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Ghibes P, Martirosian P, Grözinger G, Plajer D, Estler A, Partovi S. Quantitative Flow Measurements of Pelvic Venous Vasculature Using 4D Flow MRI. Acad Radiol 2024; 31:929-938. [PMID: 37714720 DOI: 10.1016/j.acra.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/08/2023] [Accepted: 08/12/2023] [Indexed: 09/17/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate 4D Flow magnetic resonance imaging (MRI) sequences for quantitative flow measurements of the pelvic venous vasculature. MATERIALS AND METHODS A prospective study of healthy volunteers was performed. After informed consent all subjects underwent 4D flow sequences at a 3 T MRI scanner with different isotropic resolution and different velocity encoding (Venc) settings: (sequence #1) voxel size (VS) 1.63 mm3, Venc 50 cm/s; (sequence #2) VS 1.63 mm3, Venc 100 cm/s and (sequence #3) VS 2.03 mm3, Venc 50 cm/s. Perfusion parameters were calculated for all venous vessel segments starting at the level of the inferior vena cava and extending caudally to the level of the common femoral vein. For reference, arterial flow was calculated using 1.63 mm3 isotropic resolution with a Venc of 100 cm/s. RESULTS Ten healthy subjects (median age 28 years, interquartile range [IQR]: 26.25-28 years) were enrolled in this study. Median scanning time was 12:12 minutes (IQR 10:22-13:32 minutes) for sequence #1, 11:02 minutes (IQR 9:57-11:19 minutes) for sequence #2 and 6:10 minutes (IQR 5:44-6:47 minutes) for sequence #3. Flow measurements were derived from all sequences. The venous pelvic vasculature showed similar perfusion parameters compared to its arterial counterpart, for example the right common iliac arterial segment showed a perfusion of 8.32 ml/s (IQR: 6.94-10.68 ml/s) versus 7.29 ml/s (IQR: 4.70-8.90 ml/s) in the corresponding venous segment (P = 0.218). The venous flow measurements obtained from the three investigated sequences did not reveal significant differences. CONCLUSION 4D Flow MRI is suitable for quantitative flow measurement of the venous pelvic vasculature. To reduce the scanning time without compromising quantitative results, the resolution can be decreased while increasing the Venc. This technique may be utilized in the future for the diagnosis and treatment response assessment of iliac vein compression syndromes.
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Affiliation(s)
- Patrick Ghibes
- Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany (P.G., G.G., D.P.).
| | - Petros Martirosian
- Section on Experimental Radiology, University Hospital Tuebingen, Tuebingen, Germany (P.M.)
| | - Gerd Grözinger
- Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany (P.G., G.G., D.P.)
| | - David Plajer
- Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany (P.G., G.G., D.P.)
| | - Arne Estler
- Diagnostic and Interventional Neuroradiology, Department of Radiology, University Hospital Tuebingen, Tuebingen, Germany (A.E.)
| | - Sasan Partovi
- Interventional Radiology Section, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, Ohio (S.P.)
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Shamim AMKM, Panagiotopoulos N, Spahic A, Harris DT, Roldán-Alzate A, Wieben O, Reeder SB, Oechtering TH, Johnson KM. Fat mitigation strategies to improve image quality of radial 4D flow MRI in obese subjects. Magn Reson Med 2023; 90:444-457. [PMID: 37036023 PMCID: PMC10231668 DOI: 10.1002/mrm.29652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/10/2023] [Accepted: 03/14/2023] [Indexed: 04/11/2023]
Abstract
PURPOSE This study addresses the challenges in obtaining abdominal 4D flow MRI of obese patients. We aimed to evaluate spectral saturation and inner volume excitation as methods to mitigating artifacts originating from adipose signals, with the goal of enhancing image quality and improving quantification. METHODS Radial 4D flow MRI acquisitions with fat mitigation (inner volume excitation [IVE] and intermittent fat saturation [FS]) were compared to a standard slab selective excitation (SSE) in a test-retest study of 15 obese participants. IVE selectively excited a cylindrical region of interest, avoiding contamination from peripheral adipose tissue, while FS globally suppressed fat based on spectral selection. Acquisitions were evaluated qualitatively based on expert ratings and quantitatively based on conservation of mass, test-retest repeatability, and a divergence free quality metric. Errors were evaluated statistically using the absolute and relative errors, regression, and Bland-Altman analysis. RESULTS IVE demonstrated superior performance quantitatively in the conservation of mass analysis in the portal vein, with higher correlation and lower bias in regression analysis. IVE also produced flow fields with the lowest divergence error and was rated best in overall image quality, delineating small vessels, and producing the least streaking artifacts. Evaluation results did not differ significantly between FS and SSE. Test-retest reproducibility was similarly high for all sequences, with data suggesting biological variations dominate the technical variability. CONCLUSION IVE improved hemodynamic assessment of radial 4D flow MRI in the abdomen of obese participants while FS did not lead to significant improvements in image quality or flow metrics.
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Affiliation(s)
- A M K Muntasir Shamim
- Department of Electrical and Computer Engineering, University of Wisconsin, Madison, Wisconsin, USA
| | - Nikolaos Panagiotopoulos
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Universität zu Lübeck, Department of Radiology and Nuclear Medicine, Lübeck, Germany
| | - Alma Spahic
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - David T. Harris
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Alejandro Roldán-Alzate
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Department of Biomedical Engineering, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Department of Mechanical Engineering, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Oliver Wieben
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Scott B. Reeder
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Department of Biomedical Engineering, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Department of Mechanical Engineering, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Thekla Helene Oechtering
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Universität zu Lübeck, Department of Radiology and Nuclear Medicine, Lübeck, Germany
| | - Kevin M. Johnson
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Department of Biomedical Engineering, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Hamasaki M, Araki T, Tamada D, Morisaka H, Johno H, Aikawa Y, Onishi H. Four-dimensional flow magnetic resonance imaging for assessment of hemodynamic changes in the portal venous system before and after balloon-occluded retrograde transvenous obliteration: a pilot feasibility study. Acta Radiol 2022; 64:1462-1468. [PMID: 36325676 DOI: 10.1177/02841851221133487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The effectiveness of four-dimensional (4D) flow magnetic resonance imaging (MRI) for assessing hemodynamic changes before and after balloon-occluded retrograde transvenous obliteration (BRTO) remains unclear. Purpose To evaluate the feasibility of 4D flow MRI for assessing hemodynamic changes in the portal venous system before and after BRTO. Material and Methods We included 10 patients (7 men, 3 women; mean age = 67 years) with liver cirrhosis who had a high risk of gastric variceal bleeding or hepatic encephalopathy. Non-contrast 4D flow MRI of the upper abdomen was performed before and after BRTO. In addition, we compared the blood flow rates in the portal vein (PV), superior mesenteric vein (SMV), splenic vein (SV), left renal vein, and inferior vena cava before and after BRTO. Moreover, the flow directions of the SMV and SV before and after BRTO were assessed using both portography and 4D flow MRI. Results There was a significant post-BRTO increase in the blood flow rate in the PV and SV ( P < 0.05). There was no significant post-BRTO change in the blood flow rates in the SMV, inferior vena cava, and left renal vein. In four patients, portography confirmed that hepatofugal flow in the SV and SMV changed to hepatopetal flow after BRTO. Moreover, 4D flow MRI correctly assessed the flow directions in the SMV and SV in 70%–100% of the patients. Conclusion 4D flow MRI can be used to detect hemodynamic changes in the portal venous system before and after BRTO.
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Affiliation(s)
- Masahiro Hamasaki
- Department of Radiology, University of Yamanashi, Chuo-shi, Yamanashi, Japan
| | - Takuji Araki
- Department of Radiology, University of Yamanashi, Chuo-shi, Yamanashi, Japan
| | - Daiki Tamada
- Department of Radiology, University of Yamanashi, Chuo-shi, Yamanashi, Japan
| | - Hiroyuki Morisaka
- Department of Radiology, University of Yamanashi, Chuo-shi, Yamanashi, Japan
| | - Hisashi Johno
- Department of Radiology, University of Yamanashi, Chuo-shi, Yamanashi, Japan
| | - Yoshihito Aikawa
- Department of Radiology, University of Yamanashi, Chuo-shi, Yamanashi, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Chuo-shi, Yamanashi, Japan
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