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Nie C, Tao L, Chen J, Yang J, Chen Z, Huang W. Application of 4D flow MRI for exploring factors affecting haemodynamics of iliac veins in asymptomatic population. Clin Hemorheol Microcirc 2024; 87:481-490. [PMID: 38728181 DOI: 10.3233/ch-242135] [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] [Indexed: 05/12/2024]
Abstract
BACKGROUND Haemodynamics plays an important role in the development of vascular disease. There is currently a lack of studies evaluating the characteristics and affecting factors of the iliac vein haemodynamics in clinical practice. OBJECTIVE The goal of this study was to use 4D flow MRI to explore the haemodynamic characteristics of iliac veins and its affecting factors in an asymptomatic population. METHODS Thirty consecutive volunteers without venous-related symptoms or signs underwent four-dimensional postprocessing of their MRI images. Relevant parameters, the demographic data, common iliac vein-inferior vena cava angle, iliac vein area, tortuosity, iliac vein mean flow, mean velocity was computed and analysed. T tests and Spearman's tests were used for analysing. A P value of 0.05 or less was considered significant. RESULTS Height and iliac vein area were positively correlated with flow, while degree of stenosis, and common iliac-inferior vena cava angle were negatively correlated with that. Degree of stenosis was positively correlated with velocity, but the common iliac-inferior vena cava angle and iliac vein tortuosity were negatively correlated with that. The mean flow and velocity of iliac veins in females were lower than males. The mean flow and velocity of the left iliac veins were lower than those of the right. CONCLUSION The height, gender, tortuosity, degree of stenosis, common iliac vein-inferior vena cava angle of the iliac vein are important factors that affect flow and velocity of the iliac veins. There were differences in haemodynamic parameters of the bilateral iliac veins.
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Affiliation(s)
- Chengli Nie
- The First Affiliated Hospital of Chongqing MedicalUniversity, Chongqing, China
| | - Li Tao
- The First Affiliated Hospital of Chongqing MedicalUniversity, Chongqing, China
| | - Jiangwei Chen
- The First Affiliated Hospital of Chongqing MedicalUniversity, Chongqing, China
| | - Jianghu Yang
- The First Affiliated Hospital of Chongqing MedicalUniversity, Chongqing, China
| | - Zihui Chen
- The First Affiliated Hospital of Chongqing MedicalUniversity, Chongqing, China
| | - Wen Huang
- The First Affiliated Hospital of Chongqing MedicalUniversity, Chongqing, China
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Huang YK, Hsu YC, Tseng YH, Kao CC, Ngo YG, Lee CY, Yang TY, Chang KS, Chen PY, Wang SC, Chen SY, Lin YH, Chen CW. Quantitative two-dimensional phase-contrast magnetic resonance imaging characterization of lower extremity venous disease: venous reflux versus venous obstruction. Quant Imaging Med Surg 2023; 13:5153-5167. [PMID: 37581029 PMCID: PMC10423378 DOI: 10.21037/qims-22-1194] [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: 10/31/2022] [Accepted: 05/12/2023] [Indexed: 08/16/2023]
Abstract
Background Lower extremity venous disease (LEVD) is a complex disorder, and determining the etiology of LEVD is paramount for treatment selection. Two-dimensional phase-contrast magnetic resonance imaging (2D PC-MRI) can provide an objective measure of hemodynamic status and may help differentiate between different etiologies of LEVD. A total of 271 participants, including 256 symptomatic patients with venous lower extremity disease and 15 healthy volunteers, were collected in this cohort study. Methods It is a single-center prospective observational study using 2D PC-MRI analysis to assess the hemodynamic characteristics of patients with LEVD among participants recruited between April 2017 and October 2021 at a tertiary hospital. The approval institutional review board number for this study were 201802137B0, 201901058B0, 202100938B0, and 202102344B0. Participants were classified as venous reflux (VR) and venous obstruction (VO) by standard ultrasonography. 2D PC-MRI by 1.5 T scanner revealed stroke volume (SV), forward flow volume (FFV), absolute stroke volume (ASV), mean flux (MF), velocity time integral (VTI), and mean velocity (MV) for each selected venous segments. Results 2D PC-MRI assessed 167 diseased legs from the 116 VR patients [mean age ± standard deviation (SD): 57.9±12.8 years; 39 males] and 113 diseased legs from the 95 VO patients (mean age ± SD: 66.4±12.8 years; 42 males). 2D PC-MRI analysis demonstrated discrimination ability to differentiate from VR to VO [SV, FFV, ASV, MF, VTI, and MV in the various venous segments, respectively, P≤0.001; area under the curve (AUC) =62-68.8%, P≤0.001 by Mann-Whitney U test]. The ratio data (morbid limb to normal limb) in the same individual with single-leg disease revealed differences between VR and VO (SV, FFV, ASV, and MF in the various venous segments, respectively; P<0.05; AUC =60.2-68.7%, P≤0.05 by Mann-Whitney U test). The most favorable differentiating variables of ratios were FFV in the great saphenous veins [AUC =68.7%, 95% confidence interval (CI): 59.8-77.6%] and ASV in the external iliac veins (AUC =67.4%, 95% CI: 58.7-76.2%). Conclusions Quantitative 2D PC-MRI analysis is capable of differentiating VR from VO. It also provides an important diagnostic capability for preoperative evaluation.
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Affiliation(s)
- Yao-Kuang Huang
- Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital Chiayi Branch, Chiayi
- College of Medicine, Chang Gung University, Taoyuan
- Division of Thoracic and Cardiovascular Surgery, Chiayi Hospital, Ministry of Health and Welfare (MOHW), Chiayi
| | - Yin-Chen Hsu
- College of Medicine, Chang Gung University, Taoyuan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital Chiayi Branch, Chiayi
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu
| | - Yuan-Hsi Tseng
- Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital Chiayi Branch, Chiayi
- College of Medicine, Chang Gung University, Taoyuan
- Division of Thoracic and Cardiovascular Surgery, Chiayi Hospital, Ministry of Health and Welfare (MOHW), Chiayi
| | - Chih-Chen Kao
- Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital Chiayi Branch, Chiayi
- College of Medicine, Chang Gung University, Taoyuan
- Division of Thoracic and Cardiovascular Surgery, Chiayi Hospital, Ministry of Health and Welfare (MOHW), Chiayi
| | - Yeh Giin Ngo
- College of Medicine, Chang Gung University, Taoyuan
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung
| | - Chung-Yuan Lee
- College of Medicine, Chang Gung University, Taoyuan
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Chiayi Branch, Chiayi
| | - Teng-Yao Yang
- College of Medicine, Chang Gung University, Taoyuan
- Department of Cardiovascular, Chang Gung Memorial Hospital Chiayi Branch, Chiayi
| | - Kuo-Song Chang
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei
- Mackay Junior College of Medicine Nursing and Management, Taipei
| | - Pang-Yen Chen
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei
- Institute of Public Health, National Yang Ming Chiao Tung University College of Medicine, Taipei
| | - Shih-Chung Wang
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital Chiayi Branch, Chiayi
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung
| | - Sheng-Ya Chen
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital Chiayi Branch, Chiayi
| | - Yu-Hui Lin
- Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital Chiayi Branch, Chiayi
| | - Chien-Wei Chen
- College of Medicine, Chang Gung University, Taoyuan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital Chiayi Branch, Chiayi
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung
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Chen CW, Tseng YH, Kao CC, Ngo YG, Lee CY, Yang TY, Lin YH, Huang YK. Venous Segmental Flow Changes after Superficial Venous Intervention Demonstrating by Quantitative Phase-Contrast Magnetic Resonance Analysis: Preliminary Data from a Longitudinal Cohort Study. J Pers Med 2022; 12:jpm12061000. [PMID: 35743784 PMCID: PMC9224938 DOI: 10.3390/jpm12061000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/11/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022] Open
Abstract
The effects of superficial venous intervention on hemodynamics can be quantified using two-dimensional phase-contrast magnetic resonance imaging (2D PC-MRI). Twelve patients received pre- and postintervention 2D PC-MRI analysis using quantitative hemodynamic parameters. Fifteen healthy volunteers served as controls. The 2D PC-MRI results of the target limbs (limbs scheduled for intervention for venous reflux) differed from those of the controls in terms of stroke volume (SV), forward flow volume (FFV), absolute stroke volume (ASV), and mean flux (MF) in all venous segments. The velocity time integral (VTI) and mean velocity (MV) of the popliteal vein (PV) segments were similar between the target limbs and controls preoperatively. After intervention, the target limbs exhibited an increase in VTI and MV in the femoral vein (FV) and PV segments. We compared the target and nontreated limbs of the individual patients preoperatively and postoperatively to minimalize individual bias. All QFlow parameter ratios in the FV segment increased after venous intervention (VTI, p = 0.025; MV, p = 0.024). In the PV segment, FFV and ASV increased significantly (p = 0.035 and 0.024, respectively). After interventions, the volume (FFV and ASV) of the PV segment and the efficiency (VTI and MV) of the FV segment significantly increased.
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Affiliation(s)
- Chien-Wei Chen
- Department of Diagnostic Radiology, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-C.K.); (Y.G.N.); (C.-Y.L.); (T.-Y.Y.)
| | - Yuan-Hsi Tseng
- Department of Obstetrics and Gynecology, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
| | - Chih-Chen Kao
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-C.K.); (Y.G.N.); (C.-Y.L.); (T.-Y.Y.)
- Division of Thoracic and Cardiovascular Surgery, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
- Division of Thoracic and Cardiovascular Surgery, Chia Yi Hospital, MOHW, Chiayi 61363, Taiwan
| | - Yeh Giin Ngo
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-C.K.); (Y.G.N.); (C.-Y.L.); (T.-Y.Y.)
- Department of Obstetrics and Gynecology, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
| | - Chung-Yuan Lee
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-C.K.); (Y.G.N.); (C.-Y.L.); (T.-Y.Y.)
- Department of Obstetrics and Gynecology, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
| | - Teng-Yao Yang
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-C.K.); (Y.G.N.); (C.-Y.L.); (T.-Y.Y.)
- Cardiology, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
| | - Yu-Hui Lin
- Cardiology, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
| | - Yao-Kuang Huang
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-C.K.); (Y.G.N.); (C.-Y.L.); (T.-Y.Y.)
- Division of Thoracic and Cardiovascular Surgery, Chia Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
- Division of Thoracic and Cardiovascular Surgery, Chia Yi Hospital, MOHW, Chiayi 61363, Taiwan
- Correspondence:
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