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El Sayed R, Park CC, Shah Z, Nahab FB, Haussen DC, Allen JW, Oshinski JN. Assessment of Complex Flow Patterns in Patients With Carotid Webs, Patients With Carotid Atherosclerosis, and Healthy Subjects Using 4D Flow MRI. J Magn Reson Imaging 2024; 59:2001-2010. [PMID: 37706274 PMCID: PMC10937327 DOI: 10.1002/jmri.29013] [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: 05/23/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Carotid webs (CaWs) are fibromuscular projections in the internal carotid artery (ICA) that cause mild luminal narrowing (<50%), but may be causative in up to one-third of seemingly cryptogenic strokes. Understanding hemodynamic alterations caused by CaWs is imperative to assessing stroke risk. Time-Average Wall Shear Stress (TAWSS) and Oscillatory Shear Index (OSI) are hemodynamic parameters linked to vascular dysfunction and thrombosis. PURPOSE To test the hypothesis: "CaWs are associated with lower TAWSS and higher OSI than mild atherosclerosis or healthy carotid bifurcation." STUDY TYPE Prospective study. POPULATION A total of 35 subjects (N = 14 bifurcations with CaW, 11F, age: 49 ± 10, 10 mild atherosclerosis 6F, age: 72 ± 9, 11 healthy 9F, age: 42 ± 13). FIELD STRENGTH/SEQUENCE 4D flow/STAR-MATCH/3D TOF/3T MRI, CTA. ASSESSMENT 4D Flow velocity data were analyzed in two ways: 1) 3D ROI in the ICA bulbar segment (complex flow patterns are expected) was used to quantify the regions with low TAWSS and high OSI. 2) 2D planes were placed perpendicular to the centerline of the carotid bifurcation for detailed analysis of TAWSS and OSI. STATISTICAL TESTS Independent-samples Kruskal-Wallis-H test with 0.05 used for statistical significance. RESULTS The percent surface area where low TAWSS was present in the ICA bulb was 12.3 ± 8.0% (95% CI: 7.6-16.9) in CaW subjects, 1.6 ± 1.9% (95% CI: 0.2-2.9) in atherosclerosis, and 8.5 ± 7.7% (95% CI: 3.6-13.4) in healthy subjects, all differences were statistically significant (ƞ2 = 0.3 [95% CI: 0.05-0.5], P-value CaW vs. healthy = 0.2). OSI had similar values in the CCA between groups (ƞ2 = 0.07 [95% CI: 0.0-0.2], P-value = 0.5), but OSI was significantly higher downstream of the bifurcation in CaW subjects compared to atherosclerosis and normal subjects. OSI returned to similar values between groups 1.5 diameters distal to the bifurcation (ƞ2 = 0.03 [95% CI: 0.0-0.2], P-value = 0.7). CONCLUSION Lower TAWSS and higher OSI are present in the ICA bulb in patients with CaW when compared to patients with atherosclerotic or healthy subjects. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Retta El Sayed
- Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Georgia, USA
- Department of Radiology & Imaging Sciences, Emory University, Atlanta, Georgia, USA
| | - Charlie C. Park
- Department of Radiology & Imaging Sciences, Emory University, Atlanta, Georgia, USA
| | - Zahraw Shah
- Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Georgia, USA
| | - Fadi B. Nahab
- Department of Neurology, Emory University, Atlanta, Georgia, USA
| | - Diogo C. Haussen
- Department of Neurology, Emory University, Atlanta, Georgia, USA
| | - Jason W. Allen
- Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Georgia, USA
- Department of Radiology & Imaging Sciences, Emory University, Atlanta, Georgia, USA
- Department of Neurology, Emory University, Atlanta, Georgia, USA
| | - John N. Oshinski
- Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Georgia, USA
- Department of Radiology & Imaging Sciences, Emory University, Atlanta, Georgia, USA
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2
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Dai C, Zhao P, Ding H, Lv H, Qiu X, Tang R, Xu N, Huang Y, Han X, Yang Z, Wang Z. Cerebral Sinus Hemodynamics in Adults Revealed by 4D Flow MRI. J Magn Reson Imaging 2024. [PMID: 38235948 DOI: 10.1002/jmri.29210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND The hemodynamics of the cerebral sinuses play a vital role in understanding blood flow-related diseases, yet the hemodynamics of the cerebral sinuses in normal adults remains an unresolved issue. PURPOSE To evaluate hemodynamics in the cerebral sinus of adults using 4-dimensional flow MRI (4D Flow MRI). STUDY TYPE Cross-sectional. POPULATION Ninety-nine healthy volunteers (mean age, 42.88 ± 13.16 years old; females/males, 55/44). FIELD STRENGTH/SEQUENCE 3 T/4D Flow MRI. ASSESSMENT The blood flow velocity, average blood flow rate (Q), and vortexes at the superior sagittal sinus (SSS), straight sinus (STS), transverse sinus, sigmoid sinus, and jugular bulb of each volunteer were evaluated by two independent neuroradiologists. The relationship between the total cerebral Q and sex and age was also assessed. Twelve volunteers underwent two scans within a month. STATISTICAL TESTS The intraclass correlation coefficient (ICC) evaluated the inter-observer agreement. Blood flow parameters among volunteers were compared by the independent-sample t-test or Mann-Whitney U test. The multiple linear regression equation was used to evaluate the relationship between total cerebral Q and age and sex. P < 0.05 indicated statistical significance. RESULTS The test-retest and interobserver reliability of average velocity and Q were moderate to high (ICC: 0.54-0.99). Cerebral sinus velocity varied by segment and cardiac cycle. The SSS's velocity and Q increased downstream and Q near torcular herophili was 3.5 times that through the STS. The total cerebral Q decreased by 0.06 mL/s per year (β = -0.06 ± 0.013) and was sex-independent within the group. Vortexes were found in 12.12%, 8.9%, and 59.8% of torcular herophili, transverse-sigmoid junction, and jugular bulb, respectively, and were related to higher upstream flow. DATA CONCLUSION Cerebral sinuses could be measured visually and quantitatively in vivo by 4D Flow MRI, providing a basis for future research on pulsating tinnitus, multiple sclerosis, and other related diseases. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Chihang Dai
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Heyu Ding
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiaoyu Qiu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ruowei Tang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ning Xu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yan Huang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xu Han
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Tomoto T, Lu M, Khan AM, Liu J, Pasha EP, Tarumi T, Zhang R. Cerebral blood flow and cerebrovascular resistance across the adult lifespan: A multimodality approach. J Cereb Blood Flow Metab 2023; 43:962-976. [PMID: 36708213 PMCID: PMC10196748 DOI: 10.1177/0271678x231153741] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/01/2022] [Accepted: 12/23/2022] [Indexed: 01/29/2023]
Abstract
Cerebral blood flow (CBF) decreases across the adult lifespan; however, more studies are needed to understand the underlying mechanisms. This study measured CBF and cerebrovascular resistance (CVR) using a multimodality approach in 185 healthy adults (21-80 years). Color-coded duplex ultrasonography and phase-contrast MRI were used to measure CBF, CBF velocity, and vessel diameters of the internal carotid (ICA) and vertebral arteries (VA). MRI arterial spin labeling was used to measure brain perfusion. Transcranial Doppler was used to measure CBF velocity at the middle cerebral artery. Structural MRI was used to measure brain volume. CBF was presented as total blood flow (mL/min) and normalized CBF (nCBF, mL/100g/min). Mean arterial pressure was measured to calculate CVR. Age was associated with decreased CBF by ∼3.5 mL/min/year and nCBF by ∼0.19 mL/100g/min/year across the methods. CVR increased by ∼0.011 mmHg/mL/100g/min/year. Blood flow velocities in ICA and VA decreased with age ranging from 0.07-0.15 cm/s/year, while the vessel diameters remained similar among age groups. These findings suggest that age-related decreases in CBF can be attributed mainly to decreases in blood flow velocity in the large cerebral arteries and that increased CVR likely reflects the presence of cerebral vasoconstrictions in the small cerebral arterioles and/or capillaries.
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Affiliation(s)
- Tsubasa Tomoto
- Institute for Exercise and
Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas,
Texas, USA
- Human Informatics and Interaction
Research Institute, National Institute of Advanced Industrial Science and
Technology, Tsukuba, Ibaraki, Japan
- Department of Neurology, University
of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Marilyn Lu
- Department of Neurology, University
of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ayaz M Khan
- Department of Diagnostic Imaging,
St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jie Liu
- Department of Pharmacology,
Physiology and Neuroscience, Rutgers University, Newark, New Jersey, USA
| | - Evan P Pasha
- Institute for Exercise and
Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas,
Texas, USA
- Department of Neurology, University
of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Takashi Tarumi
- Institute for Exercise and
Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas,
Texas, USA
- Human Informatics and Interaction
Research Institute, National Institute of Advanced Industrial Science and
Technology, Tsukuba, Ibaraki, Japan
- Department of Neurology, University
of Texas Southwestern Medical Center, Dallas, Texas, USA
- Graduate School of Comprehensive
Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Rong Zhang
- Institute for Exercise and
Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas,
Texas, USA
- Department of Neurology, University
of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Internal Medicine,
University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Mahinrad S, Tan CO, Ma Y, Aristova M, Milstead AL, Lloyd‐Jones D, Schnell S, Markl M, Sorond FA. Intracranial Blood Flow Quantification by Accelerated Dual-venc 4D Flow MRI: Comparison With Transcranial Doppler Ultrasound. J Magn Reson Imaging 2022; 56:1256-1264. [PMID: 35146822 PMCID: PMC9363520 DOI: 10.1002/jmri.28115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Dual-venc 4D flow MRI, recently introduced for the assessment of intracranial hemodynamics, may provide a promising complementary approach to well-established tools such as transcranial Doppler ultrasound (TCD) and overcome some of their disadvantages. However, data comparing intracranial flow measures from dual-venc 4D flow MRI and TCD are lacking. PURPOSE To compare cerebral blood flow velocity measures derived from dual-venc 4D flow MRI and TCD. STUDY TYPE Prospective cohort. SUBJECTS A total of 25 healthy participants (56 ± 4 years old, 44% female). FIELD STRENGTH/SEQUENCE A 3 T/dual-venc 4D flow MRI using a time-resolved three-dimensional phase-contrast sequence with three-dimensional velocity encoding. ASSESSMENT Peak velocity measurements in bilateral middle cerebral arteries (MCA) were quantified from dual-venc 4D flow MRI and TCD. The MRI data were quantified by two independent observers (S.M and Y.M.) and TCD was performed by a trained technician (A.L.M.). We assessed the agreement between 4D flow MRI and TCD measures, and the interobserver agreement of 4D flow MRI measurements. STATISTICAL TESTS Peak velocity from MRI and TCD was compared using Bland-Altman analysis and coefficient of variance. Intraclass correlation coefficient (ICC) was used to assess MRI interobserver agreement. A P value < 0.05 was considered statistically significant. RESULTS There was excellent interobserver agreement in dual-venc 4D flow MRI-based measurements of peak velocity in bilateral MCA (ICC = 0.97 and 0.96 for the left and right MCA, respectively). Dual-venc 4D flow MRI significantly underestimated peak velocity in the left and right MCA compared to TCD (bias = 0.13 [0.59, -0.33] m/sec and 0.15 [0.47, -0.17] m/sec, respectively). The coefficient of variance between dual-venc 4D flow MRI and TCD measurements was 26% for the left MCA and 22% for the right MCA. DATA CONCLUSION There was excellent interobserver agreement for the assessment of MCA peak velocity using dual-venc 4D flow MRI, and ≤20% under-estimation compared with TCD. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Simin Mahinrad
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Can Ozan Tan
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cerebrovascular Research LaboratorySpaulding Rehabilitation HospitalBostonMassachusettsUSA
- Department of RadiologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Yue Ma
- Department of RadiologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Department of RadiologyShengjing Hospital of China Medical UniversityChina
| | - Maria Aristova
- Department of RadiologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Department of Biomedical EngineeringNorthwestern UniversityEvanstonIllinoisUSA
| | - Andrew L. Milstead
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Donald Lloyd‐Jones
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Susanne Schnell
- Department of RadiologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Institute of Physics, Department of Medical PhysicsUniversity of GreifswaldGermany
| | - Michael Markl
- Department of RadiologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Department of Biomedical EngineeringNorthwestern UniversityEvanstonIllinoisUSA
| | - Farzaneh A. Sorond
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
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Pacheco DRQ. On the numerical treatment of viscous and convective effects in relative pressure reconstruction methods. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2022; 38:e3562. [PMID: 34873867 PMCID: PMC9286393 DOI: 10.1002/cnm.3562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 06/13/2023]
Abstract
The mechanism of many cardiovascular diseases can be understood by studying the pressure distribution in blood vessels. Direct pressure measurements, however, require invasive probing and provide only single-point data. Alternatively, relative pressure fields can be reconstructed from imaging-based velocity measurements by considering viscous and inertial forces. Both contributions can be potential troublemakers in pressure reconstruction: the former due to its higher-order derivatives, and the latter because of the quadratic nonlinearity in the convective acceleration. Viscous and convective terms can be treated in various forms, which, although equivalent for ideal measurements, can perform differently in practice. In fact, multiple versions are often used in literature, with no apparent consensus on the more suitable variants. In this context, the present work investigates the performance of different versions of relative pressure estimators. For viscous effects, in particular, two new modified estimators are presented to circumvent second-order differentiation without requiring surface integrals. In-silico and in-vitro data in the typical regime of cerebrovascular flows are considered, allowing a systematic noise sensitivity study. Convective terms are shown to be the main source of error, even for flows with pronounced viscous component. Moreover, the conservation (often integrated) form of convection exhibits higher noise sensitivity than the standard convective description, in all three families of estimators considered here. For the classical pressure Poisson estimator, the present modified version of the viscous term tends to yield better accuracy than the (recently introduced) integrated form, although this effect is in most cases negligible when compared to convection-related errors.
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Affiliation(s)
- Douglas R. Q. Pacheco
- Institute of Applied MathematicsGraz University of TechnologyGrazAustria
- Present address:
Graz Center of Computational EngineeringGraz University of TechnologyGrazAustria
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6
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Abstract
Alterations in cerebral blood flow are common in several neurological diseases among the elderly including stroke, cerebral small vessel disease, vascular dementia, and Alzheimer's disease. 4D flow magnetic resonance imaging (MRI) is a relatively new technique to investigate cerebrovascular disease, and makes it possible to obtain time-resolved blood flow measurements of the entire cerebral arterial venous vasculature and can be used to derive a repertoire of hemodynamic biomarkers indicative of cerebrovascular health. The information that can be obtained from one single 4D flow MRI scan allows both the investigation of aberrant flow patterns at a focal location in the vasculature as well as estimations of brain-wide disturbances in blood flow. Such focal and global hemodynamic biomarkers show the potential of being sensitive to impending cerebrovascular disease and disease progression and can also become useful during planning and follow-up of interventions aiming to restore a normal cerebral circulation. Here, we describe 4D flow MRI approaches for analyzing the cerebral vasculature. We then survey key hemodynamic biomarkers that can be reliably assessed using the technique. Finally, we highlight cerebrovascular diseases where one or multiple hemodynamic biomarkers are of central interest.
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Affiliation(s)
- Anders Wåhlin
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.,Department of Applied Physics and Electronics, Umeå University, Umeå, Sweden.,Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - Anders Eklund
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.,Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - Jan Malm
- Department of Clinical Science and Neurosciences, Umeå University, Umeå, Sweden
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Sakhare A, Stradford J, Ravichandran R, Deng R, Ruiz J, Subramanian K, Suh J, Pa J. Simultaneous Exercise and Cognitive Training in Virtual Reality Phase 2 Pilot Study: Impact on Brain Health and Cognition in Older Adults. Brain Plast 2021; 7:111-130. [PMID: 34868877 PMCID: PMC8609488 DOI: 10.3233/bpl-210126] [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] [Accepted: 07/27/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Aerobic exercise and environmental enrichment have been shown to enhance brain function. Virtual reality (VR) is a promising method for combining these activities in a meaningful and ecologically valid way. Objective: The purpose of this Phase 2 pilot study was to calculate relative change and effect sizes to assess the impact of simultaneous exercise and cognitive training in VR on brain health and cognition in older adults. Methods: Twelve cognitively normal older adults (64.7±8.8 years old, 8 female) participated in a 12-week intervention, 3 sessions/week for 25–50 minutes/session at 50–80% HRmax. Participants cycled on a custom-built stationary exercise bike while wearing a VR head-mounted display and navigating novel virtual environments to train spatial memory. Brain and cognitive changes were assessed using MRI imaging and a cognitive battery. Results: Medium effect size (ES) improvements in cerebral flow and brain structure were observed. Pulsatility, a measure of peripheral vascular resistance, decreased 10.5% (ES(d) = 0.47). Total grey matter volume increased 0.73% (ES(r) = 0.38), while thickness of the superior parietal lobule, a region associated with spatial orientation, increased 0.44% (ES(r) = 0.30). Visual memory discrimination related to pattern separation showed a large improvement of 68% (ES(ηp2) = 0.43). Cognitive flexibility (Trail Making Test B) (ES(r) = 0.42) and response inhibition (ES(W) = 0.54) showed medium improvements of 14% and 34%, respectively. Conclusions: Twelve weeks of simultaneous exercise and cognitive training in VR elicits positive changes in brain volume, vascular resistance, memory, and executive function with moderate-to-large effect sizes in our pilot study.
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Affiliation(s)
- Ashwin Sakhare
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA.,Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Joy Stradford
- Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Roshan Ravichandran
- Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Rong Deng
- Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Julissa Ruiz
- Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Keshav Subramanian
- Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Jaymee Suh
- Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Judy Pa
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA.,Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
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Ngo MT, Lee UY, Ha H, Jung J, Lee DH, Kwak HS. Improving Blood Flow Visualization of Recirculation Regions at Carotid Bulb in 4D Flow MRI Using Semi-Automatic Segmentation with ITK-SNAP. Diagnostics (Basel) 2021; 11:diagnostics11101890. [PMID: 34679588 PMCID: PMC8534781 DOI: 10.3390/diagnostics11101890] [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: 09/16/2021] [Revised: 10/06/2021] [Accepted: 10/10/2021] [Indexed: 11/16/2022] Open
Abstract
Assessment of carotid bulb hemodynamics using four-dimensional (4D) flow magnetic resonance imaging (MRI) requires accurate segmentation of recirculation regions that is frequently hampered by limited resolution. This study aims to improve the accuracy of 4D flow MRI carotid bulb segmentation and subsequent recirculation regions analysis. Time-of-flight (TOF) MRI and 4D flow MRI were performed on bilateral carotid artery bifurcations in seven healthy volunteers. TOF-MRI data was segmented into 3D geometry for computational fluid dynamics (CFD) simulations. ITK-SNAP segmentation software was included in the workflow for the semi-automatic generation of 4D flow MRI angiographic data. This study compared the velocities calculated at the carotid bifurcations and the 3D blood flow visualization at the carotid bulbs obtained by 4D flow MRI and CFD. By applying ITK-SNAP segmentation software, an obvious improvement in the 4D flow MRI visualization of the recirculation regions was observed. The 4D flow MRI images of the recirculation flow characteristics of the carotid artery bulbs coincided with the CFD. A reasonable agreement was found in terms of velocity calculated at the carotid bifurcation between CFD and 4D flow MRI. However, the dispersion of velocity data points relative to the local errors of measurement in 4D flow MRI remains. Our proposed strategy showed the feasibility of improving recirculation regions segmentation and the potential for reliable blood flow visualization in 4D flow MRI. However, quantitative analysis of recirculation regions in 4D flow MRI with ITK-SNAP should be enhanced for use in clinical situations.
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Affiliation(s)
- Minh Tri Ngo
- Department of Radiology of Hue Central Hospital, Hue, Thua Thien Hue 530000, Vietnam;
| | - Ui Yun Lee
- Division of Mechanical Design Engineering, College of Engineering, Jeonbuk National University, Jeon-ju 54896, Korea; (U.Y.L.); (J.J.)
| | - Hojin Ha
- Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon 24341, Korea;
| | - Jinmu Jung
- Division of Mechanical Design Engineering, College of Engineering, Jeonbuk National University, Jeon-ju 54896, Korea; (U.Y.L.); (J.J.)
- Hemorheology Research Institute, Jeonbuk National University, Jeon-ju 54896, Korea
| | - Dong Hwan Lee
- Division of Mechanical Design Engineering, College of Engineering, Jeonbuk National University, Jeon-ju 54896, Korea; (U.Y.L.); (J.J.)
- Hemorheology Research Institute, Jeonbuk National University, Jeon-ju 54896, Korea
- Correspondence: (D.H.L.); (H.S.K.); Tel.: +82-63-270-3998 (D.H.L.); +82-63-250-2582 (H.S.K.)
| | - Hyo Sung Kwak
- Department of Radiology and Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeon-ju 54907, Korea
- Correspondence: (D.H.L.); (H.S.K.); Tel.: +82-63-270-3998 (D.H.L.); +82-63-250-2582 (H.S.K.)
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Ngo MT, Lee UY, Ha H, Jin N, Chung GH, Kwak YG, Jung J, Kwak HS. Comparison of Hemodynamic Visualization in Cerebral Arteries: Can Magnetic Resonance Imaging Replace Computational Fluid Dynamics? J Pers Med 2021; 11:jpm11040253. [PMID: 33808514 PMCID: PMC8066205 DOI: 10.3390/jpm11040253] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/23/2021] [Accepted: 03/27/2021] [Indexed: 01/04/2023] Open
Abstract
A multimodality approach was applied using four-dimensional flow magnetic resonance imaging (4D flow MRI), time-of-flight magnetic resonance angiography (TOF-MRA) signal intensity gradient (SIG), and computational fluid dynamics (CFD) to investigate the 3D blood flow characteristics and wall shear stress (WSS) of the cerebral arteries. TOF-MRA and 4D flow MRI were performed on the major cerebral arteries in 16 healthy volunteers (mean age 34.7 ± 7.6 years). The flow rate measured with 4D flow MRI in the internal carotid artery, middle cerebral artery, and anterior cerebral artery were 3.8, 2.5, and 1.2 mL/s, respectively. The 3D blood flow pattern obtained through CFD and 4D flow MRI on the cerebral arteries showed reasonable consensus. CFD delivered much greater resolution than 4D flow MRI. TOF-MRA SIG and CFD WSS of the major cerebral arteries showed reasonable consensus with the locations where the WSS was relatively high. However, the visualizations were very different between TOF-MRA SIG and CFD WSS at the internal carotid artery bifurcations, the anterior cerebral arteries, and the anterior communicating arteries. 4D flow MRI, TOF-MRA SIG, and CFD are complementary methods that can provide additional insight into the hemodynamics of the human cerebral artery.
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Affiliation(s)
- Minh Tri Ngo
- Department of Radiology and Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeon-ju 54907, Korea; (M.T.N.); (G.H.C.); (Y.G.K.)
| | - Ui Yun Lee
- Division of Mechanical Design Engineering, Jeonbuk National University, Jeon-ju 54896, Korea;
| | - Hojin Ha
- Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon 24341, Korea;
| | - Ning Jin
- Siemens Medical Solutions USA, Inc., Chicago, IL 60089, USA;
| | - Gyung Ho Chung
- Department of Radiology and Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeon-ju 54907, Korea; (M.T.N.); (G.H.C.); (Y.G.K.)
| | - Yeong Gon Kwak
- Department of Radiology and Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeon-ju 54907, Korea; (M.T.N.); (G.H.C.); (Y.G.K.)
| | - Jinmu Jung
- Division of Mechanical Design Engineering, Jeonbuk National University, Jeon-ju 54896, Korea;
- Hemorheology Research Institute, Jeonbuk National University, Jeon-ju 54896, Korea
- Correspondence: (J.J.); (H.S.K.); Tel.: +82-63-270-3998 (J.J.); +82-63-250-2582 (H.S.K.)
| | - Hyo Sung Kwak
- Department of Radiology and Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeon-ju 54907, Korea; (M.T.N.); (G.H.C.); (Y.G.K.)
- Correspondence: (J.J.); (H.S.K.); Tel.: +82-63-270-3998 (J.J.); +82-63-250-2582 (H.S.K.)
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10
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Schou M, Jorgensen LT, Beers C, Traberg MS, Tomov BG, Bo Stuart M, Jensen JA. Fast 3-D Velocity Estimation in 4-D Using a 62 + 62 Row-Column Addressed Array. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:608-623. [PMID: 32804649 DOI: 10.1109/tuffc.2020.3016991] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This article presents an imaging scheme capable of estimating the full 3-D velocity vector field in a volume using row-column addressed arrays (RCAs) at a high volume rate. A 62 + 62 RCA array is employed with an interleaved synthetic aperture sequence. It contains repeated emissions with rows and columns interleaved with B-mode emissions. The sequence contains 80 emissions in total and can provide continuous volumetric data at a volume rate above 125 Hz. A transverse oscillation cross correlation estimator determines all three velocity components. The approach is investigated using Field II simulations and measurements using a specially built 3-MHz 62 + 62 RCA array connected to the SARUS experimental scanner. Both the B-mode and flow sequences have a penetration depth of 14 cm when measured on a tissue-mimicking phantom (0.5-dB/[ [Formula: see text]] attenuation). Simulations of a parabolic flow in a 12-mm-diameter vessel at a depth of 30 mm, beam-to-flow angle of 90°, and xy-rotation of 45° gave a standard deviation (SD) of (3.3, 3.4, 0.4)% and bias of (-3.3, -3.9, -0.1)%, for ( vx , vy , and vz ). Decreasing the beam-to-flow angle to 60° gave an SD of (8.9, 9.1, 0.8)% and bias of (-7.6, -9.5, -7.2)%, showing a slight increase. Measurements were carried out using a similar setup, and pulsing at 2 kHz yielded comparable results at 90° with an SD of (5.8, 5.5, 1.1)% and bias of (1.4, -6.4, 2.4)%. At 60°, the SD was (5.2, 4.7 1.2)% and bias (-4.6, 6.9, -7.4)%. Results from measurements across all tested settings showed a maximum SD of 6.8% and a maximum bias of 15.8% for a peak velocity of 10 cm/s. A tissue-mimicking phantom with a straight vessel was used to introduce clutter, tissue motion, and pulsating flow. The pulsating velocity magnitude was estimated across ten pulse periods and yielded an SD of 10.9%. The method was capable of estimating transverse flow components precisely but underestimated the flow with small beam-to-flow angles. The sequence provided continuous data in both time and space throughout the volume, allowing for retrospective analysis of the flow. Moreover, B-mode planes can be selected retrospectively anywhere in the volume. This shows that tensor velocity imaging (full 3-D volumetric vector flow imaging) can be estimated in 4-D ( x, y, z, and t ) using only 62 channels in receive, making 4-D volumetric imaging implementable on current scanner hardware.
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11
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Zhang M, Peng F, Tong X, Feng X, Li Y, Chen H, Niu H, Zhang B, Song G, Li Y, Liu P, Liu A, Li R. Associations between haemodynamics and wall enhancement of intracranial aneurysm. Stroke Vasc Neurol 2021; 6:467-475. [PMID: 33637615 PMCID: PMC8485248 DOI: 10.1136/svn-2020-000636] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/30/2020] [Accepted: 01/04/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND AND PURPOSE Previous studies have reported about inflammation processes (IPs) that play important roles in aneurysm formation and rupture, which could be driven by blood flow. IPs can be identified using aneurysmal wall enhancement (AWE) on high-resolution black-blood MRI (BB-MRI) and blood flow haemodynamics can be demonstrated by four-dimensional-flow MRI (4D-flow MRI). Thus, this study investigated the associations between AWE and haemodynamics in unruptured intracranial aneurysms (IA) by combining 4D-flow MRI and high-resolution BB-MRI. MATERIALS AND METHODS Between April 2014 and October 2017, 48 patients with 49 unruptured IA who underwent both 4D-flow MRI and high-resolution BB-MRI were retrospectively included in this study. The haemodynamic parameters demonstrated using 4D-flow MRI were compared between different AWE patterns using the Kruskal-Wallis test and ordinal regression. RESULTS The results of Kruskal-Wallis test showed that the average wall shear stress in the IA (WSSavg-IA), maximum through-plane velocity in the adjacent parent artery, inflow jet patterns and the average vorticity in IA (vorticityavg-IA) were significantly associated with the AWE patterns. Ordinal regression analysis identified WSSavg-IA (p=0.002) and vorticityavg-IA (p=0.033) as independent predictors of AWE patterns. CONCLUSION A low WSS and low average vorticity were independently associated with a high AWE grade for IAs larger than 4 mm. Therefore, WSS and average vorticity could predict AWE and circumferential AWE.
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Affiliation(s)
- Miaoqi Zhang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Fei Peng
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China
| | - Xin Tong
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China
| | - Xin Feng
- Department of Neurosurgery, Beijing Hospital, Beijing, China
| | - Yunduo Li
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Huijun Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Hao Niu
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China
| | - Baorui Zhang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China
| | - Guangrong Song
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China
| | - Youxiang Li
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China
| | - Peng Liu
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China
| | - Aihua Liu
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China
| | - Rui Li
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
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12
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Zhang M, Peng F, Li Y, He L, Liu A, Li R. Associations between morphology and hemodynamics of intracranial aneurysms based on 4D flow and black-blood magnetic resonance imaging. Quant Imaging Med Surg 2021; 11:597-607. [PMID: 33532260 DOI: 10.21037/qims-20-440] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Previous studies have hypothesized that intracranial aneurysm (IA) morphology interacts with hemodynamic conditions. Magnetic resonance imaging (MRI) provides a single image modality solution for both morphological and hemodynamic measurements for IA. This study aimed to explore the interaction between the morphology and hemodynamics of IA using black-blood MRI (BB-MRI) and 4D flow MRI. Methods A total of 97 patients with unruptured IA were recruited for this study. The IA size, size ratio (SR), and minimum wall thickness (mWT) were measured using BB-MRI. Velocity, blood flow, pulsatility index (PI), and wall shear stress (WSS) were measured with 4D flow MRI. The relationship between hemodynamic parameters and morphological indices was investigated by linear regression analysis and unpaired two-sample t-test. To determine the independent interaction, multiple linear regression analysis was further performed. Results The findings showed that mWT was negatively correlated with IA size (r=-0.665, P<0.001). Maximum blood flow in IA (FlowIA) was positively correlated with IA size (r=0.458, P<0.001). The average WSS (WSSavg) was negatively correlated with IA size (r=-0.650, P<0.001). The relationships remained the same after the multivariate analysis was adjusted for hemodynamic, morphologic, and demographic confounding factors. The WSSavg was positively correlated with mWT (r=0.528, P<0.001). In the unpaired two-sample t-test, mWT, WSSavg, and FlowIA were statistically significantly associated with the size and SR of IAs. Conclusions There is potential for BB-MRI and 4D flow MRI to provide morphological and hemodynamic information regarding IA. Blood flow, WSS, and mWT may serve as non-invasive biomarkers for IA assessments, and may contribute to a more comprehensive understanding of the mechanism of IA.
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Affiliation(s)
- Miaoqi Zhang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Fei Peng
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yunduo Li
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Le He
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Aihua Liu
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Rui Li
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
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13
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Youn SW, Lee J. From 2D to 4D Phase-Contrast MRI in the Neurovascular System: Will It Be a Quantum Jump or a Fancy Decoration? J Magn Reson Imaging 2020; 55:347-372. [PMID: 33236488 DOI: 10.1002/jmri.27430] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 12/16/2022] Open
Abstract
Considering the crosstalk between the flow and vessel wall, hemodynamic assessment of the neurovascular system may offer a well-integrated solution for both diagnosis and management by adding prognostic significance to the standard CT/MR angiography. 4D flow MRI or time-resolved 3D velocity-encoded phase-contrast MRI has long been promising for the hemodynamic evaluation of the great vessels, but challenged in clinical studies for assessing intracranial vessels with small diameter due to long scan times and low spatiotemporal resolution. Current accelerated MRI techniques, including parallel imaging with compressed sensing and radial k-space undersampling acquisitions, have decreased scan times dramatically while preserving spatial resolution. 4D flow MRI visualized and measured 3D complex flow of neurovascular diseases such as aneurysm, arteriovenous shunts, and atherosclerotic stenosis using parameters including flow volume, velocity vector, pressure gradients, and wall shear stress. In addition to the noninvasiveness of the phase contrast technique and retrospective flow measurement through the wanted windows of the analysis plane, 4D flow MRI has shown several advantages over Doppler ultrasound or computational fluid dynamics. The evaluation of the flow status and vessel wall can be performed simultaneously in the same imaging modality. This article is an overview of the recent advances in neurovascular 4D flow MRI techniques and their potential clinical applications in neurovascular disease. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
- Sung Won Youn
- Department of Radiology, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Jongmin Lee
- Department of Radiology and Biomedical Engineering, Kyungpook National University School of Medicine, Daegu, Korea
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14
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Schmitter S, Adriany G, Waks M, Moeller S, Aristova M, Vali A, Auerbach EJ, Van de Moortele PF, Ugurbil K, Schnell S. Bilateral Multiband 4D Flow MRI of the Carotid Arteries at 7T. Magn Reson Med 2020; 84:1947-1960. [PMID: 32187742 DOI: 10.1002/mrm.28256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/31/2020] [Accepted: 02/24/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE Simultaneous multislab (SMSb) 4D flow MRI was developed and implemented at 7T for accelerated acquisition of the 3D blood velocity vector field in both carotid bifurcations. METHODS SMSb was applied to 4D flow to acquire blood velocities in both carotid bifurcations in sagittal orientation using a local transmit/receive coil at 7T. B 1 + transmit efficiency was optimized by B 1 + shimming. SMSb 4D flow was obtained in 8 healthy subjects in single-band (SB) and multiband (MB) fashion. Additionally, MB data were retrospectively undersampled to simulate GRAPPA R = 2 (MB2_GRAPPA2), and both SB datasets were added to form an artificial MB dataset (SumSB). The band separation performance was quantified by signal leakage. Peak velocity and total flow values were calculated and compared to SB via intraclass correlation analysis (ICC). RESULTS Clean slab separation was achieved yielding a mean signal leakage of 13% above the mean SB noise level. Mean total flow for MB2, SumSB, and MB_GRAPPA2 deviated less than 9% from the SB values. Peak velocities averaged over all vessels and subjects were 0.48 ± 0.11 m/s for SB, 0.47 ± 0.12 m/s for SumSB, 0.50 ± 0.13 m/s for MB2, and 0.53 ± 0.13 m/s for MB2_GRAPPA2. ICC revealed excellent absolute agreement and consistency of total flow for all methods compared to SB2. Peak velocity showed good to excellent agreement and consistency for SumSB and MB2 and MB2_GRAPPA2 method showed poor to excellent agreement and good to excellent consistency. CONCLUSION Simultaneous multislab 4D Flow MRI allows accurate quantification of total flow and peak velocity while reducing scan times.
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Affiliation(s)
- Sebastian Schmitter
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA.,Physikalisch-Technische Bundesanstalt, Braunschweig and Berlin, Germany
| | - Gregor Adriany
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Matt Waks
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Steen Moeller
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Maria Aristova
- McCormick School of Engineering, Northwestern University, Evanston, USA.,Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Alireza Vali
- Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Edward J Auerbach
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | | | - Kamil Ugurbil
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Susanne Schnell
- Feinberg School of Medicine, Northwestern University, Chicago, USA
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15
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Debbich A, Ben Abdallah A, Maatouk M, Hmida B, Sigovan M, Clarysse P, Bedoui MH. A Spatiotemporal exploration and 3D modeling of blood flow in healthy carotid artery bifurcation from two modalities: Ultrasound-Doppler and phase contrast MRI. Comput Biol Med 2020; 118:103644. [DOI: 10.1016/j.compbiomed.2020.103644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 10/25/2022]
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16
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The impact of helical flow on coronary atherosclerotic plaque development. Atherosclerosis 2020; 300:39-46. [PMID: 32085872 DOI: 10.1016/j.atherosclerosis.2020.01.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/18/2019] [Accepted: 01/29/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS Atherosclerosis has been associated with near-wall hemodynamics and wall shear stress (WSS). However, the role of coronary intravascular hemodynamics, in particular of the helical flow (HF) patterns that physiologically develop in those arteries, is rarely considered. The purpose of this study was to assess how HF affects coronary plaque initiation and progression, definitively demonstrating its atheroprotective nature. METHODS The three main coronary arteries of five adult hypercholesterolemic mini-pigs on a high fat diet were imaged by computed coronary tomography angiography (CCTA) and intravascular ultrasound (IVUS) at 3 (T1, baseline) and 9.4 ± 1.9 (T2) months follow-up. The baseline geometries of imaged coronary arteries (n = 15) were reconstructed, and combined with pig-specific boundary conditions (based on in vivo Doppler blood flow measurements) to perform computational fluid dynamic simulations. Local wall thickness (WT) was measured on IVUS images at T1 and T2, and its temporal changes were assessed. Descriptors of HF and WSS nature were computed for each model, and statistically compared to WT data. RESULTS HF intensity was strongly positively associated with WSS magnitude (p < 0.001). Overall, coronary segments exposed to high baseline levels of HF intensity exhibited a significantly lower WT growth (p < 0.05), compared to regions with either mid or low HF intensity. CONCLUSIONS This study confirms the physiological significance of HF in coronary arteries, revealing its protective role against atherosclerotic WT growth and its potential in predicting regions undergoing WT development. These findings support future in vivo measurement of coronary HF as atherosclerotic risk marker, overcoming current limitations of in vivo WSS assessment.
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17
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Velocity encoding and velocity compensation for multi-spoke RF excitation. Magn Reson Imaging 2020; 66:69-85. [DOI: 10.1016/j.mri.2019.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/24/2019] [Accepted: 11/03/2019] [Indexed: 11/22/2022]
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18
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Four-Dimensional Flow Magnetic Resonance Imaging for Assessment of Velocity Magnitudes and Flow Patterns in The Human Carotid Artery Bifurcation: Comparison with Computational Fluid Dynamics. Diagnostics (Basel) 2019; 9:diagnostics9040223. [PMID: 31847224 PMCID: PMC6963916 DOI: 10.3390/diagnostics9040223] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/22/2019] [Accepted: 12/12/2019] [Indexed: 11/17/2022] Open
Abstract
Purpose: Knowledge of the hemodynamics in the vascular system is important to understand and treat vascular pathology. The present study aimed to evaluate the hemodynamics in the human carotid artery bifurcation measured by four-dimensional (4D) flow magnetic resonance imaging (MRI) as compared to computational fluid dynamics (CFD). Methods: This protocol used MRI data of 12 healthy volunteers for the 3D vascular models and 4D flow MRI measurements for the boundary conditions in CFD simulation. We compared the velocities measured at the carotid bifurcation and the 3D velocity streamlines of the carotid arteries obtained by these two methods. Results: There was a good agreement for both maximum and minimum velocity values between the 2 methods for velocity magnitude at the bifurcation plane. However, on the 3D blood flow visualization, secondary flows, and recirculation regions are of poorer quality when visualized through the 4D flow MRI. Conclusion: 4D flow MRI and CFD show reasonable agreement in demonstrated velocity magnitudes at the carotid artery bifurcation. However, the visualization of blood flow at the recirculation regions and the assessment of secondary flow characteristics should be enhanced for the use of 4D flow MRI in clinical situations.
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19
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Annio G, Torii R, Ariff B, O'Regan DP, Muthurangu V, Ducci A, Tsang V, Burriesci G. Enhancing Magnetic Resonance Imaging With Computational Fluid Dynamics. ACTA ACUST UNITED AC 2019. [DOI: 10.1115/1.4045493] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Abstract
The analysis of the blood flow in the great thoracic arteries does provide valuable information about the cardiac function and can diagnose the potential development of vascular diseases. Flow-sensitive four-dimensional flow cardiovascular magnetic resonance imaging (4D flow CMR) is often used to characterize patients' blood flow in the clinical environment. Nevertheless, limited spatial and temporal resolution hinders a detailed assessment of the hemodynamics. Computational fluid dynamics (CFD) could expand this information and, integrated with experimental velocity field, enable to derive the pressure maps. However, the limited resolution of the 4D flow CMR and the simplifications of CFD modeling compromise the accuracy of the computed flow parameters. In this article, a novel approach is proposed, where 4D flow CMR and CFD velocity fields are integrated synergistically to obtain an enhanced MR imaging (EMRI). The approach was first tested on a two-dimensional (2D) portion of a pipe, to understand the behavior of the parameters of the model in this novel framework, and afterwards in vivo, to apply it to the analysis of blood flow in a patient-specific human aorta. The outcomes of EMRI are assessed by comparing the computed velocities with the experimental one. The results demonstrate that EMRI preserves flow structures while correcting for experimental noise. Therefore, it can provide better insights into the hemodynamics of cardiovascular problems, overcoming the limitations of MRI and CFD, even when considering a small region of interest. EMRI confirmed its potential to provide more accurate noninvasive estimation of major cardiovascular risk predictors (e.g., flow patterns, endothelial shear stress) and become a novel diagnostic tool.
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Affiliation(s)
- Giacomo Annio
- Department Medical Physics and Bioengineering, University College London, Torrington Place, London WC1E 7JE, UK
| | - Ryo Torii
- UCL Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK
| | - Ben Ariff
- MRC London Institute of Medical Sciences, Imperial College London, Du Cane Road, London W12 0NN, UK
| | - Declan P. O'Regan
- MRC London Institute of Medical Sciences, Imperial College London, Du Cane Road, London W12 0NN, UK
| | - Vivek Muthurangu
- UCL Institute of Cardiovascular Science, Centre for Cardiovascular Imaging, University College London, 62 Huntley Street, Fitzrovia, London WC1E 6DD, UK; Great Ormond Street Hospital for Children, Great Ormond Street, Holborn, London WC1N 3JH, UK
| | - Andrea Ducci
- UCL Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK
| | - Victor Tsang
- Cardiothoracic Surgery Unit, Great Ormond Street Hospital for Children, Great Ormond Street, Holborn, London WC1N 3JH, UK
| | - Gaetano Burriesci
- UCL Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK; Ri.MED Foundation, Via Bandiera, 11, Palermo 90133, Italy
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Optimal 4DFlow MR sequence parameters for the assessment of internal carotid artery stenosis: a simulation study. Neuroradiology 2019; 61:1137-1144. [PMID: 31197413 DOI: 10.1007/s00234-019-02237-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 05/29/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE In patients with ICA stenosis, increased peak systolic velocity is a marker of stenosis at risk of ischemic stroke. 4DFlow MRI is a reproducible technique to evaluate velocities in ICA stenosis, although it seems to underestimate velocities as compared with Doppler ultrasonography. The purpose of our study was to confirm that velocities were underestimated on a new set of data acquired with a clinical 4DFlow sequence, and to devise optimal acquisition parameters for ICA stenosis exploration based on a numerical simulation. METHODS After review board approval, 15 healthy controls and 12 patients presenting ICA stenosis were explored with Doppler ultrasonography and 4DFlow MRI. We created a 2-dimensional simulation of ICA stenosis and its corresponding 4DFlow acquisition, and compared its mean peak systolic velocity underestimation to real MRI and Doppler. We then simulated the acquisition for voxel size ranging from 0.5 to 1.25 mm and number of phases per cardiac cycle ranging from 10 to 25. RESULTS On acquired data, 4DFlow MR underestimated peak systolic velocities (mean difference between Doppler and 4DFlow: - 35 cm/s), especially high velocities. With spatial and temporal resolutions equivalent to MR acquisition, our simulation yielded similar underestimation (mean difference: - 31 cm/s, P = 0.30). Simulations showed that 0.7-mm resolution and 20 phases per cardiac cycle would be necessary to record peak systolic velocities up to 250 cm/s. CONCLUSION Higher spatial resolution can provide accurate peak systolic velocities measurement with 4DFlow MRI, thus allowing better ICA stenosis assessment. Further studies are needed to validate the proposed parameters.
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21
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Sakhare AR, Barisano G, Pa J. Assessing test-retest reliability of phase contrast MRI for measuring cerebrospinal fluid and cerebral blood flow dynamics. Magn Reson Med 2019; 82:658-670. [PMID: 31020721 DOI: 10.1002/mrm.27752] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Pathological states occur when cerebrospinal fluid (CSF) and cerebral blood flow (CBF) dynamics become dysregulated in the brain. Phase-contrast MRI (PC-MRI) is a noninvasive imaging technique that enables quantitative measurements of CSF and CBF flow. While studies have validated PC-MRI as an imaging technique for flow, few studies have evaluated its reliability for CSF and CBF flow parameters commonly associated with neurological disease. The purpose of this study was to evaluate test-retest reliability at the cerebral aqueduct (CA) and C2-C3 area using PC-MRI to assess the feasibility of investigating CSF and CBF flow dynamics. METHODS This study was performed on 27 cognitively normal young adults (ages 20-35 years). Flow data was acquired on a 3T Siemens Prisma using a 2D cine-PC pulse sequence. Three consecutive flow measurements were acquired at the CA and C2-C3 area. Intraclass correlation coefficient (ICC) and coefficient of variance (CV) were used to evaluate intrarater, inter-rater, and test-retest reliability. RESULTS Among the 26 flow parameters analyzed, 22 had excellent reliability (ICC > 0.80), including measurements of CSF stroke volume, flush peak, and fill peak, and 4 parameters had good reliability (ICC 0.60-0.79). 16 flow parameters had a mean CV ≤ 10%, 7 had a CV ≤ 15%, and 3 had a CV ≤ 30%. All CSF and CBF flow measurements had excellent inter-rater and intrarater reliability (ICC > 0.80). CONCLUSION This study shows that CSF and CBF flow can be reliably measured at the CA and C2-C3 area using PC-MRI, making it a promising tool for studying flow dynamics in the central nervous system.
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Affiliation(s)
- Ashwin R Sakhare
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California.,Department of Neurology, Laboratory of Neuro Imaging, Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California
| | - Giuseppe Barisano
- Department of Neurology, Laboratory of Neuro Imaging, Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California.,Neuroscience Graduate Program, University of Southern California, Los Angeles, California
| | - Judy Pa
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California.,Department of Neurology, Laboratory of Neuro Imaging, Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California.,Neuroscience Graduate Program, University of Southern California, Los Angeles, California
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23
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Saqr KM, Mansour O, Tupin S, Hassan T, Ohta M. Evidence for non-Newtonian behavior of intracranial blood flow from Doppler ultrasonography measurements. Med Biol Eng Comput 2018; 57:1029-1036. [PMID: 30523533 DOI: 10.1007/s11517-018-1926-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/30/2018] [Indexed: 11/30/2022]
Abstract
Computational fluid dynamics (CFD) studies of intracranial hemodynamics often use Newtonian viscosity model to close the shear rate term in the Navier-Stokes equation. This is based on a commonly accepted hypothesis which state that non-Newtonian effects can be neglected in intracranial blood flow. This study aims to examine the validity of such hypothesis to guide future CFD studies of intracranial hemodynamics. Doppler ultrasonography (DUS) measurements of systolic and diastolic vessel diameter and blood velocity were conducted on 16 subjects (mean age 50.6). The measurements were conducted on the internal carotid (ICA), middle cerebral (MCA), and anterior communicating (AComA) arteries. Systolic and diastolic wall shear stress (WSS) values were calculated via the Hagen-Poiseuille exact solution using Newtonian and three different non-Newtonian models: namely Carreau, power-law and Herschel-Bulkley models. The Weissenberg-Rabinowitsch correction for blood shear-thinning viscosity was applied to the non-Newtonian models. The error percentage between the two sets of models was calculated and discussed. The Newtonian hypothesis was tested statistically and discussed using paired t tests. Significant differences (P < 0.0001) were found between the Newtonian and non-Newtonian WSS in ICA. In MCA and AComA, similar differences were found except in the systole and diastole for the Herschel-Bulkley and power-law models (P = 0.0669, P = 0.7298), respectively. The error between the Newtonian and non-Newtonian models ranged from - 27 to 30% (0.2 to 2.2 Pa). These values could affect the physical interpretation of IA CFD studies. Evidence suggests that the Newtonian assumption may be inappropriate to investigate intracranial hemodynamics. Graphical abstract The WSS estimation error resulting from using the Newtonian assumption compared to three non-Newtonian models for ICA, MCA, and AComA in systole and diastole conditions, based on TCCD measurements of 16 subjects. The error due to the Newtonian assumption ranged from 0.2 to 2.2 Pa (- 27 to 30%). These values could affect the physical interpretation of IA CFD studies.
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Affiliation(s)
- Khalid M Saqr
- Biomedical Flow Dynamics Laboratory, Institute of Fluid Science, Tohoku University, Sendai, Miyagi, 980-8577, Japan. .,College of Engineering and Technology, Arab Academy for Science, Technology and Maritime Transport (AASTMT), Abu Kir, Alexandria, 1029, Egypt. .,Research Center for Computational Neurovascular Biomechanics (RCCNB), Smouha University Hospital, Alexandria University, Alexandria, 21648, Egypt.
| | - Ossama Mansour
- Research Center for Computational Neurovascular Biomechanics (RCCNB), Smouha University Hospital, Alexandria University, Alexandria, 21648, Egypt.,Department of Neurology, Stroke Unit, Alexandria University School of Medicine, Azarita Medical Campus, Alexandria, 21514, Egypt
| | - Simon Tupin
- Biomedical Flow Dynamics Laboratory, Institute of Fluid Science, Tohoku University, Sendai, Miyagi, 980-8577, Japan
| | - Tamer Hassan
- Research Center for Computational Neurovascular Biomechanics (RCCNB), Smouha University Hospital, Alexandria University, Alexandria, 21648, Egypt.,Department of Neurosurgery, Alexandria University School of Medicine, Azarita Medical Campus, Alexandria, 21514, Egypt
| | - Makoto Ohta
- Biomedical Flow Dynamics Laboratory, Institute of Fluid Science, Tohoku University, Sendai, Miyagi, 980-8577, Japan
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Wen B, Tian S, Cheng J, Li Y, Zhang H, Xue K, Zhang Z, Fan Y, Wu B. Test–retest multisite reproducibility of neurovascular 4D flow MRI. J Magn Reson Imaging 2018; 49:1543-1552. [PMID: 30443945 DOI: 10.1002/jmri.26564] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
- Baohong Wen
- Department of MRI First Affiliated Hospital of Zhengzhou University Zhengzhou Henan P.R. China
| | - Shuping Tian
- Department of Radiology Navy General Hospital Beijing P.R. China
| | - Jingliang Cheng
- Department of MRI First Affiliated Hospital of Zhengzhou University Zhengzhou Henan P.R. China
| | - Yinhua Li
- Department of MRI First Affiliated Hospital of Zhengzhou University Zhengzhou Henan P.R. China
| | - Huixia Zhang
- Department of MRI First Affiliated Hospital of Zhengzhou University Zhengzhou Henan P.R. China
| | - Kangkang Xue
- Department of MRI First Affiliated Hospital of Zhengzhou University Zhengzhou Henan P.R. China
| | - Zanxia Zhang
- Department of MRI First Affiliated Hospital of Zhengzhou University Zhengzhou Henan P.R. China
| | - Yang Fan
- GE Healthcare China Beijing P.R. China
| | - Bing Wu
- GE Healthcare China Beijing P.R. China
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25
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Maier IL, Hofer S, Joseph AA, Merboldt KD, Tan Z, Schregel K, Knauth M, Bähr M, Psychogios MN, Liman J, Frahm J. Carotid artery flow as determined by real-time phase-contrast flow MRI and neurovascular ultrasound: A comparative study of healthy subjects. Eur J Radiol 2018; 106:38-45. [PMID: 30150049 DOI: 10.1016/j.ejrad.2018.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 04/02/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The assessment of carotid artery flow by neurovascular ultrasound (nvUS) can be complemented by real-time phase-contrast (RT-PC) flow MRI which apart from quantitative flow parameters offers velocity distributions across the entire vessel lumen. MATERIALS AND METHODS The feasibility and diagnostic potential of RT-PC flow MRI was evaluated in 20 healthy volunteers in comparison to conventional nvUS. RT-PC flow MRI at 40 ms temporal resolution and 0.8 mm in-plane resolution resulted in velocity maps with low phase noise and high spatiotemporal accuracy by exploiting respective advances of a recent nonlinear inverse model-based reconstruction. Peak-systolic velocities (PSV), end-diastolic velocities (EDV), flow volumes and comprehensive velocity profiles were determined in the common, internal and external carotid artery on both sides. RESULTS Flow characteristics such as pulsatility and individual abnormalities shown on nvUS could be reproduced and visualized in detail by RT-PC flow MRI. PSV to EDV differences revealed good agreement between both techniques, mean PSV and EDV were significantly lower and flow volumes were higher for MRI. CONCLUSION Our findings suggest that RT-PC flow MRI adds to clinical diagnostics, e.g. by alterations of dynamic velocity distributions in patients with carotid stenosis. Lower PSV and EDV values than for nvUS mainly reflect the longer MRI acquisition time which attenuates short peak velocities, while higher flow volumes benefit from a proper assessment of the true vessel lumen.
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Affiliation(s)
- Ilko L Maier
- Department of Neurology, University Medical Center Göttingen, Germany.
| | - Sabine Hofer
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany.
| | - Arun A Joseph
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Germany.
| | - K Dietmar Merboldt
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany.
| | - Zhengguo Tan
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany.
| | - Katharina Schregel
- Department of Neuroradiology, University Medical Center Göttingen, Germany; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Michael Knauth
- Department of Neuroradiology, University Medical Center Göttingen, Germany.
| | - Mathias Bähr
- Department of Neurology, University Medical Center Göttingen, Germany.
| | | | - Jan Liman
- Department of Neurology, University Medical Center Göttingen, Germany.
| | - Jens Frahm
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Germany.
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26
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Fekkes S, Saris AECM, Nillesen MM, Menssen J, Hansen HHG, de Korte CL. Simultaneous Vascular Strain and Blood Vector Velocity Imaging Using High-Frequency Versus Conventional-Frequency Plane Wave Ultrasound: A Phantom Study. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2018; 65:1166-1181. [PMID: 29993371 DOI: 10.1109/tuffc.2018.2834724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Plaque strain and blood vector velocity imaging of stenosed arteries are expected to aid in diagnosis and prevention of cerebrovascular disease. Ultrafast plane wave imaging enables simultaneous strain and velocity estimation. Multiple ultrasound vendors are introducing high-frequency ultrasound probes and systems. This paper investigates whether the use of high-frequency ultrafast ultrasound is beneficial for assessing blood velocities and strain in arteries. The performance of strain and blood flow velocity estimation was compared between a high-frequency transducer (MS250, fc = 21 MHz) and a clinically utilized transducer (L12-5, fc = 9 MHz). Quantitative analysis based on straight tube phantom experiments revealed that the MS250 outperformed the L12-5 in the superficial region: low velocities near the wall were more accurately estimated and wall strains were better resolved. At greater than 2-cm echo depth, the L12-5 performed better due to the high attenuation of the MS250 probe. Qualitative comparison using a perfused patient-specific carotid bifurcation phantom confirmed these findings. Thus, in conclusion, for strain and blood velocity estimation for depths up to ~2 cm, a high-frequency probe is recommended.
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27
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Experimental quantification of the fluid dynamics in blood-processing devices through 4D-flow imaging: A pilot study on a real oxygenator/heat-exchanger module. J Biomech 2018; 68:14-23. [PMID: 29279196 DOI: 10.1016/j.jbiomech.2017.12.014] [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] [Received: 06/26/2017] [Revised: 11/03/2017] [Accepted: 12/07/2017] [Indexed: 11/21/2022]
Abstract
The performance of blood-processing devices largely depends on the associated fluid dynamics, which hence represents a key aspect in their design and optimization. To this aim, two approaches are currently adopted: computational fluid-dynamics, which yields highly resolved three-dimensional data but relies on simplifying assumptions, and in vitro experiments, which typically involve the direct video-acquisition of the flow field and provide 2D data only. We propose a novel method that exploits space- and time-resolved magnetic resonance imaging (4D-flow) to quantify the complex 3D flow field in blood-processing devices and to overcome these limitations. We tested our method on a real device that integrates an oxygenator and a heat exchanger. A dedicated mock loop was implemented, and novel 4D-flow sequences with sub-millimetric spatial resolution and region-dependent velocity encodings were defined. Automated in house software was developed to quantify the complex 3D flow field within the different regions of the device: region-dependent flow rates, pressure drops, paths of the working fluid and wall shear stresses were computed. Our analysis highlighted the effects of fine geometrical features of the device on the local fluid-dynamics, which would be unlikely observed by current in vitro approaches. Also, the effects of non-idealities on the flow field distribution were captured, thanks to the absence of the simplifying assumptions that typically characterize numerical models. To the best of our knowledge, our approach is the first of its kind and could be extended to the analysis of a broad range of clinically relevant devices.
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28
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Pagé G, Bettoni J, Salsac AV, Balédent O. Influence of principal component analysis acceleration factor on velocity measurement in 2D and 4D PC-MRI. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2018; 31:469-481. [PMID: 29357015 DOI: 10.1007/s10334-018-0673-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/28/2017] [Accepted: 01/03/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The objective of the study was to determine how to optimize 2D and 4D phase-contrast magnetic resonance imaging (PC-MRI) acquisitions to acquire flow velocities in millimetric vessels. In particular, we search for the best compromise between acquisition time and accuracy and assess the influence of the principal component analysis (PCA). MATERIALS AND METHODS 2D and 4D PC-MRI measurements are conducted within two in vitro vessel phantoms: a Y-bifurcation phantom, the branches of which range from 2 to 5 mm in diameter, and a physiological subject-specific phantom of the carotid bifurcation. The same sequences are applied in vivo in carotid vasculature. RESULTS For a vessel oriented in the axial direction, both 2D and axial 4D PC-MRI provided accuracy measurements regardless of the k-t PCA factor, while the acquisition time is reduced by a factor 6 for k-t PCA maximum value. The in vivo measurements show that the proposed sequences are adequate to acquire 2D and 4D velocity fields in millimetric vessels and with clinically realistic time durations. CONCLUSION The study shows the feasibility of conducting fast, high-resolution PC-MRI flow measurements in millimetric vessels and that it is worth maximizing the k-t PCA factor to reduce the acquisition time in the case of 2D and 4D axial acquisitions.
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Affiliation(s)
- Gwenaël Pagé
- BioFlow Image, University Hospital of Amiens Picardy, Université de Picardie Jules Verne, Avenue Rene Laennec, Salouël, 80480, Amiens, France.
| | - Jérémie Bettoni
- Maxillo-Facial Surgery, University Hospital of Amiens-Picardie, Amiens, France
| | - Anne-Virginie Salsac
- Biomechanics and Bioengineering Laboratory (UMR CNRS 7338), Sorbonne Universités, Université de Technologie de Compiègne-CNRS, Compiègne, France
| | - Olivier Balédent
- BioFlow Image, University Hospital of Amiens Picardy, Université de Picardie Jules Verne, Avenue Rene Laennec, Salouël, 80480, Amiens, France.,Laboratory of Image Processing, University Hospital of Amiens-Picardie, Amiens, France
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29
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Wehrum T, Guenther F, Fuchs A, Schuchardt F, Hennemuth A, Harloff A. Measurement of cardiac valve and aortic blood flow velocities in stroke patients: a comparison of 4D flow MRI and echocardiography. Int J Cardiovasc Imaging 2018; 34:939-946. [DOI: 10.1007/s10554-018-1298-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/04/2018] [Indexed: 11/30/2022]
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30
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Holbek S, Hansen KL, Bouzari H, Ewertsen C, Stuart MB, Thomsen C, Nielsen MB, Jensen JA. Common Carotid Artery Flow Measured by 3-D Ultrasonic Vector Flow Imaging and Validated with Magnetic Resonance Imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:2213-2220. [PMID: 28711283 DOI: 10.1016/j.ultrasmedbio.2017.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 05/22/2017] [Accepted: 06/05/2017] [Indexed: 06/07/2023]
Abstract
Ultrasound (US) examination of the common carotid artery was compared with a through-plane magnetic resonance imaging (MRI) sequence to validate a recently proposed technique for 3-D US vector flow imaging. Data from the first volunteer examined were used as the training set, before volume flow and peak velocities were calculated for the remaining eight volunteers. Peak systolic velocities (PSVs) and volume flow obtained with 3-D US were, on average, 34% higher and 24% lower than those obtained with MRI, respectively. A high correlation was observed for PSV (r = 0.79), whereas a lower correlation was observed for volume flow (r = 0.43). The overall standard deviations were ±5.7% and ±5.7% for volume flow and PSV with 3-D US, compared with ±2.7% and ±3.2% for MRI. Finally, the data were re-processed with a change in the parameter settings for the echo-canceling filter to investigate its influence on overall performance. PSV was less affected by the re-processing, whereas the difference in volume flow between 3-D vector flow imaging and MRI was reduced to -9%, and with an improved overall standard deviation of ±4.7%. The results illustrate the feasibility of using 3-D US for precise and angle-independent volume flow and PSV estimation in vivo.
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Affiliation(s)
- Simon Holbek
- Center for Fast Ultrasound Imaging, Department of Electrical Engineering, Technical University of Denmark, Lyngby, Denmark.
| | | | - Hamed Bouzari
- Center for Fast Ultrasound Imaging, Department of Electrical Engineering, Technical University of Denmark, Lyngby, Denmark
| | - Caroline Ewertsen
- Department of Radiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Matthias Bo Stuart
- Center for Fast Ultrasound Imaging, Department of Electrical Engineering, Technical University of Denmark, Lyngby, Denmark
| | - Carsten Thomsen
- Department of Radiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Jørgen Arendt Jensen
- Center for Fast Ultrasound Imaging, Department of Electrical Engineering, Technical University of Denmark, Lyngby, Denmark
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31
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Design and Comparison of Large Vessel Stents: Balloon Expandable and Self-Expanding Peripheral Arterial Stents. Interv Cardiol Clin 2017; 5:365-380. [PMID: 28582034 DOI: 10.1016/j.iccl.2016.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Endovascular stenting has evolved over the last 50 years since its inception into the framework of management of vascular atherosclerotic disease. Stent design has evolved as lesion complexity has increased. Nevertheless, certain first principles regarding stent design have been recapitulated time and again with every iteration of endovascular stents. This article reviews principles of endovascular stent design and compares and contrasts key aspects of balloon expandable and self-expanding stents.
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32
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Sotelo J, Urbina J, Valverde I, Mura J, Tejos C, Irarrazaval P, Andia ME, Hurtado DE, Uribe S. Three-dimensional quantification of vorticity and helicity from 3D cine PC-MRI using finite-element interpolations. Magn Reson Med 2017; 79:541-553. [DOI: 10.1002/mrm.26687] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/01/2017] [Accepted: 03/05/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Julio Sotelo
- Biomedical Imaging Center; Pontificia Universidad Católica de Chile; Santiago Chile
- Department of Electrical Engineering; Pontificia Universidad Católica de Chile; Santiago Chile
- Department of Structural and Geotechnical Engineering; Pontificia Universidad Católica de Chile; Santiago Chile
| | - Jesús Urbina
- Biomedical Imaging Center; Pontificia Universidad Católica de Chile; Santiago Chile
- Department of Radiology; School of Medicine, Pontificia Universidad Católica de Chile; Santiago Chile
| | - Israel Valverde
- Pediatric Cardiology Unit; Hospital Virgen del Rocio; Sevilla Spain
- Cardiovascular Pathology Unit; Institute of Biomedicine of Seville (IBIS), Hospital Virgen del Rocio; Sevilla Spain
| | - Joaquín Mura
- Biomedical Imaging Center; Pontificia Universidad Católica de Chile; Santiago Chile
| | - Cristián Tejos
- Biomedical Imaging Center; Pontificia Universidad Católica de Chile; Santiago Chile
- Department of Electrical Engineering; Pontificia Universidad Católica de Chile; Santiago Chile
- Institute for Biological and Medical Engineering; Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile; Santaigo Chile
| | - Pablo Irarrazaval
- Biomedical Imaging Center; Pontificia Universidad Católica de Chile; Santiago Chile
- Department of Electrical Engineering; Pontificia Universidad Católica de Chile; Santiago Chile
- Institute for Biological and Medical Engineering; Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile; Santaigo Chile
| | - Marcelo E. Andia
- Biomedical Imaging Center; Pontificia Universidad Católica de Chile; Santiago Chile
- Department of Radiology; School of Medicine, Pontificia Universidad Católica de Chile; Santiago Chile
- Institute for Biological and Medical Engineering; Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile; Santaigo Chile
| | - Daniel E. Hurtado
- Department of Structural and Geotechnical Engineering; Pontificia Universidad Católica de Chile; Santiago Chile
- Institute for Biological and Medical Engineering; Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile; Santaigo Chile
| | - Sergio Uribe
- Biomedical Imaging Center; Pontificia Universidad Católica de Chile; Santiago Chile
- Department of Radiology; School of Medicine, Pontificia Universidad Católica de Chile; Santiago Chile
- Institute for Biological and Medical Engineering; Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile; Santaigo Chile
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Khan MA, Liu J, Tarumi T, Lawley JS, Liu P, Zhu DC, Lu H, Zhang R. Measurement of cerebral blood flow using phase contrast magnetic resonance imaging and duplex ultrasonography. J Cereb Blood Flow Metab 2017; 37:541-549. [PMID: 26873888 PMCID: PMC5381449 DOI: 10.1177/0271678x16631149] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Phase contrast magnetic resonance imaging (PC-MRI) and color-coded duplex ultrasonography (CDUS) are commonly used for measuring cerebral blood flow in the internal carotid (ICA) and vertebral arteries. However, agreement between the two methods has been controversial. Recent development of high spatial and temporal resolution blood vessel wall edge-detection and wall-tracking methods with CDUS increased the accuracy and reliability of blood vessel diameter, hence cerebral blood flow measurement. The aim of this study was to compare the improved CDUS method with 3 T PC-MRI for cerebral blood flow measurements. We found that cerebral blood flow velocity measured in the ICA was lower using PC-MRI than CDUS (left ICA: PC-MRI, 18.0 ± 4.2 vs. CDUS, 25.6 ± 8.6 cm/s; right ICA: PC-MRI, 18.5 ± 4.8 vs. CDUS, 26.6 ± 6.7 cm/s, both p < 0.01). However, ICA diameters measured using PC-MRI were larger (left ICA: PC-MRI, 4.7 ± 0.50 vs. CDUS, 4.1 ± 0.46 mm; right ICA: PC-MRI, 4.5 ± 0.49 vs. CDUS, 4.0 ± 0.45 mm, both p < 0.01). Cerebral blood flow velocity measured in the left vertebral artery with PC-MRI was also lower than CDUS, but no differences in vertebral artery diameter were observed between the methods. Dynamic changes and/or intrinsic physiological fluctuations may have caused these differences in vessel diameter and velocity measurements between the methods. However, estimation of volumetric cerebral blood flow was similar and correlated between the methods despite the presence of large individual differences. These findings support the use of CDUS for cerebral blood flow measurements in the ICA and vertebral artery.
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Affiliation(s)
- Muhammad Ayaz Khan
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA.,2 Department of Internal Medicine, University of Texas, Dallas, TX, USA
| | - Jie Liu
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA.,2 Department of Internal Medicine, University of Texas, Dallas, TX, USA
| | - Takashi Tarumi
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA.,2 Department of Internal Medicine, University of Texas, Dallas, TX, USA
| | - Justin Stevan Lawley
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA.,2 Department of Internal Medicine, University of Texas, Dallas, TX, USA
| | - Peiying Liu
- 3 Advanced Imaging Research Center, University of Texas, Dallas, TX, USA
| | - David C Zhu
- 4 Department of Radiology and Psychology, Michigan State University, East Lansing, MI, USA
| | - Hanzhang Lu
- 3 Advanced Imaging Research Center, University of Texas, Dallas, TX, USA
| | - Rong Zhang
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA.,2 Department of Internal Medicine, University of Texas, Dallas, TX, USA
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Correia M, Provost J, Tanter M, Pernot M. 4D ultrafast ultrasound flow imaging:in vivoquantification of arterial volumetric flow rate in a single heartbeat. Phys Med Biol 2016; 61:L48-L61. [DOI: 10.1088/0031-9155/61/23/l48] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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35
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Svalbring E, Fredriksson A, Eriksson J, Dyverfeldt P, Ebbers T, Bolger AF, Engvall J, Carlhäll CJ. Altered Diastolic Flow Patterns and Kinetic Energy in Subtle Left Ventricular Remodeling and Dysfunction Detected by 4D Flow MRI. PLoS One 2016; 11:e0161391. [PMID: 27532640 PMCID: PMC4988651 DOI: 10.1371/journal.pone.0161391] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 08/04/2016] [Indexed: 01/24/2023] Open
Abstract
AIMS 4D flow magnetic resonance imaging (MRI) allows quantitative assessment of left ventricular (LV) function according to characteristics of the dynamic flow in the chamber. Marked abnormalities in flow components' volume and kinetic energy (KE) have previously been demonstrated in moderately dilated and depressed LV's compared to healthy subjects. We hypothesized that these 4D flow-based measures would detect even subtle LV dysfunction and remodeling. METHODS AND RESULTS We acquired 4D flow and morphological MRI data from 26 patients with chronic ischemic heart disease with New York Heart Association (NYHA) class I and II and with no to mild LV systolic dysfunction and remodeling, and from 10 healthy controls. A previously validated method was used to separate the LV end-diastolic volume (LVEDV) into functional components: direct flow, which passes directly to ejection, and non-ejecting flow, which remains in the LV for at least 1 cycle. The direct flow and non-ejecting flow proportions of end-diastolic volume and KE were assessed. The proportions of direct flow volume and KE fell with increasing LVEDV-index (LVEDVI) and LVESV-index (LVESVI) (direct flow volume r = -0.64 and r = -0.74, both P<0.001; direct flow KE r = -0.48, P = 0.013, and r = -0.56, P = 0.003). The proportions of non-ejecting flow volume and KE rose with increasing LVEDVI and LVESVI (non-ejecting flow volume: r = 0.67 and r = 0.76, both P<0.001; non-ejecting flow KE: r = 0.53, P = 0.005 and r = 0.52, P = 0.006). The proportion of direct flow volume correlated moderately to LVEF (r = 0.68, P < 0.001) and was higher in a sub-group of patients with LVEDVI >74 ml/m2 compared to patients with LVEDVI <74 ml/m2 and controls (both P<0.05). CONCLUSION Direct flow volume and KE proportions diminish with increased LV volumes, while non-ejecting flow proportions increase. A decrease in direct flow volume and KE at end-diastole proposes that alterations in these novel 4D flow-specific markers may detect LV dysfunction even in subtle or subclinical LV remodeling.
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Affiliation(s)
- Emil Svalbring
- Department of Medical and Health Sciences, Division of Cardiovascular Medicine, Linköping University, Linköping, Sweden
| | - Alexandru Fredriksson
- Department of Medical and Health Sciences, Division of Cardiovascular Medicine, Linköping University, Linköping, Sweden
| | - Jonatan Eriksson
- Department of Medical and Health Sciences, Division of Cardiovascular Medicine, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Petter Dyverfeldt
- Department of Medical and Health Sciences, Division of Cardiovascular Medicine, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Tino Ebbers
- Department of Medical and Health Sciences, Division of Cardiovascular Medicine, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Ann F Bolger
- Department of Medical and Health Sciences, Division of Cardiovascular Medicine, Linköping University, Linköping, Sweden
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Jan Engvall
- Department of Medical and Health Sciences, Division of Cardiovascular Medicine, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Department of Clinical Physiology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Carl-Johan Carlhäll
- Department of Medical and Health Sciences, Division of Cardiovascular Medicine, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Department of Clinical Physiology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Schnell S, Wu C, Ansari SA. Four-dimensional MRI flow examinations in cerebral and extracerebral vessels - ready for clinical routine? Curr Opin Neurol 2016; 29:419-28. [PMID: 27262148 PMCID: PMC4939804 DOI: 10.1097/wco.0000000000000341] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW To evaluate the feasibility of 4-dimensional (4D) flow MRI for the clinical assessment of cerebral and extracerebral vascular hemodynamics in patients with neurovascular disease. RECENT FINDINGS 4D flow MRI has been applied in multiple studies to qualitatively and quantitatively study intracranial aneurysm blood flow for potential risk stratification and to assess treatment efficacy of various neurovascular lesions, including intraaneurysmal and parent artery blood flow after flow diverter stent placement and staged embolizations of arteriovenous malformations and vein of Galen aneurysmal malformations. Recently, the technique has been utilized to characterize age-related changes of normal cerebral hemodynamics in healthy individuals over a broad age range. SUMMARY 4D flow MRI is a useful tool for the noninvasive, volumetric and quantitative hemodynamic assessment of neurovascular disease without the need for gadolinium contrast agents. Further improvements are warranted to overcome technical limitations before broader clinical implementation. Current developments, such as advanced acceleration techniques (parallel imaging and compressed sensing) for faster data acquisition, dual or multiple velocity encoding strategies for more accurate arterial and venous flow quantification, ultrahigh-field strengths to achieve higher spatial resolution and streamlined postprocessing workflow for more efficient and standardized flow analysis, are promising advancements in 4D flow MRI.
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Affiliation(s)
- Susanne Schnell
- Dept. of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Can Wu
- Dept. of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
- Dept. of Biomedical Engineering, Northwestern University, Evanston, Illinois
| | - Sameer A. Ansari
- Dept. of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
- Dept. of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
- Dept. of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
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Schnell S, Smith DA, Barker AJ, Entezari P, Honarmand AR, Carr ML, Malaisrie SC, McCarthy PM, Collins J, Carr JC, Markl M. Altered aortic shape in bicuspid aortic valve relatives influences blood flow patterns. Eur Heart J Cardiovasc Imaging 2016; 17:1239-1247. [PMID: 27461208 DOI: 10.1093/ehjci/jew149] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 06/23/2016] [Indexed: 12/25/2022] Open
Abstract
AIMS Bicuspid aortic valve (BAV) is known to exhibit familial inheritance and is associated with aortopathy and altered aortic haemodynamics. However, it remains unclear whether BAV-related aortopathy can be inherited independently of valve morphology. METHODS AND RESULTS Four-dimensional flow magnetic resonance imaging for the in vivo assessment of thoracic aortic 3D blood flow was performed in 24 BAV relatives with trileaflet aortic valves (age = 40 ± 14 years) and 15 healthy controls (age = 37 ± 10 years). Data analysis included aortic dimensions, shape (round/gothic/cubic), and 3D blood flow characteristics (semi-quantitative vortex/helix grading and peak velocities). Cubic and gothic aortic shapes were markedly more prevalent in BAV relatives compared with controls (38 vs. 7%). Ascending aorta (AAo) vortex flow in BAV relatives was significantly increased compared with controls (grading = 1.5 ± 1.0 vs. 0.6 ± 0.9, P = 0.015). Aortic haemodynamics were influenced by aortic shape: peak velocities were reduced for gothic aortas vs. round aortas (P = 0.003); vortex flow was increased for cubic aortas in the AAo (P < 0.001) and aortic arch (P = 0.004); vortex and helix flows were elevated for gothic aortas in the AAo and descending aorta (P = 0.003, P = 0.029). Logistic regression demonstrated significant associations of shape with severity of vortex flow in AAo (P < 0.001) and aortic arch (P = 0.016) in BAV relatives. CONCLUSION BAV relatives expressed altered aortic shape and increased vortex flow despite the absence of valvular disease or aortic dilatation. These data suggest a heritable component of BAV-related aortopathy affecting aortic shape and aberrant blood flow, independent of valve morphology.
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Affiliation(s)
- Susanne Schnell
- Department of Radiology, Northwestern University, 737 N. Michigan Avenue, Suite 1600, Chicago, IL 60611, USA
| | - Danielle A Smith
- Division of Cardiac Surgery, Northwestern University, 201 E. Huron Street, Galter 11-140, Chicago, IL 60611, USA
| | - Alex J Barker
- Department of Radiology, Northwestern University, 737 N. Michigan Avenue, Suite 1600, Chicago, IL 60611, USA
| | - Pegah Entezari
- Department of Radiology, Northwestern University, 737 N. Michigan Avenue, Suite 1600, Chicago, IL 60611, USA
| | - Amir R Honarmand
- Department of Radiology, Northwestern University, 737 N. Michigan Avenue, Suite 1600, Chicago, IL 60611, USA
| | - Maria L Carr
- Department of Radiology, Northwestern University, 737 N. Michigan Avenue, Suite 1600, Chicago, IL 60611, USA
| | - S Chris Malaisrie
- Division of Cardiac Surgery, Northwestern University, 201 E. Huron Street, Galter 11-140, Chicago, IL 60611, USA
| | - Patrick M McCarthy
- Division of Cardiac Surgery, Northwestern University, 201 E. Huron Street, Galter 11-140, Chicago, IL 60611, USA
| | - Jeremy Collins
- Department of Radiology, Northwestern University, 737 N. Michigan Avenue, Suite 1600, Chicago, IL 60611, USA
| | - James C Carr
- Department of Radiology, Northwestern University, 737 N. Michigan Avenue, Suite 1600, Chicago, IL 60611, USA
| | - Michael Markl
- Department of Radiology, Northwestern University, 737 N. Michigan Avenue, Suite 1600, Chicago, IL 60611, USA.,Department Biomedical Engineering, McCormick School of Engineering, Northwestern University, 2145 Sheridan Road, Evanston, IL 60208, USA
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Odagiri K, Inui N, Hakamata A, Inoue Y, Suda T, Takehara Y, Sakahara H, Sugiyama M, Alley MT, Wakayama T, Watanabe H. Non-invasive evaluation of pulmonary arterial blood flow and wall shear stress in pulmonary arterial hypertension with 3D phase contrast magnetic resonance imaging. SPRINGERPLUS 2016; 5:1071. [PMID: 27462519 PMCID: PMC4943915 DOI: 10.1186/s40064-016-2755-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 07/04/2016] [Indexed: 12/12/2022]
Abstract
Background Recently, time-resolved 3D phase contrast magnetic resonance imaging (4D-flow) allows flow dynamics in patients with pulmonary arterial hypertension to be measured. Abnormal flow dynamics, such as vortex blood flow pattern in the pulmonary artery (PA), may reflect progression of pulmonary arterial hypertension (PAH). Some reports suggested that abnormal blood flow parameters including wall shear stress (WSS) could be markers of PAH. However, it was not fully assessed clinical usefulness of these variables. We aimed to assess whether these flow dynamic parameters, such as vortex formation time (VFT) and WSS, were associated with right ventricular (RV) function. Results Fifteen subjects, nine with PAH and six healthy volunteers, underwent 4D-flow. Differences of Blood flow patterns, blood flow velocities and WSS between PAH patients and healthy volunteers were evaluated. We also assessed the association between VFT, WSS and RV function in PAH patients. Both vortex blood flow patterns and early systolic retrograde flow in the main PA were observed in all patients with PAH. The PA flow velocities and WSS in patients with PAH were lower than those in healthy volunteers, but that blood flow volumes in the MPA, RPA and LPA and SV in the MPA were broadly comparable between the groups. The mean VFT was 35.0 ± 16.6 % of the cardiac cycle. The VFT significantly correlated with RV ejection fraction, RV end systolic volume, and RV end systolic volume index (RVEF = 75.1 + (−85.7)·VFT, p = 0.003, RVESV = 12.4 + 181.8·VFT, p = 0.037 and RVESVI = 10.6 + 114.8·VFT, p = 0.038, respectively) in PAH patients, whereas WSS did not correlate with RV function. Conclusions We confirmed that abnormal blood flow dynamics, including the vortex formation and the early onset of retrograde flow, low WSS in the PA were characteristics of PAH. The VFT may be associated with right ventricular dysfunction, whereas WSS was not. Our results suggest that 4D-flow is an effective means of detecting right heart failure as well as diagnosing PAH. Clinical trial registration URL: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi. Unique identifier: UMIN000011128 Electronic supplementary material The online version of this article (doi:10.1186/s40064-016-2755-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Keiichi Odagiri
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192 Japan
| | - Naoki Inui
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192 Japan
| | - Akio Hakamata
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192 Japan
| | - Yusuke Inoue
- Department of Internal Medicine II, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takafumi Suda
- Department of Internal Medicine II, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yasuo Takehara
- Department of Radiology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Harumi Sakahara
- Department of Radiology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masataka Sugiyama
- Department of Radiology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Marcus T Alley
- Department of Radiology, Stanford University, Palo Alto, CA USA
| | | | - Hiroshi Watanabe
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192 Japan
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Liu X, Zhang H, Ren L, Xiong H, Gao Z, Xu P, Huang W, Wu W. Functional assessment of the stenotic carotid artery by CFD-based pressure gradient evaluation. Am J Physiol Heart Circ Physiol 2016; 311:H645-53. [PMID: 27371686 DOI: 10.1152/ajpheart.00888.2015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 06/24/2016] [Indexed: 11/22/2022]
Abstract
The functional assessment of a hemodynamic significant stenosis base on blood pressure variation has been applied for evaluation of the myocardial ischemic event. This functional assessment shows great potential for improving the accuracy of the classification of the severity of carotid stenosis. To explore the value of grading the stenosis using a pressure gradient (PG)-we had reconstructed patient-specific carotid geometries based on MRI images-computational fluid dynamics were performed to analyze the PG in their stenotic arteries. Doppler ultrasound image data and the corresponding MRI image data of 19 patients with carotid stenosis were collected. Based on these, 31 stenotic carotid arterial geometries were reconstructed. A combinatorial boundary condition method was implemented for steady-state computer fluid dynamics simulations. Anatomic parameters, including tortuosity (T), the angle of bifurcation, and the cross-sectional area of the remaining lumen, were collected to investigate the effect on the pressure distribution. The PG is highly correlated with the severe stenosis (r = 0.902), whereas generally, the T and the angle of the bifurcation negatively correlate to the pressure drop of the internal carotid artery stenosis. The calculation required <10 min/case, which made it prepared for the fast diagnosis of the severe stenosis. According to the results, we had proposed a potential threshold value for distinguishing severe stenosis from mild-moderate stenosis (PG = 0.88). In conclusion, the PG could serve as the additional factor for improving the accuracy of grading the severity of the stenosis.
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Affiliation(s)
- Xin Liu
- Institute of Clinical Anatomy, Southern Medical University, Guangzhou, China
| | - Heye Zhang
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Lijie Ren
- Neurology Department, Shenzhen Second People's Hospital, Shenzhen, Guangdon, China
| | - Huahua Xiong
- Department of Ultrasound, Shenzhen Second People's Hospital, Shenzhen, Guangdon, China; and
| | - Zhifan Gao
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Pengcheng Xu
- Institute of Clinical Anatomy, Southern Medical University, Guangzhou, China
| | - Wenhua Huang
- Institute of Clinical Anatomy, Southern Medical University, Guangzhou, China
| | - Wanqing Wu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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Ha H, Kim GB, Kweon J, Lee SJ, Kim YH, Lee DH, Yang DH, Kim N. Hemodynamic Measurement Using Four-Dimensional Phase-Contrast MRI: Quantification of Hemodynamic Parameters and Clinical Applications. Korean J Radiol 2016; 17:445-62. [PMID: 27390537 PMCID: PMC4936168 DOI: 10.3348/kjr.2016.17.4.445] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 04/22/2016] [Indexed: 11/21/2022] Open
Abstract
Recent improvements have been made to the use of time-resolved, three-dimensional phase-contrast (PC) magnetic resonance imaging (MRI), which is also named four-dimensional (4D) PC-MRI or 4D flow MRI, in the investigation of spatial and temporal variations in hemodynamic features in cardiovascular blood flow. The present article reviews the principle and analytical procedures of 4D PC-MRI. Various fluid dynamic biomarkers for possible clinical usage are also described, including wall shear stress, turbulent kinetic energy, and relative pressure. Lastly, this article provides an overview of the clinical applications of 4D PC-MRI in various cardiovascular regions.
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Affiliation(s)
- Hojin Ha
- POSTECH Biotech Center, Pohang University of Science and Technology, Pohang 37673, Korea
| | - Guk Bae Kim
- Asan Institute of Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Jihoon Kweon
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Sang Joon Lee
- POSTECH Biotech Center, Pohang University of Science and Technology, Pohang 37673, Korea.; Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang 37673, Korea
| | - Young-Hak Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Deok Hee Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Dong Hyun Yang
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Namkug Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.; Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
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Kim GB, Ha H, Kweon J, Lee SJ, Kim YH, Yang DH, Kim N. Post-stenotic plug-like jet with a vortex ring demonstrated by 4D flow MRI. Magn Reson Imaging 2016; 34:371-5. [DOI: 10.1016/j.mri.2015.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 11/29/2015] [Indexed: 10/22/2022]
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Turski P, Scarano A, Hartman E, Clark Z, Schubert T, Rivera L, Wu Y, Wieben O, Johnson K. Neurovascular 4DFlow MRI (Phase Contrast MRA): emerging clinical applications. ACTA ACUST UNITED AC 2016. [DOI: 10.1186/s40809-016-0019-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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43
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Four-dimensional flow MRI for evaluation of post-stenotic turbulent flow in a phantom: comparison with flowmeter and computational fluid dynamics. Eur Radiol 2016; 26:3588-97. [DOI: 10.1007/s00330-015-4181-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 12/16/2015] [Accepted: 12/18/2015] [Indexed: 02/02/2023]
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44
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Stankovic Z. Four-dimensional flow magnetic resonance imaging in cirrhosis. World J Gastroenterol 2016; 22:89-102. [PMID: 26755862 PMCID: PMC4698511 DOI: 10.3748/wjg.v22.i1.89] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/08/2015] [Accepted: 10/13/2015] [Indexed: 02/06/2023] Open
Abstract
Since its introduction in the 1970’s, magnetic resonance imaging (MRI) has become a standard imaging modality. With its broad and standardized application, it is firmly established in the clinical routine and an essential element in cardiovascular and abdominal imaging. In addition to sonography and computer tomography, MRI is a valuable tool for diagnosing cardiovascular and abdominal diseases, for determining disease severity, and for assessing therapeutic success. MRI techniques have improved over the last few decades, revealing not just morphologic information, but functional information about perfusion, diffusion and hemodynamics as well. Four-dimensional (4D) flow MRI, a time-resolved phase contrast-MRI with three-dimensional (3D) anatomic coverage and velocity encoding along all three flow directions has been used to comprehensively assess complex cardiovascular hemodynamics in multiple regions of the body. The technique enables visualization of 3D blood flow patterns and retrospective quantification of blood flow parameters in a region of interest. Over the last few years, 4D flow MRI has been increasingly performed in the abdominal region. By applying different acceleration techniques, taking 4D flow MRI measurements has dropped to a reasonable scanning time of 8 to 12 min. These new developments have encouraged a growing number of patient studies in the literature validating the technique’s potential for enhanced evaluation of blood flow parameters within the liver’s complex vascular system. The purpose of this review article is to broaden our understanding of 4D flow MRI for the assessment of liver hemodynamics by providing insights into acquisition, data analysis, visualization and quantification. Furthermore, in this article we highlight its development, focussing on the clinical application of the technique.
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Rispoli VC, Nielsen JF, Nayak KS, Carvalho JLA. Computational fluid dynamics simulations of blood flow regularized by 3D phase contrast MRI. Biomed Eng Online 2015; 14:110. [PMID: 26611470 PMCID: PMC4661988 DOI: 10.1186/s12938-015-0104-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 11/16/2015] [Indexed: 11/23/2022] Open
Abstract
Background Phase contrast magnetic resonance imaging (PC-MRI) is used clinically for quantitative assessment of cardiovascular flow and function, as it is capable of providing directly-measured 3D velocity maps. Alternatively, vascular flow can be estimated from model-based computation fluid dynamics (CFD) calculations. CFD provides arbitrarily high resolution, but its accuracy hinges on model assumptions, while velocity fields measured with PC-MRI generally do not satisfy the equations of fluid dynamics, provide limited resolution, and suffer from partial volume effects. The purpose of this study is to develop a proof-of-concept numerical procedure for constructing a simulated flow field that is influenced by both direct PC-MRI measurements and a fluid physics model, thereby taking advantage of both the accuracy of PC-MRI and the high spatial resolution of CFD. The use of the proposed approach in regularizing 3D flow fields is evaluated. Methods The proposed algorithm incorporates both a Newtonian fluid physics model and a linear PC-MRI signal model. The model equations are solved numerically using a modified CFD algorithm. The numerical solution corresponds to the optimal solution of a generalized Tikhonov regularization, which provides a flow field that satisfies the flow physics equations, while being close enough to the measured PC-MRI velocity profile. The feasibility of the proposed approach is demonstrated on data from the carotid bifurcation of one healthy volunteer, and also from a pulsatile carotid flow phantom. Results The proposed solver produces flow fields that are in better agreement with direct PC-MRI measurements than CFD alone, and converges faster, while closely satisfying the fluid dynamics equations. For the implementation that provided the best results, the signal-to-error ratio (with respect to the PC-MRI measurements) in the phantom experiment was 6.56 dB higher than that of conventional CFD; in the in vivo experiment, it was 2.15 dB higher. Conclusions The proposed approach allows partial or complete measurements to be incorporated into a modified CFD solver, for improving the accuracy of the resulting flow fields estimates. This can be used for reducing scan time, increasing the spatial resolution, and/or denoising the PC-MRI measurements.
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Affiliation(s)
- Vinicius C Rispoli
- Department of Electrical Engineering, University of Brasilia, Brasília, Brazil. .,UnB Gama College, University of Brasilia, Brasília, Brazil.
| | - Jon F Nielsen
- fMRI Laboratory, Biomedical Engineering Department, University of Michigan, Ann Arbor, USA.
| | - Krishna S Nayak
- Magnetic Resonance Engineering Laboratory, Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, USA.
| | - Joao L A Carvalho
- Department of Electrical Engineering, University of Brasilia, Brasília, Brazil.
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Sarrami-Foroushani A, Nasr Esfahany M, Nasiraei Moghaddam A, Saligheh Rad H, Firouznia K, Shakiba M, Ghanaati H, Wilkinson ID, Frangi AF. Velocity Measurement in Carotid Artery: Quantitative Comparison of Time-Resolved 3D Phase-Contrast MRI and Image-based Computational Fluid Dynamics. IRANIAN JOURNAL OF RADIOLOGY 2015; 12:e18286. [PMID: 26793288 PMCID: PMC4711029 DOI: 10.5812/iranjradiol.18286] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 05/20/2014] [Accepted: 06/10/2014] [Indexed: 11/30/2022]
Abstract
Background: Understanding hemodynamic environment in vessels is important for realizing the mechanisms leading to vascular pathologies. Objectives: Three-dimensional velocity vector field in carotid bifurcation is visualized using TR 3D phase-contrast magnetic resonance imaging (TR 3D PC MRI) and computational fluid dynamics (CFD). This study aimed to present a qualitative and quantitative comparison of the velocity vector field obtained by each technique. Subjects and Methods: MR imaging was performed on a 30-year old male normal subject. TR 3D PC MRI was performed on a 3 T scanner to measure velocity in carotid bifurcation. 3D anatomical model for CFD was created using images obtained from time-of-flight MR angiography. Velocity vector field in carotid bifurcation was predicted using CFD and PC MRI techniques. A statistical analysis was performed to assess the agreement between the two methods. Results: Although the main flow patterns were the same for the both techniques, CFD showed a greater resolution in mapping the secondary and circulating flows. Overall root mean square (RMS) errors for all the corresponding data points in PC MRI and CFD were 14.27% in peak systole and 12.91% in end diastole relative to maximum velocity measured at each cardiac phase. Bland-Altman plots showed a very good agreement between the two techniques. However, this study was not aimed to validate any of methods, instead, the consistency was assessed to accentuate the similarities and differences between Time-resolved PC MRI and CFD. Conclusion: Both techniques provided quantitatively consistent results of in vivo velocity vector fields in right internal carotid artery (RCA). PC MRI represented a good estimation of main flow patterns inside the vasculature, which seems to be acceptable for clinical use. However, limitations of each technique should be considered while interpreting results.
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Affiliation(s)
| | - Mohsen Nasr Esfahany
- Department of Chemical Engineering, Isfahan University of Technology, Isfahan, Iran
- Corresponding author: Mohsen Nasr Esfahany, Department of Chemical Engineering, Isfahan University of Technology, Isfahan, Iran. Tel: +98-3133915631, Fax: +98-3113912677, E-mail:
| | - Abbas Nasiraei Moghaddam
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Hamidreza Saligheh Rad
- Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Kavous Firouznia
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
| | - Madjid Shakiba
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Ghanaati
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
| | - Iain David Wilkinson
- Academic Unit of Radiology, University of Sheffield, Sheffield, South Yorkshire, United Kingdom
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Kokkalis E, Aristokleous N, Houston JG. Haemodynamics and Flow Modification Stents for Peripheral Arterial Disease: A Review. Ann Biomed Eng 2015; 44:466-76. [PMID: 26467554 PMCID: PMC4764640 DOI: 10.1007/s10439-015-1483-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 10/07/2015] [Indexed: 02/02/2023]
Abstract
Endovascular stents are widely used for the treatment of peripheral arterial disease (PAD). However, the development of in-stent restenosis and downstream PAD progression remain a challenge. Stent revascularisation of PAD causes arterial trauma and introduces abnormal haemodynamics, which initiate complicated biological processes detrimental to the arterial wall. The interaction between stent struts and arterial cells in contact, and the blood flow field created in a stented region, are highly affected by stent design. Spiral flow is known as a normal physiologic characteristic of arterial circulation and is believed to prevent the development of flow disturbances. This secondary flow motion is lost in atheromatous disease and its re-introduction after endovascular treatment of PAD has been suggested as a method to induce stabilised and coherent haemodynamics. Stent designs able to generate spiral flow may support endothelial function and therefore increase patency rates. This review is focused on secondary flow phenomena in arteries and the development of flow modification stent technologies for the treatment of PAD.
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Affiliation(s)
- Efstratios Kokkalis
- Division of Cardiovascular and Diabetes Medicine, Ninewells Hospital and Medical School, University of Dundee, Mail Box 1, Dundee, DD1 9SY, United Kingdom
| | - Nicolas Aristokleous
- Division of Cardiovascular and Diabetes Medicine, Ninewells Hospital and Medical School, University of Dundee, Mail Box 1, Dundee, DD1 9SY, United Kingdom.
| | - J Graeme Houston
- Division of Cardiovascular and Diabetes Medicine, Ninewells Hospital and Medical School, University of Dundee, Mail Box 1, Dundee, DD1 9SY, United Kingdom
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SUN ANQIANG, WANG ZHENZE, ZHAN FAN, XU ZAIPIN, DENG XIAOYAN. A NEW WAY TO OPTIMIZE DRUG RELEASE RATE OF DRUG ELUTING STENT (DES). J MECH MED BIOL 2015. [DOI: 10.1142/s0219519415500645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Local hemodynamic environment is a determinant factor in drug delivery from a drug eluting stent (DES) to the target arterial tissue. By using a simplified model of a DES, we demonstrated that if a DES had a drug release mode of uniform rate the drug released from the stent will distribute non-uniformly along the stent due to the flowing blood, with a significantly higher drug concentration at the distal part of the stent than that at the proximal one. This may explain why a DES could retard neointimal formation and vascular remodeling in downstream coronary segments. To solve this problem, we thereafter optimized the drug release mode of the DES as an exponential function. The simulation results showed that the optimized drug release mode could lead to a fairly uniform drug concentration distribution along the stent. Therefore, the present study suggested that to achieve a more effective result, optimization of drug eluting strategy (drug release mode) for the DES would be essential.
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Affiliation(s)
- ANQIANG SUN
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, P. R. China
| | - ZHENZE WANG
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, P. R. China
| | - FAN ZHAN
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, P. R. China
| | - ZAIPIN XU
- College of Animal Science, Guizhou University, Guiyang, 550025 Guizhou, P. R. China
| | - XIAOYAN DENG
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, P. R. China
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49
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Dyverfeldt P, Bissell M, Barker AJ, Bolger AF, Carlhäll CJ, Ebbers T, Francios CJ, Frydrychowicz A, Geiger J, Giese D, Hope MD, Kilner PJ, Kozerke S, Myerson S, Neubauer S, Wieben O, Markl M. 4D flow cardiovascular magnetic resonance consensus statement. J Cardiovasc Magn Reson 2015; 17:72. [PMID: 26257141 PMCID: PMC4530492 DOI: 10.1186/s12968-015-0174-5] [Citation(s) in RCA: 548] [Impact Index Per Article: 60.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 07/17/2015] [Indexed: 02/07/2023] Open
Abstract
Pulsatile blood flow through the cavities of the heart and great vessels is time-varying and multidirectional. Access to all regions, phases and directions of cardiovascular flows has formerly been limited. Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) has enabled more comprehensive access to such flows, with typical spatial resolution of 1.5×1.5×1.5 - 3×3×3 mm(3), typical temporal resolution of 30-40 ms, and acquisition times in the order of 5 to 25 min. This consensus paper is the work of physicists, physicians and biomedical engineers, active in the development and implementation of 4D Flow CMR, who have repeatedly met to share experience and ideas. The paper aims to assist understanding of acquisition and analysis methods, and their potential clinical applications with a focus on the heart and greater vessels. We describe that 4D Flow CMR can be clinically advantageous because placement of a single acquisition volume is straightforward and enables flow through any plane across it to be calculated retrospectively and with good accuracy. We also specify research and development goals that have yet to be satisfactorily achieved. Derived flow parameters, generally needing further development or validation for clinical use, include measurements of wall shear stress, pressure difference, turbulent kinetic energy, and intracardiac flow components. The dependence of measurement accuracy on acquisition parameters is considered, as are the uses of different visualization strategies for appropriate representation of time-varying multidirectional flow fields. Finally, we offer suggestions for more consistent, user-friendly implementation of 4D Flow CMR acquisition and data handling with a view to multicenter studies and more widespread adoption of the approach in routine clinical investigations.
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Affiliation(s)
- Petter Dyverfeldt
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
- Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.
| | - Malenka Bissell
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, UK.
| | - Alex J Barker
- Department of Radiology, Northwestern University, Chicago, USA.
| | - Ann F Bolger
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
- Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States.
| | - Carl-Johan Carlhäll
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
- Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.
- Department 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, Linköping University, Linköping, Sweden.
| | | | - Alex Frydrychowicz
- Klinik für Radiologie und Nuklearmedizin, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
| | - Julia Geiger
- Department of Radiology, University Children's Hospital Zurich, Zurich, Switzerland.
| | - Daniel Giese
- Department of Radiology, University Hospital of Cologne, Cologne, Germany.
| | - Michael D Hope
- Department of Radiology, University of California San Francisco, San Francisco, CA, United States.
| | - Philip J Kilner
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, National Heart and Lung Institute, Imperial College, London, UK.
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.
| | - Saul Myerson
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, UK.
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, UK.
| | - Oliver Wieben
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA.
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA.
| | - Michael Markl
- Department of Radiology, Northwestern University, Chicago, USA.
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, USA.
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50
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Nayak KS, Nielsen JF, Bernstein MA, Markl M, D Gatehouse P, M Botnar R, Saloner D, Lorenz C, Wen H, S Hu B, Epstein FH, N Oshinski J, Raman SV. Cardiovascular magnetic resonance phase contrast imaging. J Cardiovasc Magn Reson 2015; 17:71. [PMID: 26254979 PMCID: PMC4529988 DOI: 10.1186/s12968-015-0172-7] [Citation(s) in RCA: 154] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 07/16/2015] [Indexed: 11/10/2022] Open
Abstract
Cardiovascular magnetic resonance (CMR) phase contrast imaging has undergone a wide range of changes with the development and availability of improved calibration procedures, visualization tools, and analysis methods. This article provides a comprehensive review of the current state-of-the-art in CMR phase contrast imaging methodology, clinical applications including summaries of past clinical performance, and emerging research and clinical applications that utilize today's latest technology.
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Affiliation(s)
- Krishna S Nayak
- Ming Hsieh Department of Electrical Engineering, University of Southern California, 3740 McClintock Ave, EEB 406, Los Angeles, California, 90089-2564, USA.
| | - Jon-Fredrik Nielsen
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
| | | | - Michael Markl
- Department of Radiology, Northwestern University, Chicago, IL, USA.
| | - Peter D Gatehouse
- Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK.
| | - Rene M Botnar
- Cardiovascular Imaging, Imaging Sciences Division, Kings's College London, London, UK.
| | - David Saloner
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
| | - Christine Lorenz
- Center for Applied Medical Imaging, Siemens Corporation, Baltimore, MD, USA.
| | - Han Wen
- Imaging Physics Laboratory, National Heart Lung and Blood Institute, Bethesda, MD, USA.
| | - Bob S Hu
- Palo Alto Medical Foundation, Palo Alto, CA, USA.
| | - Frederick H Epstein
- Departments of Radiology and Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.
| | - John N Oshinski
- Departments of Radiology and Biomedical Engineering, Emory University School of Medicine, Atlanta, GA, USA.
| | - Subha V Raman
- Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH, USA.
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