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Wieben O, Roberts GS, Corrado PA, Johnson KM, Roldán-Alzate A. Four-Dimensional Flow MR Imaging: Technique and Advances. Magn Reson Imaging Clin N Am 2023; 31:433-449. [PMID: 37414470 DOI: 10.1016/j.mric.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
4D Flow MRI is an advanced imaging technique for comprehensive non-invasive assessment of the cardiovascular system. The capture of the blood velocity vector field throughout the cardiac cycle enables measures of flow, pulse wave velocity, kinetic energy, wall shear stress, and more. Advances in hardware, MRI data acquisition and reconstruction methodology allow for clinically feasible scan times. The availability of 4D Flow analysis packages allows for more widespread use in research and the clinic and will facilitate much needed multi-center, multi-vendor studies in order to establish consistency across scanner platforms and to enable larger scale studies to demonstrate clinical value.
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Affiliation(s)
- Oliver Wieben
- Department of Medical Physics, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Avenue, Suite 1127, Madison, WI 53705-2275, USA; Department of Radiology, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Avenue, Suite 1127, Madison, WI 53705-2275, USA.
| | - Grant S Roberts
- Department of Medical Physics, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Avenue, Madison, WI 53705-2275, USA
| | - Philip A Corrado
- Accuray Incorporated, 1414 Raleigh Road, Suite 330, DurhamChapel Hill, NC 27517, USA
| | - Kevin M Johnson
- Department of Medical Physics, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Avenue, Room 1133, Madison, WI 53705-2275, USA; Department of Radiology, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Avenue, Room 1133, Madison, WI 53705-2275, USA
| | - Alejandro Roldán-Alzate
- Department of Mechanical Engineering, University of Wisconsin-Madison, Room: 3035, 1513 University Avenue, Madison, WI 53706, USA; Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA
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2
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Bissell MM, Raimondi F, Ait Ali L, Allen BD, Barker AJ, Bolger A, Burris N, Carhäll CJ, Collins JD, Ebbers T, Francois CJ, Frydrychowicz A, Garg P, Geiger J, Ha H, Hennemuth A, Hope MD, Hsiao A, Johnson K, Kozerke S, Ma LE, Markl M, Martins D, Messina M, Oechtering TH, van Ooij P, Rigsby C, Rodriguez-Palomares J, Roest AAW, Roldán-Alzate A, Schnell S, Sotelo J, Stuber M, Syed AB, Töger J, van der Geest R, Westenberg J, Zhong L, Zhong Y, Wieben O, Dyverfeldt P. 4D Flow cardiovascular magnetic resonance consensus statement: 2023 update. J Cardiovasc Magn Reson 2023; 25:40. [PMID: 37474977 PMCID: PMC10357639 DOI: 10.1186/s12968-023-00942-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/30/2023] [Indexed: 07/22/2023] Open
Abstract
Hemodynamic assessment is an integral part of the diagnosis and management of cardiovascular disease. Four-dimensional cardiovascular magnetic resonance flow imaging (4D Flow CMR) allows comprehensive and accurate assessment of flow in a single acquisition. This consensus paper is an update from the 2015 '4D Flow CMR Consensus Statement'. We elaborate on 4D Flow CMR sequence options and imaging considerations. The document aims to assist centers starting out with 4D Flow CMR of the heart and great vessels with advice on acquisition parameters, post-processing workflows and integration into clinical practice. Furthermore, we define minimum quality assurance and validation standards for clinical centers. We also address the challenges faced in quality assurance and validation in the research setting. We also include a checklist for recommended publication standards, specifically for 4D Flow CMR. Finally, we discuss the current limitations and the future of 4D Flow CMR. This updated consensus paper will further facilitate widespread adoption of 4D Flow CMR in the clinical workflow across the globe and aid consistently high-quality publication standards.
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Affiliation(s)
- Malenka M Bissell
- Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), LIGHT Laboratories, Clarendon Way, University of Leeds, Leeds, LS2 9NL, UK.
| | | | - Lamia Ait Ali
- Institute of Clinical Physiology CNR, Massa, Italy
- Foundation CNR Tuscany Region G. Monasterio, Massa, Italy
| | - Bradley D Allen
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alex J Barker
- Department of Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Center, Aurora, USA
| | - Ann Bolger
- Department of Medicine, University of California, San Francisco, CA, USA
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Nicholas Burris
- Department of Radiology, University of Michigan, Ann Arbor, USA
| | - Carl-Johan Carhäll
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | | | - Tino Ebbers
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | | | - Alex Frydrychowicz
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck and Universität Zu Lübeck, Lübeck, Germany
| | - Pankaj Garg
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Julia Geiger
- Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Hojin Ha
- Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon, South Korea
| | - Anja Hennemuth
- Institute of Computer-Assisted Cardiovascular Medicine, Charité - Universitätsmedizin, Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site, Berlin, Germany
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael D Hope
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Albert Hsiao
- Department of Radiology, University of California, San Diego, CA, USA
| | - Kevin Johnson
- Departments of Radiology and Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Liliana E Ma
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michael Markl
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Duarte Martins
- Department of Pediatric Cardiology, Hospital de Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Marci Messina
- Department of Radiology, Northwestern Medicine, Chicago, IL, USA
| | - Thekla H Oechtering
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck and Universität Zu Lübeck, Lübeck, Germany
- Departments of Radiology and Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Pim van Ooij
- Department of Radiology & Nuclear Medicine, Amsterdam Cardiovascular Sciences, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands
- Department of Pediatric Cardiology, Division of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cynthia Rigsby
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Medical Imaging, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Jose Rodriguez-Palomares
- Department of Cardiology, Hospital Universitari Vall d´Hebron,Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain
| | - Arno A W Roest
- Department of Pediatric Cardiology, Willem-Alexander's Children Hospital, Leiden University Medical Center and Center for Congenital Heart Defects Amsterdam-Leiden, Leiden, The Netherlands
| | | | - Susanne Schnell
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Medical Physics, Institute of Physics, University of Greifswald, Greifswald, Germany
| | - Julio Sotelo
- School of Biomedical Engineering, Universidad de Valparaíso, Valparaíso, Chile
- Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Millennium Institute for Intelligent Healthcare Engineering - iHEALTH, Santiago, Chile
| | - Matthias Stuber
- Département de Radiologie Médicale, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Ali B Syed
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Johannes Töger
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Rob van der Geest
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jos Westenberg
- CardioVascular Imaging Group (CVIG), Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Liang Zhong
- National Heart Centre Singapore, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Yumin Zhong
- Department of Radiology, School of Medicine, Shanghai Children's Medical Center Affiliated With Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Oliver Wieben
- Departments of Radiology and Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Petter Dyverfeldt
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
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Falcão MBL, Rossi GMC, Rutz T, Prša M, Tenisch E, Ma L, Weiss EK, Baraboo JJ, Yerly J, Markl M, Stuber M, Roy CW. Focused navigation for respiratory-motion-corrected free-running radial 4D flow MRI. Magn Reson Med 2023; 90:117-132. [PMID: 36877140 PMCID: PMC10149606 DOI: 10.1002/mrm.29634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 03/07/2023]
Abstract
PURPOSE To validate a respiratory motion correction method called focused navigation (fNAV) for free-running radial whole-heart 4D flow MRI. METHODS Using fNAV, respiratory signals derived from radial readouts are converted into three orthogonal displacements, which are then used to correct respiratory motion in 4D flow datasets. Hundred 4D flow acquisitions were simulated with non-rigid respiratory motion and used for validation. The difference between generated and fNAV displacement coefficients was calculated. Vessel area and flow measurements from 4D flow reconstructions with (fNAV) and without (uncorrected) motion correction were compared to the motion-free ground-truth. In 25 patients, the same measurements were compared between fNAV 4D flow, 2D flow, navigator-gated Cartesian 4D flow, and uncorrected 4D flow datasets. RESULTS For simulated data, the average difference between generated and fNAV displacement coefficients was 0.04± $$ \pm $$ 0.32 mm and 0.31± $$ \pm $$ 0.35 mm in the x and y directions, respectively. In the z direction, this difference was region-dependent (0.02± $$ \pm $$ 0.51 mm up to 5.85± $$ \pm $$ 3.41 mm). For all measurements (vessel area, net volume, and peak flow), the average difference from ground truth was higher for uncorrected 4D flow datasets (0.32± $$ \pm $$ 0.11 cm2 , 11.1± $$ \pm $$ 3.5 mL, and 22.3± $$ \pm $$ 6.0 mL/s) than for fNAV 4D flow datasets (0.10± $$ \pm $$ 0.03 cm2 , 2.6± $$ \pm $$ 0.7 mL, and 5.1± 0 $$ \pm 0 $$ .9 mL/s, p < 0.05). In vivo, average vessel area measurements were 4.92± $$ \pm $$ 2.95 cm2 , 5.06± $$ \pm $$ 2.64 cm2 , 4.87± $$ \pm $$ 2.57 cm2 , 4.87± $$ \pm $$ 2.69 cm2 , for 2D flow and fNAV, navigator-gated and uncorrected 4D flow datasets, respectively. In the ascending aorta, all 4D flow datasets except for the fNAV reconstruction had significantly different vessel area measurements from 2D flow. Overall, 2D flow datasets demonstrated the strongest correlation to fNAV 4D flow for both net volume (r2 = 0.92) and peak flow (r2 = 0.94), followed by navigator-gated 4D flow (r2 = 0.83 and r2 = 0.86, respectively), and uncorrected 4D flow (r2 = 0.69 and r2 = 0.86, respectively). CONCLUSION fNAV corrected respiratory motion in vitro and in vivo, resulting in fNAV 4D flow measurements that are comparable to those derived from 2D flow and navigator-gated Cartesian 4D flow datasets, with improvements over those from uncorrected 4D flow.
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Affiliation(s)
- Mariana B. L. Falcão
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Giulia M. C. Rossi
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Tobias Rutz
- Service of Cardiology, Centre de Resonance Magnétique Cardiaque (CRMC), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Milan Prša
- Woman-Mother-Child Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Estelle Tenisch
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Liliana Ma
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois USA
- Department of Biomedical Engineering, Northwestern University, Chicago, Illinois USA
| | - Elizabeth K. Weiss
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois USA
- Department of Biomedical Engineering, Northwestern University, Chicago, Illinois USA
| | - Justin J. Baraboo
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois USA
- Department of Biomedical Engineering, Northwestern University, Chicago, Illinois USA
| | - Jérôme Yerly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois USA
- Department of Biomedical Engineering, Northwestern University, Chicago, Illinois USA
| | - Matthias Stuber
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Christopher W. Roy
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
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Roberts GS, Hoffman CA, Rivera-Rivera LA, Berman SE, Eisenmenger LB, Wieben O. Automated hemodynamic assessment for cranial 4D flow MRI. Magn Reson Imaging 2023; 97:46-55. [PMID: 36581214 PMCID: PMC9892280 DOI: 10.1016/j.mri.2022.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/23/2022] [Indexed: 12/27/2022]
Abstract
Cranial 4D flow MRI post-processing typically involves manual user interaction which is time-consuming and associated with poor repeatability. The primary goal of this study is to develop a robust quantitative velocity tool (QVT) that utilizes threshold-based segmentation techniques to improve segmentation quality over prior approaches based on centerline processing schemes (CPS) that utilize k-means clustering segmentation. This tool also includes an interactive 3D display designed for simplified vessel selection and automated hemodynamic visualization and quantification. The performances of QVT and CPS were compared in vitro in a flow phantom and in vivo in 10 healthy participants. Vessel segmentations were compared with ground-truth computed tomography in vitro (29 locations) and manual segmentation in vivo (13 locations) using linear regression. Additionally, QVT and CPS MRI flow rates were compared to perivascular ultrasound flow in vitro using linear regression. To assess internal consistency of flow measures in vivo, conservation of flow was assessed at vessel junctions using linear regression and consistency of flow along vessel segments was analyzed by fitting a Gaussian distribution to a histogram of normalized flow values. Post-processing times were compared between the QVT and CPS using paired t-tests. Vessel areas segmented in vitro (CPS: slope = 0.71, r = 0.95 and QVT: slope = 1.03, r = 0.95) and in vivo (CPS: slope = 0.61, r = 0.96 and QVT: slope = 0.93, r = 0.96) were strongly correlated with ground-truth area measurements. However, CPS (using k-means segmentation) consistently underestimated vessel areas. Strong correlations were observed between QVT and ultrasound flow (slope = 0.98, r = 0.96) as well as flow at junctions (slope = 1.05, r = 0.98). Mean and standard deviation of flow along vessel segments was 9.33e-16 ± 3.05%. Additionally, the QVT demonstrated excellent interobserver agreement and significantly reduced post-processing by nearly 10 min (p < 0.001). By completely automating post-processing and providing an easy-to-use 3D visualization interface for interactive vessel selection and hemodynamic quantification, the QVT offers an efficient, robust, and repeatable means to analyze cranial 4D flow MRI. This software is freely available at: https://github.com/uwmri/QVT.
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Affiliation(s)
- Grant S Roberts
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Avenue #1005, Madison, WI 53705, USA.
| | - Carson A Hoffman
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Avenue #1005, Madison, WI 53705, USA
| | - Leonardo A Rivera-Rivera
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Avenue #1005, Madison, WI 53705, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, USA.
| | - Sara E Berman
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, USA.
| | - Laura B Eisenmenger
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, E3/366 Clinical Science Center, Madison, WI 53792, USA.
| | - Oliver Wieben
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Avenue #1005, Madison, WI 53705, USA; Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, E3/366 Clinical Science Center, Madison, WI 53792, USA.
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5
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Kim D, Jen ML, Eisenmenger LB, Johnson KM. Accelerated 4D-flow MRI with 3-point encoding enabled by machine learning. Magn Reson Med 2023; 89:800-811. [PMID: 36198027 PMCID: PMC9712238 DOI: 10.1002/mrm.29469] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 08/22/2022] [Accepted: 09/06/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE To investigate the acceleration of 4D-flow MRI using a convolutional neural network (CNN) that produces three directional velocities from three flow encodings, without requiring a fourth reference scan measuring background phase. METHODS A fully 3D CNN using a U-net architecture was trained in a block-wise fashion to take complex images from three flow encodings and to produce three real-valued images for each velocity component. Using neurovascular 4D-flow scans (n = 144), the CNN was trained to predict velocities computed from four flow encodings by standard reconstruction including correction for residual background phase offsets. Methods to optimize loss functions were investigated, including magnitude, complex difference, and uniform velocity weightings. Subsequently, 3-point encoding was evaluated using cross validation of pixelwise correlation, flow measurements in major arteries, and in experiments with data at differing acceleration rates than the training data. RESULTS The CNN-produced 3-point velocities showed excellent agreements with the 4-point velocities, both qualitatively in velocity images, in flow rate measures, and quantitatively in regression analysis (slope = 0.96, R2 = 0.992). Optimizing the training to focus on vessel velocities rather than the global velocity error and improved the correlation of velocity within vessels themselves. The lowest error was observed when the loss function used uniform velocity weighting, in which the magnitude-weighted inverse of the velocity frequency uniformly distributed weighting across all velocity ranges. When applied to highly accelerated data, the 3-point network maintained a high correlation with ground truth data and demonstrated a denoising effect. CONCLUSION The 4D-flow MRI can be accelerated using machine learning requiring only three flow encodings to produce three-directional velocity maps with small errors.
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Affiliation(s)
- Dahan Kim
- Department of Physics, University of Wisconsin, Madison, Wisconsin, USA,Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Mu-Lan Jen
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Laura B. Eisenmenger
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Kevin M. Johnson
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA,Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Vijayakrishnan Nair V, Kish BR, Inglis B, Yang HC(S, Wright AM, Wu YC, Zhou X, Schwichtenberg AJ, Tong Y. Human CSF movement influenced by vascular low frequency oscillations and respiration. Front Physiol 2022; 13:940140. [PMID: 36060685 PMCID: PMC9437252 DOI: 10.3389/fphys.2022.940140] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/11/2022] [Indexed: 12/03/2022] Open
Abstract
Cerebrospinal fluid (CSF) movement through the pathways within the central nervous system is of high significance for maintaining normal brain health and function. Low frequency hemodynamics and respiration have been shown to drive CSF in humans independently. Here, we hypothesize that CSF movement may be driven simultaneously (and in synchrony) by both mechanisms and study their independent and coupled effects on CSF movement using novel neck fMRI scans. Caudad CSF movement at the fourth ventricle and hemodynamics of the major neck blood vessels (internal carotid arteries and internal jugular veins) was measured from 11 young, healthy volunteers using novel neck fMRI scans with simultaneous measurement of respiration. Two distinct models of CSF movement (1. Low-frequency hemodynamics and 2. Respiration) and possible coupling between them were investigated. We show that the dynamics of brain fluids can be assessed from the neck by studying the interrelationships between major neck blood vessels and the CSF movement in the fourth ventricle. We also demonstrate that there exists a cross-frequency coupling between these two separable mechanisms. The human CSF system can respond to multiple coupled physiological forces at the same time. This information may help inform the pathological mechanisms behind CSF movement-related disorders.
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Affiliation(s)
| | - Brianna R. Kish
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - Ben Inglis
- Henry H. Wheeler, Jr. Brain Imaging Center, Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
| | - Ho-Ching (Shawn) Yang
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Adam M. Wright
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - Yu-Chien Wu
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Xiaopeng Zhou
- School of Health Sciences, Purdue University, West Lafayette, IN, United States
| | - Amy J. Schwichtenberg
- Department of Human Development and Family Studies, College of Health and Human Sciences, Purdue University, West Lafayette, IN, United States
| | - Yunjie Tong
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
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7
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Macdonald JA, Roberts GS, Corrado PA, Beshish AG, Haraldsdottir K, Barton GP, Goss KN, Eldridge MW, Francois CJ, Wieben O. Exercise-induced irregular right heart flow dynamics in adolescents and young adults born preterm. J Cardiovasc Magn Reson 2021; 23:116. [PMID: 34670573 PMCID: PMC8529801 DOI: 10.1186/s12968-021-00816-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/24/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Preterm birth has been linked to an elevated risk of heart failure and cardiopulmonary disease later in life. With improved neonatal care and survival, most infants born preterm are now reaching adulthood. In this study, we used 4D flow cardiovascular magnetic resonance (CMR) coupled with an exercise challenge to assess the impact of preterm birth on right heart flow dynamics in otherwise healthy adolescents and young adults who were born preterm. METHODS Eleven young adults and 17 adolescents born preterm (< 32 weeks of gestation and < 1500 g birth weight) were compared to 11 young adult and 18 adolescent age-matched controls born at term. Stroke volume, cardiac output, and flow in the main pulmonary artery were quantified with 4D flow CMR. Kinetic energy and vorticity were measured in the right ventricle. All parameters were measured at rest and during exercise at a power corresponding to 70% VO2max for each subject. Multivariate linear regression was used to perform age-adjusted term-preterm comparisons. RESULTS With exercise, stroke volume increased 10 ± 21% in term controls and decreased 4 ± 18% in preterm born subjects (p = 0.007). This resulted in significantly reduced capacity to increase cardiac output in response to exercise stress for the preterm group (58 ± 26% increase in controls, 36 ± 27% increase in preterm, p = 0.004). Elevated kinetic energy (KEterm = 71 ± 22 nJ, KEpreterm = 87 ± 38 nJ, p = 0.03) and vorticity (ωterm = 79 ± 16 s-1, ωpreterm = 94 ± 32 s-1, p = 0.01) during diastole in the right ventricle (RV) suggested altered RV flow dynamics in the preterm subjects. Streamline visualizations showed altered structure to the diastolic filling vortices in those born preterm. CONCLUSIONS For the participants examined here, preterm birth appeared to result in altered right-heart flow dynamics as early as adolescence, especially during diastole. Future studies should evaluate whether the altered dynamics identified here evolves into cardiopulmonary disease later in life. Trial registration None.
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Affiliation(s)
| | - Grant S Roberts
- Medical Physics, University of Wisconsin-Madison, Madison, USA
| | | | - Arij G Beshish
- Pediatrics, University of Wisconsin-Madison, Madison, USA
| | | | | | - Kara N Goss
- Pediatrics, University of Wisconsin-Madison, Madison, USA
- Medicine, University of Wisconsin-Madison, Madison, USA
| | - Marlowe W Eldridge
- Pediatrics, University of Wisconsin-Madison, Madison, USA
- Biomedical Engineering, University of Wisconsin-Madison, Madison, USA
| | | | - Oliver Wieben
- Medical Physics, University of Wisconsin-Madison, Madison, USA
- Biomedical Engineering, University of Wisconsin-Madison, Madison, USA
- Radiology, University of Wisconsin-Madison, Madison, USA
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8
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Liu L, Xing Y, Chen Y, Ji X, Ge J, Wang L. Eye-Neck Integrated Ultrasound in Idiopathic Intracranial Hypertension and Cerebral Venous Sinus Thrombosis. Front Neurol 2021; 12:696665. [PMID: 34354665 PMCID: PMC8334180 DOI: 10.3389/fneur.2021.696665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 06/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The clinical presentation of cerebral venous sinus thrombosis (CVST) overlaps with that of idiopathic intracranial hypertension (IIH), but no screening tool exists. We investigated the role of eye-neck integrated ultrasound in the diagnosis and differentiation of IIH and CVST. Methods: Twenty IIH patients, 30 CVST patients, and 40 healthy controls were retrospectively analyzed. The ultrasonographic optic nerve sheath diameter (ONSD) and hemodynamic characteristics of the internal jugular veins (IJVs) were recorded. The cerebrospinal fluid opening pressure was measured after ultrasonic examination. Results: The ONSD was significantly larger in IIH patients than in controls (4.71 ± 0.41 vs. 3.93 ± 0.24 mm, p < 0.001). The ONSD cut-off for IIH diagnosis was 4.25 mm (AUC = 0.978; 95% CI: 0.95-1.0, p < 0.001, sensitivity: 90%, specificity: 93%). In the CVST group, 22 (73.3%) patients had elevated intracranial pressure (ICP); the mean ONSD was significantly higher in patients with increased ICP than in those without (4.43 ± 0.33 vs. 3.95 ± 0.17 mm, p < 0.001). The mean blood flow volume (BFV) was significantly reduced in CVST patients (425.17 ± 349.83 mL/min) compared to that in controls (680.37 ± 233.03 mL/min, p < 0.001) and IIH patients (617.67 ± 282.96 mL/min, p = 0.008). The optimal BFV cut-off for predicting CVST was 527.28 mL/min (AUC = 0.804, 95% CI: 0.68-0.93, p < 0.001, sensitivity: 80%, specificity: 78%). The velocity of the unilateral IJVs-J3 segment decreased or remained constant during deep inspiration (abnormal respiratory modulate blood flow test, ARMT) in 32.5% of controls, with no bilateral ARMT. The prevalence of bilateral ARMT was 25% in IIH patients (χ2 = 12.9, p = 0.005) and 27% in CVST patients (χ2 = 17.6, p = 0.001). Conclusion: Eye-neck integrated ultrasound is an easily available bedside technique to assess ICP and hemodynamic characteristics of IJVs. ONSD measurement can identify patients with increased ICP, and reduced IJV BFV may aid the differentiation of CVST and IIH.
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Affiliation(s)
- Li Liu
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
- Department of Neurology, Changchun People's Hospital, Changchun, China
| | - Yingqi Xing
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
- Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ying Chen
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Xiaorui Ji
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Jiaojiao Ge
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Lijuan Wang
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
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9
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Ma LE, Yerly J, Piccini D, Di Sopra L, Roy CW, Carr JC, Rigsby CK, Kim D, Stuber M, Markl M. 5D Flow MRI: A Fully Self-gated, Free-running Framework for Cardiac and Respiratory Motion-resolved 3D Hemodynamics. Radiol Cardiothorac Imaging 2020; 2:e200219. [PMID: 33385164 PMCID: PMC7755133 DOI: 10.1148/ryct.2020200219] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To implement, validate, and apply a self-gated free-running whole-heart five-dimensional (5D) flow MRI framework to evaluate respiration-driven effects on three-dimensional (3D) hemodynamics in a clinical setting. MATERIALS AND METHODS In this prospective study, a free-running five-dimensional (5D) flow sequence was implemented with 3D radial sampling, self-gating, and a compressed-sensing reconstruction. The 5D flow was evaluated in a pulsatile phantom and adult participants with aortic and/or valvular disease who were enrolled between May and August 2019. Conventional twofold-accelerated four-dimensional (4D) flow of the thoracic aorta with navigator gating was performed as a reference comparison. Continuous parameters were evaluated for parameter normality and were compared between conventional 4D flow and 5D flow using a signed-rank or two-tailed paired t test. Differences between respiratory states were evaluated using a repeated-measure analysis of variance or a nonparametric Friedman test. RESULTS A total of 20 adult participants (mean age, 49 years ± 17 [standard deviation]; 18 men and two women) were included. In vitro 5D flow results showed excellent agreement with conventional 4D flow-derived values (peak and net flow, <7% difference over all quantified planes). Whole-heart 5D flow data were collected in all participants in 7.65 minutes ± 0.35 (acceleration rate = 36.0-76.9) versus 9.88 minutes ± 3.17 for conventional aortic 4D flow. In vivo, 5D flow demonstrated moderate agreement with conventional 4D flow but demonstrated overestimation in net flow and peak velocity (up to 26% and 12%, respectively) in the ascending aorta and underestimation (<12%) in the arch and descending aorta. Respiratory-resolved analyses of caval veins showed significantly increased net and peak flow in the inferior vena cava in end inspiration compared with end expiration, and the opposite trend was shown in the superior vena cava. CONCLUSION A free-running 5D flow MRI framework consistently captured cardiac and respiratory motion-resolved 3D hemodynamics in less than 8 minutes. Supplemental material is available for this article. © RSNA, 2020.
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Affiliation(s)
- Liliana E. Ma
- From the Departments of Radiology, Feinberg School of Medicine (L.E.M., J.C.C., C.K.R., D.K., M.M.) and Biomedical Engineering (L.E.M., J.C.C., D.K., M.M.), Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (J.Y., D.P., L.D.S., C.W.R., M.S.); Center for Biomedical Imaging, Lausanne, Switzerland (J.Y., M.S.); Department of Advanced Clinical Imaging Technology, Siemens Healthineers, Lausanne, Switzerland (D.P.); and Department of Medical Imaging, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Ill (C.K.R.)
| | - Jérôme Yerly
- From the Departments of Radiology, Feinberg School of Medicine (L.E.M., J.C.C., C.K.R., D.K., M.M.) and Biomedical Engineering (L.E.M., J.C.C., D.K., M.M.), Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (J.Y., D.P., L.D.S., C.W.R., M.S.); Center for Biomedical Imaging, Lausanne, Switzerland (J.Y., M.S.); Department of Advanced Clinical Imaging Technology, Siemens Healthineers, Lausanne, Switzerland (D.P.); and Department of Medical Imaging, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Ill (C.K.R.)
| | - Davide Piccini
- From the Departments of Radiology, Feinberg School of Medicine (L.E.M., J.C.C., C.K.R., D.K., M.M.) and Biomedical Engineering (L.E.M., J.C.C., D.K., M.M.), Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (J.Y., D.P., L.D.S., C.W.R., M.S.); Center for Biomedical Imaging, Lausanne, Switzerland (J.Y., M.S.); Department of Advanced Clinical Imaging Technology, Siemens Healthineers, Lausanne, Switzerland (D.P.); and Department of Medical Imaging, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Ill (C.K.R.)
| | - Lorenzo Di Sopra
- From the Departments of Radiology, Feinberg School of Medicine (L.E.M., J.C.C., C.K.R., D.K., M.M.) and Biomedical Engineering (L.E.M., J.C.C., D.K., M.M.), Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (J.Y., D.P., L.D.S., C.W.R., M.S.); Center for Biomedical Imaging, Lausanne, Switzerland (J.Y., M.S.); Department of Advanced Clinical Imaging Technology, Siemens Healthineers, Lausanne, Switzerland (D.P.); and Department of Medical Imaging, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Ill (C.K.R.)
| | - Christopher W. Roy
- From the Departments of Radiology, Feinberg School of Medicine (L.E.M., J.C.C., C.K.R., D.K., M.M.) and Biomedical Engineering (L.E.M., J.C.C., D.K., M.M.), Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (J.Y., D.P., L.D.S., C.W.R., M.S.); Center for Biomedical Imaging, Lausanne, Switzerland (J.Y., M.S.); Department of Advanced Clinical Imaging Technology, Siemens Healthineers, Lausanne, Switzerland (D.P.); and Department of Medical Imaging, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Ill (C.K.R.)
| | - James C. Carr
- From the Departments of Radiology, Feinberg School of Medicine (L.E.M., J.C.C., C.K.R., D.K., M.M.) and Biomedical Engineering (L.E.M., J.C.C., D.K., M.M.), Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (J.Y., D.P., L.D.S., C.W.R., M.S.); Center for Biomedical Imaging, Lausanne, Switzerland (J.Y., M.S.); Department of Advanced Clinical Imaging Technology, Siemens Healthineers, Lausanne, Switzerland (D.P.); and Department of Medical Imaging, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Ill (C.K.R.)
| | - Cynthia K. Rigsby
- From the Departments of Radiology, Feinberg School of Medicine (L.E.M., J.C.C., C.K.R., D.K., M.M.) and Biomedical Engineering (L.E.M., J.C.C., D.K., M.M.), Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (J.Y., D.P., L.D.S., C.W.R., M.S.); Center for Biomedical Imaging, Lausanne, Switzerland (J.Y., M.S.); Department of Advanced Clinical Imaging Technology, Siemens Healthineers, Lausanne, Switzerland (D.P.); and Department of Medical Imaging, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Ill (C.K.R.)
| | - Daniel Kim
- From the Departments of Radiology, Feinberg School of Medicine (L.E.M., J.C.C., C.K.R., D.K., M.M.) and Biomedical Engineering (L.E.M., J.C.C., D.K., M.M.), Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (J.Y., D.P., L.D.S., C.W.R., M.S.); Center for Biomedical Imaging, Lausanne, Switzerland (J.Y., M.S.); Department of Advanced Clinical Imaging Technology, Siemens Healthineers, Lausanne, Switzerland (D.P.); and Department of Medical Imaging, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Ill (C.K.R.)
| | - Matthias Stuber
- From the Departments of Radiology, Feinberg School of Medicine (L.E.M., J.C.C., C.K.R., D.K., M.M.) and Biomedical Engineering (L.E.M., J.C.C., D.K., M.M.), Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (J.Y., D.P., L.D.S., C.W.R., M.S.); Center for Biomedical Imaging, Lausanne, Switzerland (J.Y., M.S.); Department of Advanced Clinical Imaging Technology, Siemens Healthineers, Lausanne, Switzerland (D.P.); and Department of Medical Imaging, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Ill (C.K.R.)
| | - Michael Markl
- From the Departments of Radiology, Feinberg School of Medicine (L.E.M., J.C.C., C.K.R., D.K., M.M.) and Biomedical Engineering (L.E.M., J.C.C., D.K., M.M.), Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (J.Y., D.P., L.D.S., C.W.R., M.S.); Center for Biomedical Imaging, Lausanne, Switzerland (J.Y., M.S.); Department of Advanced Clinical Imaging Technology, Siemens Healthineers, Lausanne, Switzerland (D.P.); and Department of Medical Imaging, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Ill (C.K.R.)
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Macdonald JA, Beshish AG, Corrado PA, Barton GP, Goss KN, Eldridge MW, François CJ, Wieben O. Feasibility of Cardiovascular Four-dimensional Flow MRI during Exercise in Healthy Participants. Radiol Cardiothorac Imaging 2020; 2:e190033. [PMID: 32734274 DOI: 10.1148/ryct.2020190033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 11/04/2019] [Accepted: 12/23/2019] [Indexed: 11/11/2022]
Abstract
Purpose To explore the feasibility of using four-dimensional (4D) flow MRI to quantify blood flow and kinetic energy (KE) in the heart during strenuous exercise. Materials and Methods For this prospective study, cardiac 4D flow MRI was performed in 11 healthy young adult participants (eight men, three women; mean age, 26 years ± 1 [standard deviation]) at rest and during exercise with an MRI-compatible exercise stepper between March 2016 and July 2017. Flow was measured in the ascending aorta (AAo) and main pulmonary artery (MPA). KE was quantified in the left and right ventricle. Significant changes in flow and KE during exercise were identified by using t tests. Repeatability was assessed with inter- and intraobserver comparisons and an analysis of internal flow consistency. Results Nine participants successfully completed both rest and exercise imaging. Internal flow consistency analysis in systemic and pulmonary circulation showed average relative differences of 10% at rest and 16% during exercise. For flow measurements in the AAo and MPA, relative differences between observers never exceeded 6% in any vessel and showed excellent correlation, even during exercise. Relative differences were increased for KE, typically on the order of 30%, with poor interobserver correlation between measurements. Conclusion Four-dimensional flow MRI can quantify increases in flow in the AAo and MPA during strenuous exercise and is highly repeatable. KE had reduced repeatability because of suboptimal segmentation methods and requires further development before clinical implementation. Supplemental material is available for this article. © RSNA, 2020See also the commentary by Markl and Lee in this issue.
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Affiliation(s)
- Jacob A Macdonald
- Departments of Medical Physics (J.A.M., P.A.C., O.W.), Pediatrics (A.G.B., G.P.B., K.N.G., M.W.E.), Medicine (K.N.G.), Biomedical Engineering (M.W.E., O.W.), and Radiology (C.J.F., O.W.), University of Wisconsin, 1111 Highland Ave, Room 1005, Madison, WI 53705
| | - Arij G Beshish
- Departments of Medical Physics (J.A.M., P.A.C., O.W.), Pediatrics (A.G.B., G.P.B., K.N.G., M.W.E.), Medicine (K.N.G.), Biomedical Engineering (M.W.E., O.W.), and Radiology (C.J.F., O.W.), University of Wisconsin, 1111 Highland Ave, Room 1005, Madison, WI 53705
| | - Philip A Corrado
- Departments of Medical Physics (J.A.M., P.A.C., O.W.), Pediatrics (A.G.B., G.P.B., K.N.G., M.W.E.), Medicine (K.N.G.), Biomedical Engineering (M.W.E., O.W.), and Radiology (C.J.F., O.W.), University of Wisconsin, 1111 Highland Ave, Room 1005, Madison, WI 53705
| | - Gregory P Barton
- Departments of Medical Physics (J.A.M., P.A.C., O.W.), Pediatrics (A.G.B., G.P.B., K.N.G., M.W.E.), Medicine (K.N.G.), Biomedical Engineering (M.W.E., O.W.), and Radiology (C.J.F., O.W.), University of Wisconsin, 1111 Highland Ave, Room 1005, Madison, WI 53705
| | - Kara N Goss
- Departments of Medical Physics (J.A.M., P.A.C., O.W.), Pediatrics (A.G.B., G.P.B., K.N.G., M.W.E.), Medicine (K.N.G.), Biomedical Engineering (M.W.E., O.W.), and Radiology (C.J.F., O.W.), University of Wisconsin, 1111 Highland Ave, Room 1005, Madison, WI 53705
| | - Marlowe W Eldridge
- Departments of Medical Physics (J.A.M., P.A.C., O.W.), Pediatrics (A.G.B., G.P.B., K.N.G., M.W.E.), Medicine (K.N.G.), Biomedical Engineering (M.W.E., O.W.), and Radiology (C.J.F., O.W.), University of Wisconsin, 1111 Highland Ave, Room 1005, Madison, WI 53705
| | - Christopher J François
- Departments of Medical Physics (J.A.M., P.A.C., O.W.), Pediatrics (A.G.B., G.P.B., K.N.G., M.W.E.), Medicine (K.N.G.), Biomedical Engineering (M.W.E., O.W.), and Radiology (C.J.F., O.W.), University of Wisconsin, 1111 Highland Ave, Room 1005, Madison, WI 53705
| | - Oliver Wieben
- Departments of Medical Physics (J.A.M., P.A.C., O.W.), Pediatrics (A.G.B., G.P.B., K.N.G., M.W.E.), Medicine (K.N.G.), Biomedical Engineering (M.W.E., O.W.), and Radiology (C.J.F., O.W.), University of Wisconsin, 1111 Highland Ave, Room 1005, Madison, WI 53705
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11
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Rutkowski DR, Barton GP, François CJ, Aggarwal N, Roldán-Alzate A. Sex Differences in Cardiac Flow Dynamics of Healthy Volunteers. Radiol Cardiothorac Imaging 2020; 2. [PMID: 32666051 DOI: 10.1148/ryct.2020190058] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Purpose The purpose of this study was to further understand the relationship between cardiac function and flow, on the basis of sex, by quantifying cardiac flow characteristics and relating them to cardiac muscle performance in young adults. Materials and Methods In this cross-sectional study, cardiac four-dimensional flow (4D flow) magnetic resonance imaging (MRI) and two-dimensional cine MRI were performed on 20 male and 19 female volunteers aged 20-35. Velocity-based metrics of flow, kinetic energy, vorticity, and efficiency indices were quantified, as well as cardiac strain metrics. Results* Peak systolic blood kinetic energy (male: 4.76 ± 2.66 mJ; female: 3.36 ± 1.43 mJ; p=0.047) was significantly higher in the male left ventricle (LV) than in the female LV. Peak systolic vorticity index (male: 0.008 ± 0.005 rad-m2/ml-s; female: 0.014 ± 0.007 rad-m2/ml-s; p=0.007), peak diastolic vorticity index (male: 0.007 ± 0.006 rad-m2/ml-s; female: 0.014 ± 0.010 rad-m2/ml-s; p=0.015), and cycle-average vorticity (male: 0.006 ± 0.001 rad-m2/ml-s; female: 0.011 ± 0.002 rad/s; p=0.001) were all significantly higher in the LV of women than they were in the LV of men. Radial, circumferential, and long-axis strain metrics were significantly higher in the female LV than in the male LV (p<0.05). Circumferential systolic and diastolic strain rates displayed moderate correlation to peak systolic (r=-0.38, p=0.022) and diastolic vorticity (r=0.40, p=0.015) values, respectively. *Results are reported as mean ± standard deviation. Conclusion Left ventricular vorticity metrics were observed to be higher in women than in men and displayed moderate correlation to cardiac strain metrics. The methods and results of this study may be used to further understand the sex-based cardiac efficiency relationship between cardiac function and flow.
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Affiliation(s)
- David R Rutkowski
- Departments of Mechanical Engineering (D.R.R., A.R.A.), Radiology (D.R.R., G.P.B., C.J.F., A.R.A.), Medical Physics (G.P.B.), Cardiovascular Medicine (N.A.), and Biomedical Engineering (A.R.A.), University of Wisconsin-Madison, 1111 Highland Ave, Madison, WI 53705
| | - Gregory P Barton
- Departments of Mechanical Engineering (D.R.R., A.R.A.), Radiology (D.R.R., G.P.B., C.J.F., A.R.A.), Medical Physics (G.P.B.), Cardiovascular Medicine (N.A.), and Biomedical Engineering (A.R.A.), University of Wisconsin-Madison, 1111 Highland Ave, Madison, WI 53705
| | - Christopher J François
- Departments of Mechanical Engineering (D.R.R., A.R.A.), Radiology (D.R.R., G.P.B., C.J.F., A.R.A.), Medical Physics (G.P.B.), Cardiovascular Medicine (N.A.), and Biomedical Engineering (A.R.A.), University of Wisconsin-Madison, 1111 Highland Ave, Madison, WI 53705
| | - Niti Aggarwal
- Departments of Mechanical Engineering (D.R.R., A.R.A.), Radiology (D.R.R., G.P.B., C.J.F., A.R.A.), Medical Physics (G.P.B.), Cardiovascular Medicine (N.A.), and Biomedical Engineering (A.R.A.), University of Wisconsin-Madison, 1111 Highland Ave, Madison, WI 53705
| | - Alejandro Roldán-Alzate
- Departments of Mechanical Engineering (D.R.R., A.R.A.), Radiology (D.R.R., G.P.B., C.J.F., A.R.A.), Medical Physics (G.P.B.), Cardiovascular Medicine (N.A.), and Biomedical Engineering (A.R.A.), University of Wisconsin-Madison, 1111 Highland Ave, Madison, WI 53705
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12
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Schrauben EM, Lim JM, Goolaub DS, Marini D, Seed M, Macgowan CK. Motion robust respiratory-resolved 3D radial flow MRI and its application in neonatal congenital heart disease. Magn Reson Med 2019; 83:535-548. [PMID: 31464030 DOI: 10.1002/mrm.27945] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/09/2019] [Accepted: 07/23/2019] [Indexed: 11/08/2022]
Abstract
PURPOSE To test and implement a motion-robust and respiratory-resolved 3D Radial Flow framework that addresses the need for rapid, high resolution imaging in neonatal patients with congenital heart disease. METHODS A 4-point velocity encoding and 3D radial trajectory with double-golden angle ordering was combined with bulk motion correction (from projection center of mass) and respiration phase detection (from principal component analysis of heartbeat-averaged data) to create motion-robust 3D velocity cardiac time-averaged data. This framework was tested in a whole-chest digital phantom with simulated bulk and realistic physiological motion. In vivo imaging was performed in 20 congenital heart disease infants under feed-and-sleep with submillimeter isotropic resolution in ~3 min. Flows were validated against clinical 2D PCMRI and whole-heart visualizations of blood flow were performed. RESULTS The proposed framework resolved all simulated digital phantom motion states (mean ± standard error: rotation - azimuthal = 0.29 ± 0.02°; translation - Ty = 1.29 ± 0.12 mm, Tz = -0.27 ± 0.13 mm; rotation+translation - polar = 0.49 ± 0.16°, Tx = -2.47 ± 0.51 mm, Tz = 5.78 ± 1.33 mm). Measured timing errors of peak expiration across all signal-to-noise ratio values were 22% of the true respiratory period (range = [404-489 ± 298-334] ms). For in vivo imaging, motion correction improved 3D Radial Flow measurements (no correction: R2 = 0.62, root mean square error = 0.80 L/min/m2 , Bland-Altman bias [limits of agreement] = -0.21 [-1.40, 0.94] L/min/m2 ; motion corrected, expiration: R2 = 0.90, root mean square error = 0.46 L/min/m2 , bias [limits of agreement] = 0.06 [-0.49, 0.62] L/min/m2 ). Respiratory-resolved 3D velocity visualizations were achieved in various neonatal pathologies pre- and postsurgical correction. CONCLUSION 3D cardiac flow may be visualized and accurately quantified in neonatal subjects using the proposed framework. This technique may enable more comprehensive hemodynamic studies in small infants.
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Affiliation(s)
- Eric M Schrauben
- Translational Medicine, Hospital for Sick Children, Toronto, Canada
| | | | - Datta Singh Goolaub
- Translational Medicine, Hospital for Sick Children, Toronto, Canada.,Medical Biophysics, University of Toronto, Toronto, Canada
| | | | - Mike Seed
- Division of Cardiology, Hospital for Sick Children, Toronto, Canada.,Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Christopher K Macgowan
- Translational Medicine, Hospital for Sick Children, Toronto, Canada.,Medical Biophysics, University of Toronto, Toronto, Canada
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Liu J, Wang Y, Wen Z, Feng L, Lima APS, Mahadevan VS, Bolger A, Saloner D, Ordovas K. Extending Cardiac Functional Assessment with Respiratory-Resolved 3D Cine MRI. Sci Rep 2019; 9:11563. [PMID: 31399608 PMCID: PMC6689015 DOI: 10.1038/s41598-019-47869-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 07/25/2019] [Indexed: 01/23/2023] Open
Abstract
This study aimed to develop a cardiorespiratory-resolved 3D magnetic resonance imaging (5D MRI: x-y-z-cardiac-respiratory) approach based on 3D motion tracking for investigating the influence of respiration on cardiac ventricular function. A highly-accelerated 2.5-minute sparse MR protocol was developed for a continuous acquisition of cardiac images through multiple cardiac and respiratory cycles. The heart displacement along respiration was extracted using a 3D image deformation algorithm, and this information was used to cluster the acquired data into multiple respiratory phases. The proposed approach was tested in 15 healthy volunteers (7 females). Cardiac function parameters, including the end-systolic volume (ESV), end-diastolic volume (EDV), stroke volume (SV), and ejection fraction (EF), were measured for the left and right ventricle in both end-expiration and end-inspiration. Although with the proposed 5D cardiac MRI, there were no significant differences (p > 0.05, t-test) between end-expiration and end-inspiration measurements of the cardiac function in volunteers, incremental respiratory motion parameters that were derived from 3D motion tracking, such as the depth, expiration and inspiration distribution, correlated (p < 0.05, correlation coefficient, Mann-Whitney) with those volume-based parameters of cardiac function and varied between genders. The obtained initial results suggested that this new approach allows evaluation of cardiac function during specific respiratory phases. Thus, it can enable investigation of effects related to respiratory variability and better assessment of cardiac function for studying respiratory and/or cardiac dysfunction.
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Affiliation(s)
- Jing Liu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States.
| | - Yan Wang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States
| | - Zhaoying Wen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States.
- Department of Radiology, Anzhen Hospital, Capital Medical University, Beijing, China.
| | - Li Feng
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Ana Paula Santos Lima
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States
| | - Vaikom S Mahadevan
- Department of Cardiology, University of California San Francisco, San Francisco, California, United States
| | - Ann Bolger
- Department of Cardiology, University of California San Francisco, San Francisco, California, United States
| | - David Saloner
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States
- Radiology Service, VA Medical Center, San Francisco, California, United States
| | - Karen Ordovas
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States
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14
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Rutkowski DR, Barton G, François CJ, Bartlett HL, Anagnostopoulos PV, Roldán-Alzate A. Analysis of cavopulmonary and cardiac flow characteristics in fontan Patients: Comparison with healthy volunteers. J Magn Reson Imaging 2019; 49:1786-1799. [PMID: 30635978 DOI: 10.1002/jmri.26583] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/06/2018] [Accepted: 11/06/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Characterizing the flow of the Fontan circuit, and correlating flow characteristics with the development of complications, is an important clinical challenge. Past work has analyzed the flow characteristics of Fontan circulation on a component-by-component basis. 4D flow MRI with radial projections allows for large volumetric coverage, and therefore can be used to analyze the flow through many codependent cardiovascular components in a single imaging session. PURPOSE To describe flow characteristics across the entire Fontan circuit and to compare these with the flow characteristics in healthy volunteers. STUDY TYPE Prospective. SUBJECTS Eleven single ventricle patients with a Fontan connection and 15 healthy controls. SEQUENCE Phase contrast with vastly undersampled isotropic projection reconstruction (PC-VIPR) at a field strength of 3 T. ASSESSMENT Cavopulmonary and ventricular flow distributions, blood flow kinetic energy, vorticities, efficiency indices, and other flow parameters were analyzed using Ensight and MatLab. STATISTICAL TESTS The results were compared across Fontan subjects, between respiratory phases, and between Fontan subjects and healthy volunteers using a Student's t-test for unequal sample sizes and linear regression. RESULTS Cava-specific pulmonary flow distributions of Fontan patients varied significantly between respiratory phases (P < 0.05). Ventricular kinetic energy (KE) was significantly higher in Fontan patients than it was in healthy controls, leading to a lower cardiac efficiency metric in the Fontan group. A significant diastolic KE time-shift was also observed in the Fontan patient group. Peak diastolic KE was significantly higher in the single ventricle of patients with right ventricle morphology than it was in left ventricle morphology patients. DATA CONCLUSION Radial 4D flow MRI can be used for comprehensive analysis of single ventricle Fontan flow characteristics. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019.
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Affiliation(s)
- David R Rutkowski
- Mechanical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Radiology, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Gregory Barton
- Radiology, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Medical Physics, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | | | - Heather L Bartlett
- Pediatrics and Medicine, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | | | - Alejandro Roldán-Alzate
- Mechanical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Radiology, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA
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15
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De Vis JB, Lu H, Ravi H, Hendrikse J, Liu P. Spatial distribution of flow and oxygenation in the cerebral venous drainage system. J Magn Reson Imaging 2018; 47:1091-1098. [PMID: 28791759 PMCID: PMC5807233 DOI: 10.1002/jmri.25833] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/25/2017] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To investigate the venous oxygenation and flow in the brain, and determine how they might change under challenged states. MATERIALS AND METHODS Eight healthy human subjects (24-37 years) were studied. T2 -relaxation under spin tagging (TRUST) magnetic resonance imaging (MRI) and phase-contrast MRI were performed to measure venous oxygenation and venous blood flow, respectively, in the superior sagittal sinus (SSS), the straight sinus (SS), and the internal jugular veins (IJVs). Venous oxygenation was assessed at room air (0.03%CO2 , 21%O2 ) and under hyperoxia (O%CO2 , 95%O2 , and 5%N2 ) conditions. Venous blood flow was assessed at room air and under hypercapnia (5%CO2 , 21%O2 , and 74%N2 ) conditions. Whole-brain blood flow was also measured at the four feeding arteries of the brain using phase-contrast MRI. The changes in venous oxygenation and blood flow from room air to hyperoxia or hypercapnia conditions were tested using paired t-tests. RESULTS Venous oxygenation in the SSS, the SS, and the IJVs was 61 ± 4%, 64 ± 4%, and 62 ± 4%, respectively, at room air, and increased to 70 ± 3% (P < 0.01 compared to room air), 71 ± 5% (P = 0.59), and 68 ± 5% (P < 0.05) under hyperoxic condition. The SSS, SS, and IJV drained 46 ± 9%, 16 ± 4%, and 79 ± 1% of whole-brain blood flow, respectively, and this flow distribution did not change under hypercapnic condition (P > 0.5). CONCLUSION The results found in this study provide insight into the venous oxygenation and venous flow distribution and its heterogeneity among different venous structures. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:1091-1098.
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Affiliation(s)
- Jill B. De Vis
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Harshan Ravi
- Center for Neuroscience and Regenerative Medicine, National Institutes of Health, Bethesda, MD
| | - Jeroen Hendrikse
- Department of Radiology, University Medical Center Utrecht, The Netherlands
| | - Peiying Liu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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16
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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
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17
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Comprehensive Multi-Dimensional MRI for the Simultaneous Assessment of Cardiopulmonary Anatomy and Physiology. Sci Rep 2017; 7:5330. [PMID: 28706270 PMCID: PMC5509743 DOI: 10.1038/s41598-017-04676-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 05/18/2017] [Indexed: 01/22/2023] Open
Abstract
Diagnostic testing often assesses the cardiovascular or respiratory systems in isolation, ignoring the major pathophysiologic interactions between the systems in many diseases. When both systems are assessed currently, multiple modalities are utilized in costly fashion with burdensome logistics and decreased accessibility. Thus, we have developed a new acquisition and reconstruction paradigm using the flexibility of MRI to enable a comprehensive exam from a single 5-15 min scan. We constructed a compressive-sensing approach to pseudo-randomly acquire highly subsampled, multi-dimensionally-encoded and time-stamped data from which we reconstruct volumetric cardiac and respiratory motion phases, contrast-agent dynamics, and blood flow velocity fields. The proposed method, named XD flow, is demonstrated for (a) evaluating congenital heart disease, where the impact of bulk motion is reduced in a non-sedated neonatal patient and (b) where the observation of the impact of respiration on flow is necessary for diagnostics; (c) cardiopulmonary imaging, where cardiovascular flow, function, and anatomy information is needed along with pulmonary perfusion quantification; and in (d) renal function imaging, where blood velocities and glomerular filtration rates are simultaneously measured, which highlights the generality of the technique. XD flow has the ability to improve quantification and to provide additional data for patient diagnosis for comprehensive evaluations.
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18
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Laganà MM, Di Rienzo M, Rizzo F, Ricci C, D'Onofrio S, Forzoni L, Cecconi P. Cardiac, Respiratory and Postural Influences on Venous Return of Internal Jugular and Vertebral Veins. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:1195-1204. [PMID: 28385470 DOI: 10.1016/j.ultrasmedbio.2017.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 01/17/2017] [Accepted: 02/12/2017] [Indexed: 06/07/2023]
Abstract
It is known from physiology that heartbeat and respiration influence venous return, but little is known regarding the extent to which these two factors affect flow. In this study, we estimated the prevalence of cardiac- and breathing-induced venous flow modulations in the internal jugular vein (IJV) and vertebral vein (VV) and the effects of posture. In 19 healthy patients, neck vein flow was examined with pulsed wave Doppler. Electrocardiogram and respiratory signals were simultaneously acquired. In supine position, heart contraction always influenced venous flow, whereas breathing influenced 68% of IJV and 34% of VV flow. In sitting position, heart contraction influenced 74% of IJV and 42% of VV flow; breathing influenced 68% of IJV and 61% of VV measures. Thus, cardiac influence is greatly present in supine position, whereas breathing influence prevails in the VV while sitting. This setup allowed us to observe that in some patients, expiration may cause an unexpected increase in venous flow.
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Affiliation(s)
- Maria M Laganà
- Fondazione Don Carlo Gnocchi ONLUS, IRCCS S. Maria Nascente, Milan, Italy.
| | - Marco Di Rienzo
- Fondazione Don Carlo Gnocchi ONLUS, IRCCS S. Maria Nascente, Milan, Italy
| | - Francesco Rizzo
- Fondazione Don Carlo Gnocchi ONLUS, IRCCS S. Maria Nascente, Milan, Italy
| | - Cristian Ricci
- Fondazione Don Carlo Gnocchi ONLUS, IRCCS S. Maria Nascente, Milan, Italy; Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, South Africa
| | | | | | - Pietro Cecconi
- Fondazione Don Carlo Gnocchi ONLUS, IRCCS S. Maria Nascente, Milan, Italy
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19
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Schrauben EM, Kohn S, Macdonald J, Johnson KM, Kliewer M, Frost S, Fleming JO, Wieben O, Field A. Four-dimensional flow magnetic resonance imaging and ultrasound assessment of cerebrospinal venous flow in multiple sclerosis patients and controls. J Cereb Blood Flow Metab 2017; 37:1483-1493. [PMID: 27364001 PMCID: PMC5453467 DOI: 10.1177/0271678x16657345] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A possibly causal relationship between multiple sclerosis and chronic cerebrospinal venous insufficiency has recently been hypothesized. Studies investigating chronic cerebrospinal venous insufficiency have reported conflicting results and few have employed multiple diagnostic imaging modalities across a large patient and control population. In this study, three complementary imaging modalities were used to investigate the chronic cerebrospinal venous insufficiency hypothesis in patients with multiple sclerosis and two age- and sex-matched control groups: healthy volunteers and patients with other neurological diseases. Strictly blinded Doppler ultrasound according to the original chronic cerebrospinal venous insufficiency hypothesis; four-dimensional flow magnetic resonance imaging of venous flow in the head, neck, and chest; and contrast-enhanced magnetic resonance venography for neck and chest venous luminography were acquired. An internal jugular vein stenosis evaluation was also performed across modalities. Percentage of subjects meeting ultrasound-based chronic cerebrospinal venous insufficiency criteria was small and similar between groups. In group-wise and pairwise testing, no four-dimensional flow magnetic resonance imaging variables were statistically significantly different, for any measurement location. In contrast-enhanced magnetic resonance venography of the internal jugular and azygos veins, no statistically significant differences were observed in stenosis scores between groups. These results represent compelling evidence against the chronic cerebrospinal venous insufficiency hypothesis in multiple sclerosis.
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Affiliation(s)
- Eric M Schrauben
- 1 Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sarah Kohn
- 2 Department of Radiology, University of Wisconsin-Madison, Madison, USA
| | - Jacob Macdonald
- 3 Department of Medical Physics, University of Wisconsin-Madison, Madison, USA
| | - Kevin M Johnson
- 3 Department of Medical Physics, University of Wisconsin-Madison, Madison, USA
| | - Mark Kliewer
- 2 Department of Radiology, University of Wisconsin-Madison, Madison, USA
| | - Sam Frost
- 2 Department of Radiology, University of Wisconsin-Madison, Madison, USA
| | - John O Fleming
- 4 Department of Neurology, University of Wisconsin-Madison, Madison, USA
| | - Oliver Wieben
- 2 Department of Radiology, University of Wisconsin-Madison, Madison, USA.,3 Department of Medical Physics, University of Wisconsin-Madison, Madison, USA
| | - Aaron Field
- 2 Department of Radiology, University of Wisconsin-Madison, Madison, USA.,5 Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, USA
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20
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Raz N, Daugherty AM, Sethi SK, Arshad M, Haacke EM. Age differences in arterial and venous extra-cerebral blood flow in healthy adults: contributions of vascular risk factors and genetic variants. Brain Struct Funct 2017; 222:2641-2653. [PMID: 28120105 DOI: 10.1007/s00429-016-1362-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 12/24/2016] [Indexed: 01/01/2023]
Abstract
Sufficient cerebral blood flow (CBF) and venous drainage are critical for normal brain function, and their alterations can affect brain aging. However, to date, most studies focused on arterial CBF (inflow) with little attention paid to the age differences in venous outflow. We measured extra-cerebral arterial and venous blood flow rates with phase-contrast MRI and assessed the influence of vascular risk factors and genetic polymorphisms (ACE insertion/deletion, COMT val158met, and APOEε4) in 73 adults (age 18-74 years). Advanced age, elevated vascular risk, ACE Deletion, and COMT met alleles were linked to lower in- and outflow, with no effects of APOE ε4 noted. Lower age-related CBF rate was unrelated to brain volume and was observed only in val homozygotes of COMTval158met. Thus, in a disease-free population, age differences in CBF may be notable only in persons with high vascular risk and carriers of genetic variants associated with vasoconstriction and lower dopamine availability. It remains to be established if treatments targeting alleviation of the mutable factors can improve the course of cerebrovascular aging in spite of the immutable genetic influence.
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Affiliation(s)
- Naftali Raz
- Institute of Gerontology, Wayne State University, 87 E Ferry St. 226 Knapp Bldg., Detroit, MI, 48202, USA. .,Department of Psychology, Wayne State University, 5057 Woodward Ave., Detroit, MI, 48202, USA.
| | - Ana M Daugherty
- Institute of Gerontology, Wayne State University, 87 E Ferry St. 226 Knapp Bldg., Detroit, MI, 48202, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N Matthews Ave., Urbana, IL, 61801, USA
| | - Sean K Sethi
- The MRI Institute of Biomedical Research, 440 E Ferry St., Detroit, MI, 48202, USA
| | - Muzamil Arshad
- Institute of Gerontology, Wayne State University, 87 E Ferry St. 226 Knapp Bldg., Detroit, MI, 48202, USA.,Department of Psychiatry and Behavioral Sciences, Wayne State University, 3990 John R, Detroit, MI, 48201, USA
| | - E Mark Haacke
- The MRI Institute of Biomedical Research, 440 E Ferry St., Detroit, MI, 48202, USA.,Department of Radiology, Wayne State University, 3990 John R, Detroit, MI, 48201, USA
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21
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Hahn AD, Higano NS, Walkup LL, Thomen RP, Cao X, Merhar SL, Tkach JA, Woods JC, Fain SB. Pulmonary MRI of neonates in the intensive care unit using 3D ultrashort echo time and a small footprint MRI system. J Magn Reson Imaging 2016; 45:463-471. [PMID: 27458992 DOI: 10.1002/jmri.25394] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 07/01/2016] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To determine the feasibility of pulmonary magnetic resonance imaging (MRI) of neonatal lung structures enabled by combining two novel technologies: first, a 3D radial ultrashort echo time (UTE) pulse sequence capable of high spatial resolution full-chest imaging in nonsedated quiet-breathing neonates; and second, a unique, small-footprint 1.5T MRI scanner design adapted for neonatal imaging and installed within the neonatal intensive care unit (NICU). MATERIALS AND METHODS Ten patients underwent MRI within the NICU, in accordance with an approved Institutional Review Board protocol. Five had clinical diagnoses of bronchopulmonary dysplasia (BPD), and five had putatively normal lung function. Pulmonary imaging was performed at 1.5T using 3D radial UTE and standard 3D fast gradient recalled echo (FGRE). Diagnostic quality, presence of motion artifacts, and apparent severity of lung pathology were evaluated by two radiologists. Quantitative metrics were additionally used to evaluate lung parenchymal signal. RESULTS UTE images showed significantly higher signal in lung parenchyma (P < 0.0001) and fewer apparent motion artifacts compared to FGRE (P = 0.046). Pulmonary pathology was more severe in patients diagnosed with BPD relative to controls (P = 0.001). Infants diagnosed with BPD also had significantly higher signal in lung parenchyma, measured using UTE, relative to controls (P = 0.002). CONCLUSION These results demonstrate the technical feasibility of pulmonary MRI in free-breathing, nonsedated infants in the NICU at high, isotropic resolutions approaching that achievable with computed tomography (CT). There is potential for pulmonary MRI to play a role in improving how clinicians understand and manage care of neonatal and pediatric pulmonary diseases. J. Magn. Reson. Imaging 2016. LEVEL OF EVIDENCE 2 J. Magn. Reson. Imaging 2017;45:463-471.
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Affiliation(s)
- Andrew D Hahn
- Department of Medical Physics, University of Wisconsin, Madison, WI
| | - Nara S Higano
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Physics, Washington University in St. Louis, St. Louis, MO
| | - Laura L Walkup
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Robert P Thomen
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Physics, Washington University in St. Louis, St. Louis, MO
| | - Xuefeng Cao
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Physics, University of Cincinnati, Cincinnati, OH
| | - Stephanie L Merhar
- Perinatal Institute, Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Jean A Tkach
- Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Physics, Washington University in St. Louis, St. Louis, MO
| | - Sean B Fain
- Department of Medical Physics, University of Wisconsin, Madison, WI
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