5
|
Rahman O, Markl M, Balte P, Berhane H, Blanken C, Suwa K, Dashnaw S, Wieben O, Bluemke DA, Prince MR, Lima J, Michos E, Ambale-Venkatesh B, Hoffman EA, Gomes AS, Watson K, Sun Y, Carr J, Barr RG. Reproducibility and Changes in Vena Caval Blood Flow by Using 4D Flow MRI in Pulmonary Emphysema and Chronic Obstructive Pulmonary Disease (COPD): The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Substudy. Radiology 2019; 292:585-594. [PMID: 31335282 PMCID: PMC6736177 DOI: 10.1148/radiol.2019182143] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 05/19/2019] [Accepted: 06/03/2019] [Indexed: 11/11/2022]
Abstract
BackgroundChronic obstructive pulmonary disease (COPD) is associated with hemodynamic changes in the pulmonary vasculature. However, cardiac effects are not fully understood and vary by phenotype of chronic lower respiratory disease.PurposeTo use four-dimensional (4D) flow MRI for comprehensive assessment of the right-sided cardiovascular system, assess its interrater and intraobserver reproducibility, and examine associations with venous return to the right heart in individuals with chronic COPD and emphysema.Materials and MethodsThe Multi-Ethnic Study of Atherosclerosis COPD substudy prospectively recruited participants who smoked and who had COPD and nested control participants from population-based samples. Electrocardiography and respiratory gated 4D flow 1.5-T MRI was performed at three sites with full volumetric coverage of the thoracic vessels in 2014-2017 with postbronchodilator spirometry and inspiratory chest CT to quantify percent emphysema. Net flow, peak velocity, retrograde flow, and retrograde fraction were measured on 14 analysis planes. Interrater reproducibility was assessed by two independent observers, and the principle of conservation of mass was employed to evaluate the internal consistency of flow measures. Partial correlation coefficients were adjusted for age, sex, race/ethnicity, height, weight, and smoking status.ResultsAmong 70 participants (29 participants with COPD [mean age, 73.5 years ± 8.1 {standard deviation}; 20 men] and 41 control participants [mean age, 71.0 years ± 6.1; 22 men]), the interrater reproducibility of the 4D flow MRI measures was good to excellent (intraclass correlation coefficient range, 0.73-0.98), as was the internal consistency. There were no statistically significant differences in venous flow parameters according to COPD severity (P > .05). Greater percent emphysema at CT was associated with greater regurgitant flow in the superior and inferior caval veins and tricuspid valve (adjusted r = 0.28-0.55; all P < .01), particularly in the superior vena cava.ConclusionFour-dimensional flow MRI had good-to-excellent observer variability and flow consistency. Percent emphysema at CT was associated with statistically significant differences in retrograde flow, greatest in the superior vena cava.© RSNA, 2019Online supplemental material is available for this article.See also the editorial by Choe in this issue.
Collapse
Affiliation(s)
| | | | - Pallavi Balte
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Haben Berhane
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Carmen Blanken
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Kenichiro Suwa
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Stephen Dashnaw
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Oliver Wieben
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - David A. Bluemke
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Martin R. Prince
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Joao Lima
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Erin Michos
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Bharath Ambale-Venkatesh
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Eric A. Hoffman
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Antoinette S. Gomes
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Karol Watson
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - Yanping Sun
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - James Carr
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| | - R. Graham Barr
- From the Department of Radiology, Feinberg School of Medicine,
Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611
(O.R., M.M., H.B., C.B., K.S., J.C.); Departments of Radiology (O.R., S.D.,
M.R.P., Y.S.), Medicine (P.B., Y.S., R.G.B.), and Epidemiology (R.G.B.),
Columbia University Medical Center, New York, NY; Department of Radiology,
NewYork–Presbyterian Hospital, New York, NY (O.R.); Department of
Biomedical Engineering, McCormick School of Engineering, Northwestern
University, Evanston, Ill (M.M.); Departments of Medical Physics (O.W.) and
Radiology (D.A.B.), University of Wisconsin School of Medicine and Public
Health, Madison, Wis; Division of Cardiology, Johns Hopkins University,
Baltimore, Md (J.L., E.M., B.A.V.); Department of Radiology, Biomedical
Engineering and Medicine, University of Iowa, Iowa City, Iowa (E.A.H.); and
Departments of Radiology (A.S.G.) and Medicine (K.W.), University of California
Los Angeles, Los Angeles, Calif
| |
Collapse
|