinical study. J Magn Reson Imaging 2019; 50:136-145. [PMID: 30659686 DOI: 10.1002/jmri.26655] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/03/2019] [Accepted: 01/03/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The relationship between blood flow characteristics and ascending aortic (AA) dilatation has not been studied in patients with a tricuspid aortic valve (TAV) without aortic stenosis. PURPOSE To evaluate whether 4D flow characteristics determined in MRI are related to AA dilatation by comparing dilated AA and nondilated AA subjects with TAV. STUDY TYPE Prospective. POPULATION Twenty patients with dilated AA and 20 age-matched patients with nondilated AA. FIELD STRENGTH/SEQUENCE 1.5T/4D flow, 2D flow, and anatomic images. ASSESSMENT Altogether, 16 different 4D flow parameters were assessed in 10 planes in the thoracic aorta. Intra- and interobserver reproducibility were analyzed. STATISTICAL TESTS Independent t-test for normally distributed and the Mann-Whitney test for skewed distributed parameters were used. A paired-samples t-test was used to compare 2D and 4D flow parameters. Intraclass correlation coefficient (ICC) was used in intra- and interobserver reproducibility analysis. RESULTS Aortic flow was displaced from the centerline of the aorta in the proximal and tubular planes. Flow displacement (FD) was greatest in the proximal plane of AA and was higher in dilated AA (4.5%, range 3.0-5.8%) than in nondilated AA (2.0%, 1.0-3.0%, P < 0.001). Total wall shear stress (WSS) values were 1.3 ± 0.4 times higher on the displaced side than on the opposite side of the aorta (P < 0.01). The circumferential WSS (WSSC ) ratio to total WSS was greater in dilated AA, being 0.48 ± 0.11 vs. 0.32 ± 0.09 in the inner curvature of the proximal AA (P < 0.001) and 0.37 ± 0.11 vs. 0.26 ± 0.07 in the whole aortic ring in the distal AA (P < 0.001). Depending on 4D flow parameters, reproducibility varied from excellent (ICC = 0.923) to very low (ICC = 0.204). DATA CONCLUSION The present study demonstrates that 4D flow measurements help to visualize the pathological flow patterns related to aortic dilatation. Flow displacement and an increased WSSc/WSS ratio are significantly associated with AA dilatation. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:136-145.
Collapse
Affiliation(s)
- S Petteri Kauhanen
- School of Medicine, Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Radiology, Kuopio University Hospital, Imaging Center, Kuopio, Finland
| | - Marja Hedman
- Department of Clinical Radiology, Kuopio University Hospital, Imaging Center, Kuopio, Finland
| | - Elina Kariniemi
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Imaging Center, Kuopio, Finland
| | - Pekka Jaakkola
- Department of Heart and Thoracic Surgery, Kuopio University Hospital, Heart Center, Kuopio, Finland
| | - Ritva Vanninen
- Department of Clinical Radiology, Kuopio University Hospital, Imaging Center, Kuopio, Finland
| | - Petri Saari
- Department of Clinical Radiology, Kuopio University Hospital, Imaging Center, Kuopio, Finland
| | - Timo Liimatainen
- Department of Clinical Radiology, Kuopio University Hospital, Imaging Center, Kuopio, Finland.,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| |
Collapse
|
59
|
Nguyen TQ, Hansen KL, Bechsgaard T, Lönn L, Jensen JA, Nielsen MB. Non-Invasive Assessment of Intravascular Pressure Gradients: A Review of Current and Proposed Novel Methods. Diagnostics (Basel) 2018; 9:diagnostics9010005. [PMID: 30597993 PMCID: PMC6468662 DOI: 10.3390/diagnostics9010005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/21/2018] [Accepted: 12/26/2018] [Indexed: 11/16/2022] Open
Abstract
Invasive catheterization is associated with a low risk of serious complications. However, although it is the gold standard for measuring pressure gradients, it induces changes to blood flow and requires significant resources. Therefore, non-invasive alternatives are urgently needed. Pressure gradients are routinely estimated non-invasively in clinical settings using ultrasound and calculated with the simplified Bernoulli equation, a method with several limitations. A PubMed literature search on validation of non-invasive techniques was conducted, and studies were included if non-invasively estimated pressure gradients were compared with invasively measured pressure gradients in vivo. Pressure gradients were mainly estimated from velocities obtained with Doppler ultrasound or magnetic resonance imaging. Most studies used the simplified Bernoulli equation, but more recent studies have employed the expanded Bernoulli and Navier⁻Stokes equations. Overall, the studies reported good correlation between non-invasive estimation of pressure gradients and catheterization. Despite having strong correlations, several studies reported the non-invasive techniques to either overestimate or underestimate the invasive measurements, thus questioning the accuracy of the non-invasive methods. In conclusion, more advanced imaging techniques may be needed to overcome the shortcomings of current methods.
Collapse
Affiliation(s)
- Tin-Quoc Nguyen
- Department of Diagnostic Radiology, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
| | - Kristoffer Lindskov Hansen
- Department of Diagnostic Radiology, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
| | - Thor Bechsgaard
- Department of Radiology, Odense University Hospital Svendborg Hospital, Baagøes Alle 31, 5700 Svendborg, Denmark.
| | - Lars Lönn
- Department of Diagnostic Radiology, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
| | - Jørgen Arendt Jensen
- Center for Fast Ultrasound Imaging, DTU Elektro, Technical University of Denmark, Ørsteds Plads Building 349, 2800 Lyngby, Denmark.
| | - Michael Bachmann Nielsen
- Department of Diagnostic Radiology, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
| |
Collapse
|
60
|
48 Reference flow and role of medical physicist in the validation of 4D flow MRI protocols. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.09.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
61
|
Abstract
Aortic injury remains a major contributor to morbidity and mortality from acute thoracic trauma. While such injuries were once nearly uniformly fatal, the advent of cross-sectional imaging in recent years has facilitated rapid diagnosis and triage, greatly improving outcomes. In fact, cross-sectional imaging is now the diagnostic test of choice for traumatic aortic injury (TAI), specifically computed tomography angiography (CTA) in the acute setting and CTA or magnetic resonance angiography (MRA) in follow-up. In this review, we present an up-to-date discussion of acute traumatic thoracic aortic injury with a focus on optimal and emerging CT/MR techniques, imaging findings of TAI, and potential pitfalls.
Collapse
Affiliation(s)
- Lewis D Hahn
- 1 Department of Radiology, Stanford University School of Medicine, Stanford, USA
| | - Anand M Prabhakar
- 2 Divisions of Cardiovascular and Emergency Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Evan J Zucker
- 1 Department of Radiology, Stanford University School of Medicine, Stanford, USA
| |
Collapse
|
62
|
Stacy MR, Best CA, Maxfield MW, Qiu M, Naito Y, Kurobe H, Mahler N, Rocco KA, Sinusas AJ, Shinoka T, Sampath S, Breuer CK. Magnetic Resonance Imaging of Shear Stress and Wall Thickness in Tissue-Engineered Vascular Grafts. Tissue Eng Part C Methods 2018; 24:465-473. [PMID: 29978768 DOI: 10.1089/ten.tec.2018.0144] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES Tissue-engineered vascular grafts (TEVGs) have demonstrated potential for treating congenital heart disease (CHD); however, quantitative imaging for tracking functional and structural remodeling of TEVGs has not been applied. Therefore, we evaluated the potential of magnetic resonance (MR) imaging for assessing TEVG wall shear stress (WSS) and wall thickness in a large animal model. METHODS Cell-seeded (n = 3) or unseeded (n = 3) TEVGs were implanted as inferior vena cava interposition grafts in juvenile lambs. Six months following implantation, two-dimensional phase-contrast MR imaging was performed at 3 slice locations (proximal, middle, and distal) to assess normalized WSS (i.e., WSS-to-cross sectional area). T2-weighted MR imaging was performed to assess TEVG wall thickness. Histology was qualitatively assessed, whereas immunohistochemistry was semiquantitatively assessed for smooth muscle cells (αSMA), macrophage lineage cells (CD11b), and matrix metalloproteinase activity (MMP-2 and MMP-9). Picrosirius Red staining was performed to quantify collagen content. RESULTS TEVG wall thickness was significantly higher for proximal, middle, and distal slices in unseeded versus cell-seeded grafts. Significantly higher WSS values existed for proximal versus distal slice locations for cell-seeded TEVGs, whereas no differences in WSS existed between slices for unseeded TEVGs. Additionally, no differences in WSS existed between cell-seeded and unseeded groups. Both groups demonstrated elastin formation, without vascular calcification. Unseeded TEVGs possessed greater content of smooth muscle cells when compared with cell-seeded TEVGs. No differences in macrophage, MMP activity, or collagen content existed between groups. CONCLUSION MR imaging allows for in vivo assessment of functional and anatomical characteristics of TEVGs and may provide a nonionizing approach that is clinically translatable to children undergoing treatment for CHD.
Collapse
Affiliation(s)
- Mitchel R Stacy
- 1 Department of Internal Medicine, Yale University School of Medicine , New Haven, Connecticut.,2 Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio
| | - Cameron A Best
- 2 Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio
| | - Mark W Maxfield
- 3 Department of Surgery, Yale University School of Medicine , New Haven, Connecticut
| | - Maolin Qiu
- 4 Department of Radiology & Biomedical Imaging, Yale University School of Medicine , New Haven, Connecticut
| | - Yuji Naito
- 3 Department of Surgery, Yale University School of Medicine , New Haven, Connecticut
| | - Hirotsugu Kurobe
- 3 Department of Surgery, Yale University School of Medicine , New Haven, Connecticut
| | - Nathan Mahler
- 2 Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio
| | - Kevin A Rocco
- 5 Department of Biomedical Engineering, Yale University , New Haven, Connecticut
| | - Albert J Sinusas
- 1 Department of Internal Medicine, Yale University School of Medicine , New Haven, Connecticut.,4 Department of Radiology & Biomedical Imaging, Yale University School of Medicine , New Haven, Connecticut
| | - Toshiharu Shinoka
- 2 Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio
| | - Smita Sampath
- 4 Department of Radiology & Biomedical Imaging, Yale University School of Medicine , New Haven, Connecticut
| | - Christopher K Breuer
- 2 Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio
| |
Collapse
|
63
|
Dai Y, Lv P, Javadzadegan A, Tang X, Qian Y, Lin J. Hemodynamic analysis of carotid artery after endarterectomy: a preliminary and quantitative imaging study based on computational fluid dynamics and magnetic resonance angiography. Quant Imaging Med Surg 2018; 8:399-409. [PMID: 29928605 DOI: 10.21037/qims.2018.05.02] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The carotid blood flow following carotid endarterectomy (CEA) is not fully understood. Computational fluid dynamics (CFD) is a promising method to study blood flow. This study is to investigate local hemodynamic characteristics after CEA via the use of unenhanced magnetic resonance angiography (MRA) and CFD. Methods Eight carotid arteries with atherosclerosis and sixteen normal carotid arteries were included in this study. Time-of-flight (TOF) and phase contrast (PC) MRA were applied for the measurement of three-dimensional artery geometries and velocity profile under CFD simulation. The hemodynamic parameters of the proximal internal carotid artery (ICA) including velocity, ICA/common carotid artery (CCA) velocity ratio, mean, maximum, minimum and gradient of wall shear stress (WSSmean, WSSmax, WSSmin and WSSG) were calculated before and after CEA. Morphologic characteristics of the carotid including bifurcation angle, tortuosity and planarity were also analyzed. Results Compared with pre-CEA, there was a significant reduction in post-CEA velocity, WSSmax, WSSmean, and WSSG, by 87.24%±13.38%, 86.86%±14.97%, 57.32%±56.71% and 69.74%±37.03% respectively, whereas WSSmin was almost unchanged. ICA/ CCA velocity ratios increased significantly after CEA. We also found that the post-CEA flow conditions were positively remodelled to approximate the conditions in normal arteries. The correlation between PC-MRA and CFD was excellent for the measurement of maximum velocity at the external carotid artery (r=0.846). Conclusions Our preliminary results indicated that major flow dynamics were restored shortly following CEA, and CFD based on MRA measurements could be useful for quantitative evaluation of hemodynamic outcomes after CEA.
Collapse
Affiliation(s)
- Yuanyuan Dai
- Department of Radiology, Zhongshan Hospital of Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China.,Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Peng Lv
- Department of Radiology, Zhongshan Hospital of Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - Ashkan Javadzadegan
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Xiao Tang
- Department of Vascular Surgery, Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Yi Qian
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Jiang Lin
- Department of Radiology, Zhongshan Hospital of Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China
| |
Collapse
|
64
|
Bollache E, Guzzardi DG, Sattari S, Olsen KE, Di Martino ES, Malaisrie SC, van Ooij P, Collins J, Carr J, McCarthy PM, Markl M, Barker AJ, Fedak PWM. Aortic valve-mediated wall shear stress is heterogeneous and predicts regional aortic elastic fiber thinning in bicuspid aortic valve-associated aortopathy. J Thorac Cardiovasc Surg 2018; 156:2112-2120.e2. [PMID: 30060930 DOI: 10.1016/j.jtcvs.2018.05.095] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 05/03/2018] [Accepted: 05/26/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The objectives of this study were to investigate an association between the magnitude of flow-mediated aortic wall shear stress (WSS) and medial wall histopathology in patients with bicuspid aortic valve (BAV) with aortopathy. METHODS Patients with BAV (n = 27; 52 ± 15 years; 3 women; proximal thoracic aorta diameter = 4.4 ± 0.7 and 4.6 ± 0.5 cm) who underwent prophylactic aortic resection received preoperative 3-dimensional time-resolved phase-contrast magnetic resonance imaging with 3-dimensional velocity encoding to quantify WSS relative to a population of healthy age- and sex-matched tricuspid aortic valve control participants (n = 20). Quantitative histopathology was conducted on BAV aorta tissue samples resected at surgery (n = 93), and correlation was performed between elastic fiber thickness and in vivo aortic WSS as continuous variables. Validation of elastic fiber thickness was achieved by correlation relative to tissue stiffness determined using biaxial biomechanical testing (n = 22 samples). RESULTS Elastic fibers were thinner and WSS was higher along the greater curvature compared with other circumferential regions (vs anterior wall: P = .003 and P = .0001, respectively; lesser curvature: both P = .001). Increased regional WSS was associated with decreased elastic fiber thickness (r = -0.25; P = .02). Patient stratification with subanalysis showed an increase in the correlation between WSS and histopathology with aortic valve stenosis (r = -0.36; P = .002) and smaller aortic diameters (<4.5 cm: r = -0.39; P = .03). Elastic fiber thinning was associated with circumferential stiffness (r = -0.41; P = .06). CONCLUSIONS For patients with BAV, increased aortic valve-mediated WSS is significantly associated with elastic fiber thinning, particularly with aortic valve stenosis and in earlier stages of aortopathy. Elastic fiber thinning correlates with impaired tissue biomechanics. These novel findings further implicate valve-mediated hemodynamics in the progression of BAV aortopathy.
Collapse
Affiliation(s)
- Emilie Bollache
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - David G Guzzardi
- Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Samaneh Sattari
- Graduate Program in Biomedical Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Katherine E Olsen
- Graduate Program in Biomedical Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Elena S Di Martino
- Department of Civil Engineering, Schulich School of Engineering, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - S Chris Malaisrie
- Division of Surgery-Cardiac Surgery, Northwestern University, Bluhm Cardiovascular Institute, Chicago, Ill
| | - Pim van Ooij
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Jeremy Collins
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Patrick M McCarthy
- Division of Surgery-Cardiac Surgery, Northwestern University, Bluhm Cardiovascular Institute, Chicago, Ill
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill; Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, Ill
| | - Alex J Barker
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Paul W M Fedak
- Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada; Division of Surgery-Cardiac Surgery, Northwestern University, Bluhm Cardiovascular Institute, Chicago, Ill.
| |
Collapse
|
65
|
Bhave NM, Nienaber CA, Clough RE, Eagle KA. Multimodality Imaging of Thoracic Aortic Diseases in Adults. JACC Cardiovasc Imaging 2018; 11:902-919. [DOI: 10.1016/j.jcmg.2018.03.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/16/2018] [Accepted: 03/20/2018] [Indexed: 12/28/2022]
|
66
|
Scan-rescan reproducibility of segmental aortic wall shear stress as assessed by phase-specific segmentation with 4D flow MRI in healthy volunteers. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2018; 31:653-663. [PMID: 29804208 PMCID: PMC6132557 DOI: 10.1007/s10334-018-0688-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 04/17/2018] [Accepted: 04/30/2018] [Indexed: 11/24/2022]
Abstract
Objective The aim was to investigate scan–rescan reproducibility and observer variability of segmental aortic 3D systolic wall shear stress (WSS) by phase-specific segmentation with 4D flow MRI in healthy volunteers. Materials and methods Ten healthy volunteers (age 26.5 ± 2.6 years) underwent aortic 4D flow MRI twice. Maximum 3D systolic WSS (WSSmax) and mean 3D systolic WSS (WSSmean) for five thoracic aortic segments over five systolic cardiac phases by phase-specific segmentations were calculated. Scan–rescan analysis and observer reproducibility analysis were performed. Results Scan–rescan data showed overall good reproducibility for WSSmean (coefficient of variation, COV 10–15%) with moderate-to-strong intraclass correlation coefficient (ICC 0.63–0.89). The variability in WSSmax was high (COV 16–31%) with moderate-to-good ICC (0.55–0.79) for different aortic segments. Intra- and interobserver reproducibility was good-to-excellent for regional aortic WSSmax (ICC ≥ 0.78; COV ≤ 17%) and strong-to-excellent for WSSmean (ICC ≥ 0.86; COV ≤ 11%). In general, ascending aortic segments showed more WSSmax/WSSmean variability compared to aortic arch or descending aortic segments for scan–rescan, intraobserver and interobserver comparison. Conclusions Scan–rescan reproducibility was good for WSSmean and moderate for WSSmax for all thoracic aortic segments over multiple systolic phases in healthy volunteers. Intra/interobserver reproducibility for segmental WSS assessment was good-to-excellent. Variability of WSSmax is higher and should be taken into account in case of individual follow-up or in comparative rest–stress studies to avoid misinterpretation. Electronic supplementary material The online version of this article (10.1007/s10334-018-0688-6) contains supplementary material, which is available to authorized users.
Collapse
|
67
|
He Y, Shiu YT, Pike DB, Roy-Chaudhury P, Cheung AK, Berceli SA. Comparison of hemodialysis arteriovenous fistula blood flow rates measured by Doppler ultrasound and phase-contrast magnetic resonance imaging. J Vasc Surg 2018; 68:1848-1857.e2. [PMID: 29779960 DOI: 10.1016/j.jvs.2018.02.043] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 02/20/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The objective of this study was to compare blood flow rates measured by Doppler ultrasound (DUS) and phase-contrast magnetic resonance imaging (MRI) in patients having a hemodialysis arteriovenous fistula (AVF) and to identify scenarios in which there was significant discordance between these two approaches. METHODS Blood flow rates in the proximal artery (PA) and draining vein (DV) of newly created upper extremity AVFs were measured and compared using DUS and phase-contrast MRI at 1 day, 6 weeks, and 6 months postoperatively. RESULTS Blood flow rates in the PA measured by DUS (1155 ± 907 mL/min, mean ± standard deviation) and by MRI (1170 ± 657 mL/min) were not statistically different (P = .812) based on 78 data pairs from 49 patients. DV DUS flow (1277 ± 995 mL/min) and MRI flow (1130 ± 655 mL/min) were also not statistically different (P = .071) based on 64 data pairs. In both PA and DV, the two methods substantially agreed with each other (Cohen κ: PA, 0.66; DV, 0.67) when flow rates were put into four clinically relevant categories (<300, 300-599, 600-1499, and ≥1500 mL/min). The Bland-Altman analyses of DUS and MRI flow identified six and four outliers for PA and DV, respectively. Seven outliers had higher DUS than MRI flow, with all DUS scan sites having a large lumen or significant local curvature; the other three had lower DUS flow, partly due to an underestimation of lumen diameter by DUS. CONCLUSIONS DUS and MRI flow rates are generally comparable in both PA and DV. When DUS is used for flow measurements, careful attention to accurate lumen diameter measurements is needed and scan sites with marked curvature should be avoided. Our result may improve the accuracy of DUS-measured AVF blood flow rate.
Collapse
Affiliation(s)
- Yong He
- Department of Surgery, University of Florida, Gainesville, Fla; Malcom Randall VA Medical Center, Gainesville, Fla
| | - Yan-Ting Shiu
- Division of Nephrology & Hypertension, University of Utah, Salt Lake City, Utah
| | - Daniel B Pike
- Department of Bioengineering, University of Utah, Salt Lake City, Utah
| | | | - Alfred K Cheung
- Division of Nephrology & Hypertension, University of Utah, Salt Lake City, Utah; Medical Service, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah; Department of Nephrology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Scott A Berceli
- Department of Surgery, University of Florida, Gainesville, Fla; Malcom Randall VA Medical Center, Gainesville, Fla.
| |
Collapse
|
68
|
Galea N, Piatti F, Lau C, Sturla F, Weltert L, Carbone I, De Paulis R, Gaudino M, Girardi LN. 4D flow characterization of aortic blood flow after valve sparing root reimplantation procedure. J Vis Surg 2018; 4:95. [PMID: 29963384 DOI: 10.21037/jovs.2018.03.17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 03/15/2018] [Indexed: 11/06/2022]
Abstract
Valve-sparing aortic root replacement (VSRR) with reimplantation technique is an effective alternative for young patients with dilated roots and preserved cusps, which avoids the risks of lifelong anticoagulation or valve degeneration. New grafts with anatomically-shaped sinuses have been developed in order to preserve aortic root physiology, which could decrease complication rates and improve durability. However, controversy remains regarding the effect of recreation of the sinuses of Valsalva during VSRR on long-term outcomes. The novel 4D flow technique, exploiting its unique ability to combine anatomical evaluation of the root with fluid-dynamic assessment of aortic flow, enables integrated analysis of the close interaction between graft design, valvular morphology and three-dimensional (3D) flow characteristics. Early experimental studies have shown how graft shape affects the aortic root flow pattern, formation of vortexes and helicity of downstream flow; however, the clinical significance of these findings is yet to be clarified. Various and still unexplored knowledge can be obtained from the qualitative and quantitative analysis of these complex datasets, that could shed more light on which is the best among myriad surgical techniques and grafts adopted in VSRR. The extraordinary potential 4D flow imaging opens new boundless horizons in the perspective of an increasingly patient-tailored surgical planning.
Collapse
Affiliation(s)
- Nicola Galea
- Department of Experimental Medicine, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy.,Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Filippo Piatti
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Christopher Lau
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, USA
| | - Francesco Sturla
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.,3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Luca Weltert
- Department of Cardiac Surgery, European Hospital, Rome, Italy
| | - Iacopo Carbone
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, USA
| | - Leonard N Girardi
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, USA
| | | |
Collapse
|
69
|
Del Chicca F, Schwarz A, Grest P, Willmitzer F, Dennler M, Kircher PR. Cardiac-gated, phase contrast magnetic resonance angiography is a reliable and reproducible technique for quantifying blood flow in canine major cranial abdominal vessels. Vet Radiol Ultrasound 2018; 59:423-431. [PMID: 29667282 DOI: 10.1111/vru.12615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 11/23/2017] [Accepted: 01/17/2018] [Indexed: 11/29/2022] Open
Abstract
Blood flow changes in cranial abdominal vessels are important contributing factors for canine hepatic disease. This prospective, experimental, pilot study aimed to evaluate cardiac-gated, phase contrast magnetic resonance angiography (PCMRA) as a method for characterizing blood flow in canine major cranial abdominal vessels. Eleven, healthy, adult beagle dogs were sampled. Cardiac-gated, phase contrast magnetic resonance angiography of the cranial abdomen was performed in each dog and blood flow was independently measured in each of the major cranial abdominal vessels by three observers, with two observers recording blood flow values once and one observer recording blood flow values three times. Each dog then underwent ultrasonographic examination of the liver with fine needle aspirations and biopsies submitted to cytologic and histologic examination. The mean absolute stroke volume and velocity were respectively 9.6 ± 1.9 ml and -11.1 ± 1.1 cm/s for the cranial abdominal aorta, 2.1 ± 0.6 ml and -6.6 ± 1.9 cm/s for the celiac artery, and 2.3 ± 1.0 ml and -7.9 ± 3.1 cm/s for the cranial mesenteric artery. The mean absolute stroke volume and velocity were respectively 6.7 ± 1.3 ml and 3.9 ± 0.9 cm/s for the caudal vena cava and 2.6 ± 0.9 ml and 3.2 ± 1.2 cm/s for the portal vein. Intraobserver reliability was excellent (intraclass correlation coefficient > 0.9). Interobserver reproducibility was also excellent (intraclass correlation coefficient 0.89-0.99). Results of liver ultrasonography, cytology, and histopathology were unremarkable. Findings indicated that cardiac-gated, phase contrast magnetic resonance angiography is a feasible technique for quantifying blood blow in canine major cranial abdominal vessels. Blood flow values from this sample of healthy beagles can be used as background for future studies on canine hepatic disease.
Collapse
Affiliation(s)
- Francesca Del Chicca
- Clinic of Diagnostic Imaging, Vetsuisse Faculty University of Zurich, Zurich, 8057, Switzerland.,Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, 3012, Switzerland
| | - Andrea Schwarz
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty University of Zurich, Zurich, 8057, Switzerland
| | - Paula Grest
- Institute of Veterinary Pathology, Vetsuisse Faculty University of Zurich, Zurich, 8057, Switzerland
| | - Florian Willmitzer
- Clinic of Diagnostic Imaging, Vetsuisse Faculty University of Zurich, Zurich, 8057, Switzerland
| | - Matthias Dennler
- Clinic of Diagnostic Imaging, Vetsuisse Faculty University of Zurich, Zurich, 8057, Switzerland
| | - Patrick R Kircher
- Clinic of Diagnostic Imaging, Vetsuisse Faculty University of Zurich, Zurich, 8057, Switzerland
| |
Collapse
|
70
|
Abstract
A number of congenital defects and acquired disease processes affect the thoracic aorta, and traditionally, computed tomography (CT) has been the mainstay of imaging, especially in evaluation of the acute aorta. However, recent advances in magnetic resonance (MR) imaging such as electrocardiographically (ECG) triggered breath-hold sequences and ultrafast 3-dimensional MR angiography (MRA) are bringing MR imaging to the forefront of imaging of the thoracic aorta. By providing high-resolution morphological imaging and sophisticated vascular flow analysis for functional data, this modality can provide a comprehensive, reproducible evaluation of the thoracic aorta. In this review, we discuss the role of MR imaging in the evaluation of thoracic aorta pathology along with pertinent examples of aortic abnormalities.
Collapse
Affiliation(s)
- John P Lichtenberger
- Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Derek F Franco
- Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Jason S Kim
- Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Brett W Carter
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
71
|
De Cocker LJ, Lindenholz A, Zwanenburg JJ, van der Kolk AG, Zwartbol M, Luijten PR, Hendrikse J. Clinical vascular imaging in the brain at 7T. Neuroimage 2018; 168:452-458. [PMID: 27867089 PMCID: PMC5862656 DOI: 10.1016/j.neuroimage.2016.11.044] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 09/30/2016] [Accepted: 11/16/2016] [Indexed: 01/23/2023] Open
Abstract
Stroke and related cerebrovascular diseases are a major cause of mortality and disability. Even at standard-field-strengths (1.5T), MRI is by far the most sensitive imaging technique to detect acute brain infarctions and to characterize incidental cerebrovascular lesions, such as white matter hyperintensities, lacunes and microbleeds. Arterial time-of-flight (TOF) MR angiography (MRA) can depict luminal narrowing or occlusion of the major brain feeding arteries, and this without the need for contrast administration. Compared to 1.5T MRA, the use of high-field strength (3T) and even more so ultra-high-field strengths (7T), enables the visualization of the lumen of much smaller intracranial vessels, while adding a contrast agent to TOF MRA at 7T may enable the visualization of even more distal arteries in addition to veins and venules. Moreover, with 3T and 7T, the arterial vessel walls beyond the circle of Willis become visible with high-resolution vessel wall imaging. In addition, with 7T MRI, the brain parenchyma can now be visualized on a submillimeter scale. As a result, high-resolution imaging studies of the brain and its blood supply at 7T have generated new concepts of different cerebrovascular diseases. In the current article, we will discuss emerging clinical applications and future directions of vascular imaging in the brain at 7T MRI.
Collapse
Affiliation(s)
- Laurens Jl De Cocker
- Department of Radiology, University Medical Center Utrecht, The Netherlands; Department of Radiology, Kliniek Sint-Jan, Brussels, Belgium.
| | - Arjen Lindenholz
- Department of Radiology, University Medical Center Utrecht, The Netherlands
| | - Jaco Jm Zwanenburg
- Department of Radiology, University Medical Center Utrecht, The Netherlands
| | | | - Maarten Zwartbol
- Department of Radiology, University Medical Center Utrecht, The Netherlands
| | - Peter R Luijten
- Department of Radiology, University Medical Center Utrecht, The Netherlands
| | - Jeroen Hendrikse
- Department of Radiology, University Medical Center Utrecht, The Netherlands
| |
Collapse
|
72
|
Bastkowski R, Weiss K, Maintz D, Giese D. Self-gated golden-angle spiral 4D flow MRI. Magn Reson Med 2018; 80:904-913. [PMID: 29344990 DOI: 10.1002/mrm.27085] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 12/07/2017] [Accepted: 12/20/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Rene Bastkowski
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| | - Kilian Weiss
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
- Philips Healthcare Germany, Hamburg, Germany
| | - David Maintz
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| | - Daniel Giese
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| |
Collapse
|
73
|
Muthusami P, Yoo SJ, Chaturvedi R, Gill N, Windram J, Schantz D, Prsa M, Caro-Dominguez P, Seed M, Grosse-Wortmann L, Ling SC, Chavhan GB. Splanchnic, Thoracoabdominal, and Cerebral Blood Flow Volumes in Healthy Children and Young Adults in Fasting and Postprandial States: Determining Reference Ranges by Using Phase-Contrast MR Imaging. Radiology 2017; 285:231-241. [DOI: 10.1148/radiol.2017162114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Prakash Muthusami
- From the Department of Diagnostic Imaging (P.M., S.J.Y., N.T., J.W., D.S., M.P., P.C.D., M.S., L.G.W., G.B.C.), Division of Cardiology, Department of Pediatrics (S.J.Y., R.C., J.W., D.S., M.P., M.S., L.G.W.), and Division of Gastroenterology, Hepatology, and Nutrition (S.C.L.), the Hospital For Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Medical Imaging (P.M., S.J.Y., P.C.D., M.S., L.G.W., G.B.C.), and Pediatrics (R.C., S.C.L.), University of Toronto, Toronto, Canada
| | - Shi-Joon Yoo
- From the Department of Diagnostic Imaging (P.M., S.J.Y., N.T., J.W., D.S., M.P., P.C.D., M.S., L.G.W., G.B.C.), Division of Cardiology, Department of Pediatrics (S.J.Y., R.C., J.W., D.S., M.P., M.S., L.G.W.), and Division of Gastroenterology, Hepatology, and Nutrition (S.C.L.), the Hospital For Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Medical Imaging (P.M., S.J.Y., P.C.D., M.S., L.G.W., G.B.C.), and Pediatrics (R.C., S.C.L.), University of Toronto, Toronto, Canada
| | - Rajiv Chaturvedi
- From the Department of Diagnostic Imaging (P.M., S.J.Y., N.T., J.W., D.S., M.P., P.C.D., M.S., L.G.W., G.B.C.), Division of Cardiology, Department of Pediatrics (S.J.Y., R.C., J.W., D.S., M.P., M.S., L.G.W.), and Division of Gastroenterology, Hepatology, and Nutrition (S.C.L.), the Hospital For Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Medical Imaging (P.M., S.J.Y., P.C.D., M.S., L.G.W., G.B.C.), and Pediatrics (R.C., S.C.L.), University of Toronto, Toronto, Canada
| | - Navjot Gill
- From the Department of Diagnostic Imaging (P.M., S.J.Y., N.T., J.W., D.S., M.P., P.C.D., M.S., L.G.W., G.B.C.), Division of Cardiology, Department of Pediatrics (S.J.Y., R.C., J.W., D.S., M.P., M.S., L.G.W.), and Division of Gastroenterology, Hepatology, and Nutrition (S.C.L.), the Hospital For Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Medical Imaging (P.M., S.J.Y., P.C.D., M.S., L.G.W., G.B.C.), and Pediatrics (R.C., S.C.L.), University of Toronto, Toronto, Canada
| | - Jonathan Windram
- From the Department of Diagnostic Imaging (P.M., S.J.Y., N.T., J.W., D.S., M.P., P.C.D., M.S., L.G.W., G.B.C.), Division of Cardiology, Department of Pediatrics (S.J.Y., R.C., J.W., D.S., M.P., M.S., L.G.W.), and Division of Gastroenterology, Hepatology, and Nutrition (S.C.L.), the Hospital For Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Medical Imaging (P.M., S.J.Y., P.C.D., M.S., L.G.W., G.B.C.), and Pediatrics (R.C., S.C.L.), University of Toronto, Toronto, Canada
| | - Daryl Schantz
- From the Department of Diagnostic Imaging (P.M., S.J.Y., N.T., J.W., D.S., M.P., P.C.D., M.S., L.G.W., G.B.C.), Division of Cardiology, Department of Pediatrics (S.J.Y., R.C., J.W., D.S., M.P., M.S., L.G.W.), and Division of Gastroenterology, Hepatology, and Nutrition (S.C.L.), the Hospital For Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Medical Imaging (P.M., S.J.Y., P.C.D., M.S., L.G.W., G.B.C.), and Pediatrics (R.C., S.C.L.), University of Toronto, Toronto, Canada
| | - Milan Prsa
- From the Department of Diagnostic Imaging (P.M., S.J.Y., N.T., J.W., D.S., M.P., P.C.D., M.S., L.G.W., G.B.C.), Division of Cardiology, Department of Pediatrics (S.J.Y., R.C., J.W., D.S., M.P., M.S., L.G.W.), and Division of Gastroenterology, Hepatology, and Nutrition (S.C.L.), the Hospital For Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Medical Imaging (P.M., S.J.Y., P.C.D., M.S., L.G.W., G.B.C.), and Pediatrics (R.C., S.C.L.), University of Toronto, Toronto, Canada
| | - Pablo Caro-Dominguez
- From the Department of Diagnostic Imaging (P.M., S.J.Y., N.T., J.W., D.S., M.P., P.C.D., M.S., L.G.W., G.B.C.), Division of Cardiology, Department of Pediatrics (S.J.Y., R.C., J.W., D.S., M.P., M.S., L.G.W.), and Division of Gastroenterology, Hepatology, and Nutrition (S.C.L.), the Hospital For Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Medical Imaging (P.M., S.J.Y., P.C.D., M.S., L.G.W., G.B.C.), and Pediatrics (R.C., S.C.L.), University of Toronto, Toronto, Canada
| | - Mike Seed
- From the Department of Diagnostic Imaging (P.M., S.J.Y., N.T., J.W., D.S., M.P., P.C.D., M.S., L.G.W., G.B.C.), Division of Cardiology, Department of Pediatrics (S.J.Y., R.C., J.W., D.S., M.P., M.S., L.G.W.), and Division of Gastroenterology, Hepatology, and Nutrition (S.C.L.), the Hospital For Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Medical Imaging (P.M., S.J.Y., P.C.D., M.S., L.G.W., G.B.C.), and Pediatrics (R.C., S.C.L.), University of Toronto, Toronto, Canada
| | - Lars Grosse-Wortmann
- From the Department of Diagnostic Imaging (P.M., S.J.Y., N.T., J.W., D.S., M.P., P.C.D., M.S., L.G.W., G.B.C.), Division of Cardiology, Department of Pediatrics (S.J.Y., R.C., J.W., D.S., M.P., M.S., L.G.W.), and Division of Gastroenterology, Hepatology, and Nutrition (S.C.L.), the Hospital For Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Medical Imaging (P.M., S.J.Y., P.C.D., M.S., L.G.W., G.B.C.), and Pediatrics (R.C., S.C.L.), University of Toronto, Toronto, Canada
| | - Simon C. Ling
- From the Department of Diagnostic Imaging (P.M., S.J.Y., N.T., J.W., D.S., M.P., P.C.D., M.S., L.G.W., G.B.C.), Division of Cardiology, Department of Pediatrics (S.J.Y., R.C., J.W., D.S., M.P., M.S., L.G.W.), and Division of Gastroenterology, Hepatology, and Nutrition (S.C.L.), the Hospital For Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Medical Imaging (P.M., S.J.Y., P.C.D., M.S., L.G.W., G.B.C.), and Pediatrics (R.C., S.C.L.), University of Toronto, Toronto, Canada
| | - Govind B. Chavhan
- From the Department of Diagnostic Imaging (P.M., S.J.Y., N.T., J.W., D.S., M.P., P.C.D., M.S., L.G.W., G.B.C.), Division of Cardiology, Department of Pediatrics (S.J.Y., R.C., J.W., D.S., M.P., M.S., L.G.W.), and Division of Gastroenterology, Hepatology, and Nutrition (S.C.L.), the Hospital For Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Medical Imaging (P.M., S.J.Y., P.C.D., M.S., L.G.W., G.B.C.), and Pediatrics (R.C., S.C.L.), University of Toronto, Toronto, Canada
| |
Collapse
|
74
|
Cardiovascular MRI in Thoracic Aortopathy: A Focused Review of Recent Literature Updates. CURRENT RADIOLOGY REPORTS 2017. [DOI: 10.1007/s40134-017-0246-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
75
|
Zwanenburg JJM, van Osch MJP. Targeting Cerebral Small Vessel Disease With MRI. Stroke 2017; 48:3175-3182. [PMID: 28970280 DOI: 10.1161/strokeaha.117.016996] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 08/28/2017] [Accepted: 09/05/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Jaco J M Zwanenburg
- From the Deptartment of Radiology, University Medical Center Utrecht, the Netherlands (J.J.M.Z.); and Department of Radiology, Leiden University Medical Center, the Netherlands (M.J.P.v.O.).
| | - Matthias J P van Osch
- From the Deptartment of Radiology, University Medical Center Utrecht, the Netherlands (J.J.M.Z.); and Department of Radiology, Leiden University Medical Center, the Netherlands (M.J.P.v.O.)
| |
Collapse
|
76
|
Assi KC, Gay E, Chnafa C, Mendez S, Nicoud F, Abascal JFPJ, Lantelme P, Tournoux F, Garcia D. Intraventricular vector flow mapping—a Doppler-based regularized problem with automatic model selection. ACTA ACUST UNITED AC 2017; 62:7131-7147. [DOI: 10.1088/1361-6560/aa7fe7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
77
|
Montalba C, Urbina J, Sotelo J, Andia ME, Tejos C, Irarrazaval P, Hurtado DE, Valverde I, Uribe S. Variability of 4D flow parameters when subjected to changes in MRI acquisition parameters using a realistic thoracic aortic phantom. Magn Reson Med 2017; 79:1882-1892. [DOI: 10.1002/mrm.26834] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/02/2017] [Accepted: 06/19/2017] [Indexed: 01/28/2023]
Affiliation(s)
- Cristian Montalba
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiago Chile
| | - Jesus Urbina
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiago Chile
- Department of RadiologySchool of Medicine, Pontificia Universidad Católica de ChileSantiago Chile
| | - Julio Sotelo
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiago Chile
- Department of Electrical EngineeringPontificia Universidad Católica de ChileSantiago Chile
| | - Marcelo E. Andia
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiago Chile
- Department of RadiologySchool of Medicine, Pontificia Universidad Católica de ChileSantiago Chile
| | - Cristian Tejos
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiago Chile
- Department of Electrical EngineeringPontificia Universidad Católica de ChileSantiago Chile
| | - Pablo Irarrazaval
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiago Chile
- Department of Electrical EngineeringPontificia Universidad Católica de ChileSantiago Chile
| | - Daniel E. Hurtado
- Department of Structural and Geotechnical EngineeringPontificia Universidad Católica de ChileSantiago Chile
- Institute for Biological and Medical EngineeringSchools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de ChileSantiago Chile
| | - Israel Valverde
- Hospital Virgen del RocioUniversidad de SevillaSeville Spain
- Institute of Biomedicine of SevilleUniversidad de SevillaSeville Spain
| | - Sergio Uribe
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiago Chile
- Department of RadiologySchool of Medicine, Pontificia Universidad Católica de ChileSantiago Chile
| |
Collapse
|
78
|
Pediatric brain MRI, Part 2: Advanced techniques. Pediatr Radiol 2017; 47:544-555. [PMID: 28409252 DOI: 10.1007/s00247-017-3792-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 11/13/2016] [Accepted: 01/26/2017] [Indexed: 10/19/2022]
Abstract
Pediatric neuroimaging is a complex and specialized field that uses magnetic resonance (MR) imaging as the workhorse for diagnosis. MR protocols should be tailored to the specific indication and reviewed by the supervising radiologist in real time. Targeted advanced imaging sequences can be added to provide information regarding tissue microstructure, perfusion, metabolism and function. In part 2 of this review, we highlight the utility of advanced imaging techniques for superior evaluation of pediatric neurologic disease. We focus on the following techniques, with clinical examples: phase-contrast imaging, perfusion-weighted imaging, vessel wall imaging, diffusion tensor imaging, task-based functional MRI and MR spectroscopy.
Collapse
|
79
|
van der Palen RLF, Barker AJ, Bollache E, Garcia J, Rose MJ, van Ooij P, Young LT, Roest AAW, Markl M, Robinson JD, Rigsby CK. Altered aortic 3D hemodynamics and geometry in pediatric Marfan syndrome patients. J Cardiovasc Magn Reson 2017; 19:30. [PMID: 28302143 PMCID: PMC5356404 DOI: 10.1186/s12968-017-0345-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 02/16/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Blood flow dynamics make it possible to better understand the development of aortopathy and cardiovascular events in patients with Marfan syndrome (MFS). Aortic 3D blood flow characteristics were investigated in relation to aortic geometry in children and adolescents with MFS. METHODS Twenty-five MFS patients (age 15.6 ± 4.0 years; 11 females) and 21 healthy controls (age 16.0 ± 2.6 years; 12 females) underwent magnetic resonance angiography and 4D flow CMR for assessment of thoracic aortic size and 3D blood flow velocities. Data analysis included calculation of aortic diameter and BSA-indexed aortic dimensions (Z-score) along the thoracic aorta, 3D mean systolic wall shear stress (WSSmean) in ten aortic segments and assessment of aortic blood flow patterns. RESULTS Aortic root (root), ascending (AAo) and descending (DAo) aortic size was significantly larger in MFS patients than healthy controls (Root Z-score: 3.56 ± 1.45 vs 0.49 ± 0.78, p < 0.001; AAo Z-score 0.21 ± 0.95 vs -0.54 ± 0.64, p = 0.004; proximal DAo Z-score 2.02 ± 1.60 vs 0.56 ± 0.66, p < 0.001). A regional variation in prevalence and severity of flow patterns (vortex and helix flow patterns) was observed, with the aortic root and the proximal DAo (pDAo) being more frequently affected in MFS. MFS patients had significantly reduced WSSmean in the proximal AAo (pAAo) outer segment (0.65 ± 0.12 vs. 0.73 ± 0.14 Pa, p = 0.029) and pDAo inner segment (0.74 ± 0.17 vs. 0.87 ± 0.21 Pa, p = 0.021), as well as higher WSSmean in the inner segment of the distal AAo (0.94 ± 0.14 vs. 0.84 ± 0.15 Pa, p = 0.036) compared to healthy subjects. An inverse relationship existed between pDAo WSSmean and both pDAo diameter (R = -0.53, p < 0.001) and % diameter change along the pDAo segment (R = -0.64, p < 0.001). CONCLUSIONS MFS children and young adults have altered aortic flow patterns and differences in aortic WSS that were most pronounced in the pAAo and pDAo, segments where aortic dissection or rupture often originate. The presence of vortex flow patterns and abnormal WSS correlated with regional size of the pDAo and are potentially valuable additional markers of disease severity.
Collapse
Affiliation(s)
- Roel L. F. van der Palen
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
- Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Alex J. Barker
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
| | - Emilie Bollache
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
| | - Julio Garcia
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
- Department of Cardiac Sciences, Stephenson Cardiac Imaging Centre, University of Calgary - Cumming School of Medicine, Calgary, AB Canada
| | - Michael J. Rose
- Department of Medical Imaging, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
| | - Pim van Ooij
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Luciana T. Young
- Department of Pediatrics, Division of Pediatric Cardiology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
| | - Arno A. W. Roest
- Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
- Department of Biomedical Engineering, McCormick School; of Engineering, Northwestern University, Chicago, IL USA
| | - Joshua D. Robinson
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
- Department of Pediatrics, Division of Pediatric Cardiology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Cynthia K. Rigsby
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
- Department of Medical Imaging, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| |
Collapse
|
80
|
Cibis M, Bustamante M, Eriksson J, Carlhäll CJ, Ebbers T. Creating hemodynamic atlases of cardiac 4D flow MRI. J Magn Reson Imaging 2017; 46:1389-1399. [PMID: 28295788 PMCID: PMC5655727 DOI: 10.1002/jmri.25691] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/14/2017] [Indexed: 01/22/2023] Open
Abstract
Purpose Hemodynamic atlases can add to the pathophysiological understanding of cardiac diseases. This study proposes a method to create hemodynamic atlases using 4D Flow magnetic resonance imaging (MRI). The method is demonstrated for kinetic energy (KE) and helicity density (Hd). Materials and Methods Thirteen healthy subjects underwent 4D Flow MRI at 3T. Phase‐contrast magnetic resonance cardioangiographies (PC‐MRCAs) and an average heart were created and segmented. The PC‐MRCAs, KE, and Hd were nonrigidly registered to the average heart to create atlases. The method was compared with 1) rigid, 2) affine registration of the PC‐MRCAs, and 3) affine registration of segmentations. The peak and mean KE and Hd before and after registration were calculated to evaluate interpolation error due to nonrigid registration. Results The segmentations deformed using nonrigid registration overlapped (median: 92.3%) more than rigid (23.1%, P < 0.001), and affine registration of PC‐MRCAs (38.5%, P < 0.001) and affine registration of segmentations (61.5%, P < 0.001). The peak KE was 4.9 mJ using the proposed method and affine registration of segmentations (P = 0.91), 3.5 mJ using rigid registration (P < 0.001), and 4.2 mJ using affine registration of the PC‐MRCAs (P < 0.001). The mean KE was 1.1 mJ using the proposed method, 0.8 mJ using rigid registration (P < 0.001), 0.9 mJ using affine registration of the PC‐MRCAs (P < 0.001), and 1.0 mJ using affine registration of segmentations (P = 0.028). The interpolation error was 5.2 ± 2.6% at mid‐systole, 2.8 ± 3.8% at early diastole for peak KE; 9.6 ± 9.3% at mid‐systole, 4.0 ± 4.6% at early diastole, and 4.9 ± 4.6% at late diastole for peak Hd. The mean KE and Hd were not affected by interpolation. Conclusion Hemodynamic atlases can be obtained with minimal user interaction using nonrigid registration of 4D Flow MRI. Level of Evidence: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1389–1399.
Collapse
Affiliation(s)
- Merih Cibis
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Mariana Bustamante
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Jonatan Eriksson
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Carl-Johan Carlhäll
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Division of Clinical Physiology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Tino Ebbers
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| |
Collapse
|
81
|
Bouillot P, Delattre BMA, Brina O, Ouared R, Farhat M, Chnafa C, Steinman DA, Lovblad KO, Pereira VM, Vargas MI. 3D phase contrast MRI: Partial volume correction for robust blood flow quantification in small intracranial vessels. Magn Reson Med 2017; 79:129-140. [PMID: 28244132 DOI: 10.1002/mrm.26637] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/19/2017] [Accepted: 01/19/2017] [Indexed: 11/11/2022]
Abstract
PURPOSE Recent advances in 3D-PCMRI (phase contrast MRI) sequences allow for measuring the complex hemodynamics in cerebral arteries. However, the small size of these vessels vs spatial resolution can lead to non-negligible partial volume artifacts, which must be taken into account when computing blood flow rates. For this purpose, we combined the velocity information provided by 3D-PCMRI with vessel geometry measured with 3DTOF (time of flight MRI) or 3DRA (3D rotational angiography) to correct the partial volume effects in flow rate assessments. METHODS The proposed methodology was first tested in vitro on cylindrical and patient specific vessels subject to fully controlled pulsatile flows. Both 2D- and 3D-PCMRI measurements using various spatial resolutions ranging from 20 to 1.3 voxels per vessel diameter were analyzed and compared with flowmeter baseline. Second, 3DTOF, 2D- and 3D-PCMRI measurements were performed in vivo on 35 patients harboring internal carotid artery (ICA) aneurysms indicated for endovascular treatments requiring 3DRA imaging. RESULTS The in vitro 2D- and 3D-PCMRI mean flow rates assessed with partial volume correction showed very low sensitivity to the acquisition resolution above ≈2 voxels per vessel diameter while uncorrected flow rates deviated critically when decreasing the spatial resolution. 3D-PCMRI flow rates measured in vivo in ICA agreed very well with 2D-PCMRI data and a good flow conservation was observed at the C7 bifurcation. Globally, partial volume correction led to 10-15% lower flow rates than uncorrected values as those reported in most of the published studies on intracranial flows. CONCLUSION Partial volume correction may improve the accuracy of PCMRI flow rate measurements especially in small vessels such as intracranial arteries. Magn Reson Med 79:129-140, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
Collapse
Affiliation(s)
- Pierre Bouillot
- Division of Neuroradiology, Geneva University Hospitals & Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Laboratory for Hydraulic Machines (LMH), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Bénédicte M A Delattre
- Division of Radiology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Olivier Brina
- Division of Neuroradiology, Geneva University Hospitals & Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Canada
| | - Rafik Ouared
- Division of Neuroradiology, Geneva University Hospitals & Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Mohamed Farhat
- Laboratory for Hydraulic Machines (LMH), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Christophe Chnafa
- Biomedical Simulation Laboratory, Department of Mechanical & Industrial Engineering, University of Toronto, Toronto, Canada
| | - David A Steinman
- Biomedical Simulation Laboratory, Department of Mechanical & Industrial Engineering, University of Toronto, Toronto, Canada
| | - Karl-Olof Lovblad
- Division of Neuroradiology, Geneva University Hospitals & Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Vitor M Pereira
- Division of Neuroradiology, Geneva University Hospitals & Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Canada.,Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, Toronto, Canada
| | - Maria I Vargas
- Division of Neuroradiology, Geneva University Hospitals & Faculty of Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
82
|
Youssefi P, Sharma R, Figueroa CA, Jahangiri M. Functional assessment of thoracic aortic aneurysms - the future of risk prediction? Br Med Bull 2017; 121:61-71. [PMID: 27989994 PMCID: PMC5862296 DOI: 10.1093/bmb/ldw049] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 12/13/2016] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Treatment guidelines for the thoracic aorta concentrate on size, yet acute aortic dissection or rupture can occur when aortic size is below intervention criteria. Functional imaging and computational techniques are a means of assessing haemodynamic parameters involved in aortic pathology. SOURCES OF DATA Original articles, reviews, international guidelines. AREAS OF AGREEMENT Computational fluid dynamics and 4D flow MRI allow non-invasive assessment of blood flow parameters and aortic wall biomechanics. AREAS OF CONTROVERSY Aortic valve morphology (particularly bicuspid aortic valve) is associated with aneurysm of the ascending aorta, although the exact mechanism of aneurysm formation is not yet established. GROWING POINTS Haemodynamic assessment of the thoracic aorta has highlighted parameters which are linked with both clinical outcome and protein changes in the aortic wall. Wall shear stress, flow displacement and helicity are elevated in patients with bicuspid aortic valve, particularly at locations of aneurysm formation. AREAS TIMELY FOR DEVELOPING RESEARCH With further validation, functional assessment of the aorta may help identify patients at risk of aortic complications, and introduce new haemodynamic indices into management guidelines.
Collapse
Affiliation(s)
- Pouya Youssefi
- Department of Cardiothoracic Surgery & Cardiology, St. George's Hospital, St. George's University of London, Blackshaw Road, London, SW17 0QT, United Kingdom.,Department of Biomedical Engineering, Rayne Institute, St. Thomas' Hospital, King's College London, London SE1 7EH, United Kingdom
| | - Rajan Sharma
- Department of Cardiothoracic Surgery & Cardiology, St. George's Hospital, St. George's University of London, Blackshaw Road, London, SW17 0QT, United Kingdom
| | - C Alberto Figueroa
- Department of Biomedical Engineering, Rayne Institute, St. Thomas' Hospital, King's College London, London SE1 7EH, United Kingdom.,Departments of Surgery and Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109 USA
| | - Marjan Jahangiri
- Department of Cardiothoracic Surgery & Cardiology, St. George's Hospital, St. George's University of London, Blackshaw Road, London, SW17 0QT, United Kingdom
| |
Collapse
|
83
|
Laviña B. Brain Vascular Imaging Techniques. Int J Mol Sci 2016; 18:ijms18010070. [PMID: 28042833 PMCID: PMC5297705 DOI: 10.3390/ijms18010070] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 12/13/2016] [Accepted: 12/26/2016] [Indexed: 12/13/2022] Open
Abstract
Recent major improvements in a number of imaging techniques now allow for the study of the brain in ways that could not be considered previously. Researchers today have well-developed tools to specifically examine the dynamic nature of the blood vessels in the brain during development and adulthood; as well as to observe the vascular responses in disease situations in vivo. This review offers a concise summary and brief historical reference of different imaging techniques and how these tools can be applied to study the brain vasculature and the blood-brain barrier integrity in both healthy and disease states. Moreover, it offers an overview on available transgenic animal models to study vascular biology and a description of useful online brain atlases.
Collapse
Affiliation(s)
- Bàrbara Laviña
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, 75185 Uppsala, Sweden.
| |
Collapse
|
84
|
Atkins SK, McNally A, Sucosky P. Mechanobiology in Cardiovascular Disease Management: Potential Strategies and Current Needs. Front Bioeng Biotechnol 2016; 4:79. [PMID: 27777927 PMCID: PMC5056184 DOI: 10.3389/fbioe.2016.00079] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 09/26/2016] [Indexed: 01/17/2023] Open
Affiliation(s)
- Samantha K Atkins
- Department of Aerospace and Mechanical Engineering, University of Notre Dame , Notre Dame, IN , USA
| | - Andrew McNally
- Department of Aerospace and Mechanical Engineering, University of Notre Dame , Notre Dame, IN , USA
| | - Philippe Sucosky
- Department of Materials and Mechanical Engineering, Wright State University , Dayton, OH , USA
| |
Collapse
|
85
|
Roditi G. Special Issue - Spotlight on Cardiovascular Imaging. Clin Radiol 2016; 71:719-21. [PMID: 27180080 DOI: 10.1016/j.crad.2016.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 04/15/2016] [Accepted: 04/18/2016] [Indexed: 11/26/2022]
Affiliation(s)
- G Roditi
- Department of Radiology, University of Glasgow, Glasgow Royal Infirmary, 16 Alexandra Parade, Glasgow G31 2ER, UK.
| |
Collapse
|