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Merton R, Bosshardt D, Strijkers GJ, Nederveen AJ, Schrauben EM, van Ooij P. Reproducibility of 3D thoracic aortic displacement from 3D cine balanced SSFP at 3 T without contrast enhancement. Magn Reson Med 2024; 91:466-480. [PMID: 37831612 DOI: 10.1002/mrm.29856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/02/2023] [Accepted: 08/16/2023] [Indexed: 10/15/2023]
Abstract
PURPOSE Aortic motion has direct impact on the mechanical stresses acting on the aorta. In aortic disease, increased stiffness of the aorta may lead to decreased aortic motion over time, which could be a predictor for aortic dissection or rupture. This study investigates the reproducibility of obtaining 3D displacement and diameter maps quantified using accelerated 3D cine MRI at 3 T. METHODS A noncontrast-enhanced, free-breathing 3D cine sequence based on balanced SSFP and pseudo-spiral undersampling with high spatial isotropic resolution was developed (spatial/temporal resolution [1.6 mm]3 /67 ms). The thoracic aorta of 14 healthy volunteers was prospectively scanned three times at 3 T: twice on the same day and a third time 2 weeks later. Aortic displacement was calculated using iterative closest point nonrigid registration of manual segmentations of the 3D aorta at end-systole and mid-diastole. Interexamination and interobserver regional analysis of mean displacement for five regions of interest was performed using Bland-Altman analysis. Additionally, a complementary voxel-by-voxel analysis was done, allowing a more local inspection of the method. RESULTS No significant differences were found in mean and maximum displacement for any of the regions of interest for the interexamination and interobserver analysis. The maximum displacement measured in the lower half of the ascending aorta was 11.0 ± 3.4 mm (range: 3.0-17.5 mm) for the first scan. The smallest detectable change in mean displacement in the lower half of the ascending aorta was 3 mm. CONCLUSION Detailed 3D cine balanced SSFP at 3 T allows for reproducible quantification of systolic-diastolic mean aortic displacement within acceptable limits.
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Affiliation(s)
- Renske Merton
- Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Daan Bosshardt
- Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Gustav J Strijkers
- Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
- Biomedical Physics and Engineering, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Aart J Nederveen
- Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Eric M Schrauben
- Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Pim van Ooij
- Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Amsterdam, the Netherlands
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2
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van Ooij P. Editorial for "Edge-Type Hyperintense Intracranial Artery Plaque: A Potential MRI Biomarker of Stroke Recurrence". J Magn Reson Imaging 2024. [PMID: 38284751 DOI: 10.1002/jmri.29264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 01/30/2024] Open
Affiliation(s)
- Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center Location AMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam University Medical, Amsterdam, The Netherlands
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3
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van Tuijl RJ, Timmins KM, Velthuis BK, van Ooij P, Zwanenburg JJM, Ruigrok YM, van der Schaaf IC. Hemodynamic Parameters in the Parent Arteries of Unruptured Intracranial Aneurysms Depend on Aneurysm Size and Are Different Compared to Contralateral Arteries: A 7 Tesla 4D Flow MRI Study. J Magn Reson Imaging 2024; 59:223-230. [PMID: 37144669 DOI: 10.1002/jmri.28756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Different Circle of Willis (CoW) variants have variable prevalences of aneurysm development, but the hemodynamic variation along the CoW and its relation to presence and size of unruptured intracranial aneurysms (UIAs) are not well known. PURPOSE Gain insight into hemodynamic imaging markers of the CoW for UIA development by comparing these outcomes to the corresponding contralateral artery without an UIA using 4D flow magnetic resonance imaging (MRI). STUDY TYPE Retrospective, cross-sectional study. SUBJECTS Thirty-eight patients with an UIA, whereby 27 were women and a mean age of 62 years old. FIELD STRENGTH/SEQUENCE Four-dimensional phase-contrast (PC) MRI with a 3D time-resolved velocity encoded gradient echo sequence at 7 T. ASSESSMENT Hemodynamic parameters (blood flow, velocity pulsatility index [vPI], mean velocity, distensibility, and wall shear stress [peak systolic (WSSMAX ), and time-averaged (WSSMEAN )]) in the parent artery of the UIA were compared to the corresponding contralateral artery without an UIA and were related to UIA size. STATISTICAL TESTS Paired t-tests and Pearson Correlation tests. The threshold for statistical significance was P < 0.05 (two-tailed). RESULTS Blood flow, mean velocity, WSSMAX , and WSSMEAN were significantly higher, while vPI was lower, in the parent artery relative to contralateral artery. The WSSMAX of the parent artery significantly increased linearly while the WSSMEAN decreased linearly with increasing UIA size. CONCLUSIONS Hemodynamic parameters and WSS differ between parent vessels of UIAs and corresponding contralateral vessels. WSS correlates with UIA size, supporting a potential hemodynamic role in aneurysm pathology. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Rick J van Tuijl
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kimberley M Timmins
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Birgitta K Velthuis
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Pim van Ooij
- Department of Pediatric Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jaco J M Zwanenburg
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ynte M Ruigrok
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Aalbregt E, Indrakusuma R, Jalalzadeh H, Planken RN, van Schuppen J, Meijboom L, Balm R, Nederveen AJ, Yeung KK, van Ooij P. Four-Dimensional Flow MRI-Derived Hemodynamics in Abdominal Aortic Aneurysms: Reproducibility and Associations With Diameter, Intraluminal Thrombus Volume, and Vorticity. J Magn Reson Imaging 2023. [PMID: 38006298 DOI: 10.1002/jmri.29138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Maximum diameter measurements are used to assess the rupture risk of abdominal aortic aneurysms (AAAs); however, these are not precise enough to predict all ruptures. Four-dimensional (4D) flow MRI-derived parameters provide additional information by visualizing hemodynamics in AAAs but merit further investigation before they are clinically applicable. PURPOSE To assess the reproducibility of 4D flow MRI-derived hemodynamics, to investigate possible correlations with lumen and maximum diameter, and to explore potential relationships with vorticity and aneurysm growth. STUDY TYPE Prospective single-arm study. POPULATION A total of 22 (71.5 ± 6.1 years, 20 male) asymptomatic AAA patients with a maximum diameter of at least 30 mm. FIELD STRENGTH/SEQUENCE A 3.0 T/Free-breathing 4D flow MRI phase-contrast acquisition with retrospective ECG-gating. ASSESSMENT Patients underwent two consecutive 4D flow MRI scans 1-week apart. Aortic volumes were segmented from time-averaged phase contrast magnetic resonance angiographies. Reproducibility was assessed by voxelwise analysis after registration. Mean flow velocity, mean wall shear stress (WSS), mean lumen diameter, and qualitative vorticity scores were assessed. In addition, Dixon MRI and retrospective surveillance data were used to study maximum diameter (including thrombus), intraluminal thrombus volume (ILT), and growth rate. STATISTICAL TESTS For reproducibility assessment, Bland-Altman analyses, Pearson correlation, Spearman's correlation, and orthogonal regression were conducted. Potential correlations between hemodynamics and vorticity scores were assessed using linear regression. P < 0.05 was considered statistically significant. RESULTS Test-retest median Pearson correlation coefficients for flow velocity and WSS were 0.85 (IQR = 0.08) m/sec and 0.82 (IQR = 0.10) Pa, respectively. Mean WSS significantly correlated with mean flow velocity (R = 0.75) and inversely correlated with mean lumen diameter (R = -0.73). No significant associations were found between 4D flow MRI-derived hemodynamic parameters and maximum diameter (flow velocity: P = 0.98, WSS: P = 0.22). DATA CONCLUSION A 4D flow MRI is robust for assessing the hemodynamics within AAAs. No correlations were found between hemodynamic parameters and maximum diameter, ILT volume and growth rate. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Eva Aalbregt
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Reza Indrakusuma
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hamid Jalalzadeh
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - R Nils Planken
- Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Joost van Schuppen
- Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Lilian Meijboom
- Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Ron Balm
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Kak Khee Yeung
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Pim van Ooij
- Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
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5
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Aalbregt E, Rijken L, Nederveen A, van Ooij P, Yeung KK, Jongkind V. Quantitative Magnetic Resonance Imaging to Assess Progression and Rupture Risk of Aortic Aneurysms: A Scoping Review. J Endovasc Ther 2023:15266028231204830. [PMID: 37853734 DOI: 10.1177/15266028231204830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
PURPOSE In current practice, the diameter of an aortic aneurysm is utilized to estimate the rupture risk and decide upon timing of elective repair, although it is known to be imprecise and not patient-specific. Quantitative magnetic resonance imaging (MRI) enables the visualization of several biomarkers that provide information about processes within the aneurysm and may therefore facilitate patient-specific risk stratification. We performed a scoping review of the literature on quantitative MRI techniques to assess aortic aneurysm progression and rupture risk, summarized these findings, and identified knowledge gaps. METHODS Literature concerning primary research was of interest and the medical databases PubMed, Scopus, Embase, and Cochrane were systematically searched. This study used the PRISMA protocol extension for scoping reviews. Articles published between January 2010 and February 2023 involving animals and/or humans were included. Data were extracted by 2 authors using a predefined charting method. RESULTS A total of 1641 articles were identified, of which 21 were included in the scoping review. Quantitative MRI-derived biomarkers were categorized into hemodynamic (8 studies), wall (5 studies) and molecular biomarkers (8 studies). Fifteen studies included patients and/or healthy human subjects. Animal models were investigated in the other 6 studies. A cross-sectional study design was the most common, whereas 5 animal studies had a longitudinal component and 2 studies including patients had a prospective design. A promising hemodynamic biomarker is wall shear stress (WSS), which is estimated based on 4D-flow MRI. Molecular biomarkers enable the assessment of inflammatory and wall deterioration processes. The ADAMTS4-specific molecular magnetic resonance (MR) probe showed potential to predict abdominal aortic aneurysm (AAA) formation and rupture in a murine model. Wall biomarkers assessed using dynamic contrast-enhanced (DCE) MRI showed great potential for assessing AAA progression independent of the maximum diameter. CONCLUSION This scoping review provides an overview of quantitative MRI techniques studied and the biomarkers derived from them to assess aortic aneurysm progression and rupture risk. Longitudinal studies are needed to validate the causal relationships between the identified biomarkers and aneurysm growth, rupture, or repair. In the future, quantitative MRI could play an important role in the personalized risk assessment of aortic aneurysm rupture. CLINICAL IMPACT The currently used maximum aneurysm diameter fails to accurately assess the multifactorial pathology of an aortic aneurysm and precisely predicts rupture in a patient-specific manner. Quantitative magnetic resonance imaging (MRI) enables the detection of various quantitative parameters involved in aneurysm progression and subsequent rupture. This scoping review provides an overview of the studied quantitative MRI techniques, the biomarkers derived from them, and recommendations for future research needed for the implementation of these biomarkers. Ultimately, quantitative MRI could facilitate personalized risk assessment for patients with aortic aneurysms, thereby reducing untimely repairs and improving rupture prevention.
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Affiliation(s)
- Eva Aalbregt
- Department of Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Lotte Rijken
- Department of Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Aart Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Kak Khee Yeung
- Department of Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Vincent Jongkind
- Department of Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
- Amsterdam UMC, location AMC, Amsterdam, The Netherlands
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6
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van Ooij P. Editorial for "Dynamic Contrast-Enhanced MRI in Abdominal Aortic Aneurysms as a Potential Marker for Disease Progression". J Magn Reson Imaging 2023; 58:1268-1269. [PMID: 36762910 DOI: 10.1002/jmri.28635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 02/11/2023] Open
Affiliation(s)
- Pim van Ooij
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Center location AMC, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Department of Paediatric Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
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7
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Bissell MM, Raimondi F, Ait Ali L, Allen BD, Barker AJ, Bolger A, Burris N, Carhäll CJ, Collins JD, Ebbers T, Francois CJ, Frydrychowicz A, Garg P, Geiger J, Ha H, Hennemuth A, Hope MD, Hsiao A, Johnson K, Kozerke S, Ma LE, Markl M, Martins D, Messina M, Oechtering TH, van Ooij P, Rigsby C, Rodriguez-Palomares J, Roest AAW, Roldán-Alzate A, Schnell S, Sotelo J, Stuber M, Syed AB, Töger J, van der Geest R, Westenberg J, Zhong L, Zhong Y, Wieben O, Dyverfeldt P. 4D Flow cardiovascular magnetic resonance consensus statement: 2023 update. J Cardiovasc Magn Reson 2023; 25:40. [PMID: 37474977 PMCID: PMC10357639 DOI: 10.1186/s12968-023-00942-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/30/2023] [Indexed: 07/22/2023] Open
Abstract
Hemodynamic assessment is an integral part of the diagnosis and management of cardiovascular disease. Four-dimensional cardiovascular magnetic resonance flow imaging (4D Flow CMR) allows comprehensive and accurate assessment of flow in a single acquisition. This consensus paper is an update from the 2015 '4D Flow CMR Consensus Statement'. We elaborate on 4D Flow CMR sequence options and imaging considerations. The document aims to assist centers starting out with 4D Flow CMR of the heart and great vessels with advice on acquisition parameters, post-processing workflows and integration into clinical practice. Furthermore, we define minimum quality assurance and validation standards for clinical centers. We also address the challenges faced in quality assurance and validation in the research setting. We also include a checklist for recommended publication standards, specifically for 4D Flow CMR. Finally, we discuss the current limitations and the future of 4D Flow CMR. This updated consensus paper will further facilitate widespread adoption of 4D Flow CMR in the clinical workflow across the globe and aid consistently high-quality publication standards.
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Affiliation(s)
- Malenka M Bissell
- Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), LIGHT Laboratories, Clarendon Way, University of Leeds, Leeds, LS2 9NL, UK.
| | | | - Lamia Ait Ali
- Institute of Clinical Physiology CNR, Massa, Italy
- Foundation CNR Tuscany Region G. Monasterio, Massa, Italy
| | - Bradley D Allen
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alex J Barker
- Department of Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Center, Aurora, USA
| | - Ann Bolger
- Department of Medicine, University of California, San Francisco, CA, USA
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Nicholas Burris
- Department of Radiology, University of Michigan, Ann Arbor, USA
| | - Carl-Johan Carhäll
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | | | - Tino Ebbers
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | | | - Alex Frydrychowicz
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck and Universität Zu Lübeck, Lübeck, Germany
| | - Pankaj Garg
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Julia Geiger
- Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Hojin Ha
- Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon, South Korea
| | - Anja Hennemuth
- Institute of Computer-Assisted Cardiovascular Medicine, Charité - Universitätsmedizin, Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site, Berlin, Germany
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael D Hope
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Albert Hsiao
- Department of Radiology, University of California, San Diego, CA, USA
| | - Kevin Johnson
- Departments of Radiology and Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Liliana E Ma
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michael Markl
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Duarte Martins
- Department of Pediatric Cardiology, Hospital de Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Marci Messina
- Department of Radiology, Northwestern Medicine, Chicago, IL, USA
| | - Thekla H Oechtering
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck and Universität Zu Lübeck, Lübeck, Germany
- Departments of Radiology and Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Pim van Ooij
- Department of Radiology & Nuclear Medicine, Amsterdam Cardiovascular Sciences, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands
- Department of Pediatric Cardiology, Division of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cynthia Rigsby
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Medical Imaging, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Jose Rodriguez-Palomares
- Department of Cardiology, Hospital Universitari Vall d´Hebron,Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain
| | - Arno A W Roest
- Department of Pediatric Cardiology, Willem-Alexander's Children Hospital, Leiden University Medical Center and Center for Congenital Heart Defects Amsterdam-Leiden, Leiden, The Netherlands
| | | | - Susanne Schnell
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Medical Physics, Institute of Physics, University of Greifswald, Greifswald, Germany
| | - Julio Sotelo
- School of Biomedical Engineering, Universidad de Valparaíso, Valparaíso, Chile
- Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Millennium Institute for Intelligent Healthcare Engineering - iHEALTH, Santiago, Chile
| | - Matthias Stuber
- Département de Radiologie Médicale, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Ali B Syed
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Johannes Töger
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Rob van der Geest
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jos Westenberg
- CardioVascular Imaging Group (CVIG), Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Liang Zhong
- National Heart Centre Singapore, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Yumin Zhong
- Department of Radiology, School of Medicine, Shanghai Children's Medical Center Affiliated With Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Oliver Wieben
- Departments of Radiology and Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Petter Dyverfeldt
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
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el Mathari S, Kluin J, Hopman LHGA, Bhagirath P, Oudeman MAP, Vonk ABA, Nederveen AJ, Eberl S, Klautz RJM, Chamuleau SAJ, van Ooij P, Götte MJW. The role and implications of left atrial fibrosis in surgical mitral valve repair as assessed by CMR: the ALIVE study design and rationale. Front Cardiovasc Med 2023; 10:1166703. [PMID: 37252116 PMCID: PMC10213679 DOI: 10.3389/fcvm.2023.1166703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/03/2023] [Indexed: 05/31/2023] Open
Abstract
Background Patients with mitral regurgitation (MR) commonly suffer from left atrial (LA) remodeling. LA fibrosis is considered to be a key player in the LA remodeling process, as observed in atrial fibrillation (AF) patients. Literature on the presence and extent of LA fibrosis in MR patients however, is scarce and its clinical implications remain unknown. Therefore, the ALIVE trial was designed to investigate the presence of LA remodeling including LA fibrosis in MR patients prior to and after mitral valve repair (MVR) surgery. Methods The ALIVE trial is a single center, prospective pilot study investigating LA fibrosis in patients suffering from MR in the absence of AF (identifier NCT05345730). In total, 20 participants will undergo a CMR scan including 3D late gadolinium enhancement (LGE) imaging 2 week prior to MVR surgery and at 3 months follow-up. The primary objective of the ALIVE trial is to assess the extent and geometric distribution of LA fibrosis in MR patients and to determine effects of MVR surgery on reversed atrial remodelling. Implications This study will provide novel insights into the pathophysiological mechanism of fibrotic and volumetric atrial (reversed) remodeling in MR patients undergoing MVR surgery. Our results may contribute to improved clinical decision making and patient-specific treatment strategies in patients suffering from MR.
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Affiliation(s)
- Sulayman el Mathari
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Jolanda Kluin
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Luuk H. G. A. Hopman
- Department of Cardiology, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Pranav Bhagirath
- Department of Cardiology, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Maurice A. P. Oudeman
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Alexander B. A. Vonk
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Aart J. Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Susanne Eberl
- Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Robert J. M. Klautz
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
- Department of Cardiothoracic Surgery, Leiden University Medical Center, Rotterdam, Netherlands
| | | | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Marco J. W. Götte
- Department of Cardiology, Amsterdam University Medical Center, Amsterdam, Netherlands
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Perinajová R, van Ooij P, Kenjereš S. On the identification of hypoxic regions in subject-specific cerebral vasculature by combined CFD/MRI. R Soc Open Sci 2023; 10:220645. [PMID: 36636311 PMCID: PMC9810418 DOI: 10.1098/rsos.220645] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/30/2022] [Indexed: 05/22/2023]
Abstract
A long-time exposure to lack of oxygen (hypoxia) in some regions of the cerebrovascular system is believed to be one of the causes of cerebral neurological diseases. In the present study, we show how a combination of magnetic resonance imaging (MRI) and computational fluid dynamics (CFD) can provide a non-invasive alternative for studying blood flow and transport of oxygen within the cerebral vasculature. We perform computer simulations of oxygen mass transfer in the subject-specific geometry of the circle of Willis. The computational domain and boundary conditions are based on four-dimensional (4D)-flow MRI measurements. Two different oxygen mass transfer models are considered: passive (where oxygen is treated as a dilute chemical species in plasma) and active (where oxygen is bonded to haemoglobin) models. We show that neglecting haemoglobin transport results in a significant underestimation of the arterial wall mass transfer of oxygen. We identified the hypoxic regions along the arterial walls by introducing the critical thresholds that are obtained by comparison of the estimated range of Damköhler number (Da ⊂ 〈9; 57〉) with the local Sherwood number. Finally, we recommend additional validations of the combined MRI/CFD approach proposed here for larger groups of subject- or patient-specific brain vasculature systems.
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Affiliation(s)
- Romana Perinajová
- Department of Chemical Engineering, Delft University of Technology, Faculty of Applied Sciences, 2628 CD Delft, The Netherlands
- J.M. Burgerscentrum Research School for Fluid Mechanics, 2628 CD Delft, The Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location AMC, 1007 MB Amsterdam, The Netherlands
| | - Saša Kenjereš
- Department of Chemical Engineering, Delft University of Technology, Faculty of Applied Sciences, 2628 CD Delft, The Netherlands
- J.M. Burgerscentrum Research School for Fluid Mechanics, 2628 CD Delft, The Netherlands
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10
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Moerdijk AS, Claessens NH, van Ooijen IM, van Ooij P, Alderliesten T, Grotenhuis HB, Benders MJNL, Bohte AE, Breur JMPJ, Charisopoulou D, Clur SA, Cornette JMJ, Fejzic Z, Franssen MTM, Frerich S, Geerdink LM, Go ATJI, Gommers S, Helbing WA, Hirsch A, Holtackers RJ, Klein WM, Krings GJ, Lamb HJ, Nijman M, Pajkrt E, Planken RN, Schrauben EM, Steenhuis TJ, ter Heide H, Vanagt WYR, van Beynum IM, van Gaalen MD, van Iperen GG, van Schuppen J, Willems TP, Witters I. Fetal MRI of the heart and brain in congenital heart disease. Lancet Child Adolesc Health 2023; 7:59-68. [PMID: 36343660 DOI: 10.1016/s2352-4642(22)00249-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/12/2022] [Accepted: 08/22/2022] [Indexed: 11/06/2022]
Abstract
Antenatal assessment of congenital heart disease and associated anomalies by ultrasound has improved perinatal care. Fetal cardiovascular MRI and fetal brain MRI are rapidly evolving for fetal diagnostic testing of congenital heart disease. We give an overview on the use of fetal cardiovascular MRI and fetal brain MRI in congenital heart disease, focusing on the current applications and diagnostic yield of structural and functional imaging during pregnancy. Fetal cardiovascular MRI in congenital heart disease is a promising supplementary imaging method to echocardiography for the diagnosis of antenatal congenital heart disease in weeks 30-40 of pregnancy. Concomitant fetal brain MRI is superior to brain ultrasound to show the complex relationship between fetal haemodynamics in congenital heart disease and brain development.
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Affiliation(s)
- Anouk S Moerdijk
- Department of Pediatric Cardiology, Division of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Nathalie Hp Claessens
- Department of Pediatric Cardiology, Division of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands; Department of Neonatology, Division of Woman and Baby, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Inge M van Ooijen
- Department of Neonatology, Division of Woman and Baby, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Pim van Ooij
- Department of Pediatric Cardiology, Division of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Thomas Alderliesten
- Department of Pediatric Cardiology, Division of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands; Department of Neonatology, Division of Woman and Baby, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Heynric B Grotenhuis
- Department of Pediatric Cardiology, Division of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands.
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11
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Peper ES, van Ooij P, Jung B, Huber A, Gräni C, Bastiaansen JAM. Advances in machine learning applications for cardiovascular 4D flow MRI. Front Cardiovasc Med 2022; 9:1052068. [PMID: 36568555 PMCID: PMC9780299 DOI: 10.3389/fcvm.2022.1052068] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
Four-dimensional flow magnetic resonance imaging (MRI) has evolved as a non-invasive imaging technique to visualize and quantify blood flow in the heart and vessels. Hemodynamic parameters derived from 4D flow MRI, such as net flow and peak velocities, but also kinetic energy, turbulent kinetic energy, viscous energy loss, and wall shear stress have shown to be of diagnostic relevance for cardiovascular diseases. 4D flow MRI, however, has several limitations. Its long acquisition times and its limited spatio-temporal resolutions lead to inaccuracies in velocity measurements in small and low-flow vessels and near the vessel wall. Additionally, 4D flow MRI requires long post-processing times, since inaccuracies due to the measurement process need to be corrected for and parameter quantification requires 2D and 3D contour drawing. Several machine learning (ML) techniques have been proposed to overcome these limitations. Existing scan acceleration methods have been extended using ML for image reconstruction and ML based super-resolution methods have been used to assimilate high-resolution computational fluid dynamic simulations and 4D flow MRI, which leads to more realistic velocity results. ML efforts have also focused on the automation of other post-processing steps, by learning phase corrections and anti-aliasing. To automate contour drawing and 3D segmentation, networks such as the U-Net have been widely applied. This review summarizes the latest ML advances in 4D flow MRI with a focus on technical aspects and applications. It is divided into the current status of fast and accurate 4D flow MRI data generation, ML based post-processing tools for phase correction and vessel delineation and the statistical evaluation of blood flow.
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Affiliation(s)
- Eva S. Peper
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland,Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland,*Correspondence: Eva S. Peper,
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands,Department of Pediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Bernd Jung
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland,Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Adrian Huber
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Gräni
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jessica A. M. Bastiaansen
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland,Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
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12
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van Andel MM, van Ooij P, de Waard V, Gottwald LM, van Kimmenade RR, Scholte AJ, Dickinson MG, Zwinderman AH, Mulder BJ, Nederveen AJ, Groenink M. Abnormal aortic hemodynamics are associated with risk factors for aortic complications in patients with marfan syndrome. Int J Cardiol Heart Vasc 2022; 43:101128. [PMID: 36268203 PMCID: PMC9576530 DOI: 10.1016/j.ijcha.2022.101128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 09/09/2022] [Accepted: 09/26/2022] [Indexed: 11/18/2022]
Abstract
Background It is difficult to assess the risk for aortic dissection beyond the aortic root in patients with Marfan syndrome (MFS). To aid risk assessment in these patients, we investigated aortic flow and wall shear stress (WSS) by 4D flow magnetic resonance imaging (MRI) in patients with MFS and compared the results with healthy volunteers. We hypothesized that MFS patients with a high-risk profile for aortic dissection would show abnormal hemodynamics in aortic regions associated with aortic dissection. Methods MFS patients (n = 55) and healthy subjects (n = 25), matched for age and sex, prospectively underwent 4D flow MRI. 4D flow maps were constructed to detect elevated (defined as higher than the three-dimensional 95 % confidence interval) and deviant directed (defined as vector angle differences higher than 120°) WSS in MFS patients as compared to the controls. Univariate and multivariate associations with risk factors for aortic dissection in MFS patients were assessed. Results The maximum incidence for elevated WSS was 20 % (CI 9 %-31 %) and found in the ascending aorta. The maximum for deviant directed WSS was 39 % (CI 26 %-52 %) and found in the inner descending aorta. Significantly more male patients had deviant directed WSS in the inner proximal descending aorta (63 % vs 24 %, p = 0.014). Multivariate analysis showed that deviant directed WSS was associated with male sex (p = 0.019), and a haplo-insufficient FBN1 mutation type (p = 0.040). In 60 % of MFS patients with a previous aortic root replacement surgery, abnormal hemodynamics were found in the ascending aorta. No significant differences between hemodynamics were found in the descending aorta between operated and non-operated patients. Conclusion Deviant directed WSS in the proximal descending aorta is associated with known risk factors for aortic dissection in MFS patients, namely male sex and a haploinsufficient FBN1 mutation type.
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Affiliation(s)
- Mitzi M. van Andel
- Department of Cardiology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Pim van Ooij
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Vivian de Waard
- Department of Medical Biochemistry, Amsterdam University Medical Center, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Lukas M. Gottwald
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | | | - Arthur J. Scholte
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Michael G. Dickinson
- Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Aeilko H. Zwinderman
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Barbara J.M. Mulder
- Department of Cardiology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Aart J. Nederveen
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Maarten Groenink
- Department of Cardiology, Amsterdam University Medical Center, Amsterdam, the Netherlands,Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands,Corresponding author at: Amsterdam UMC, University of Amsterdam, Department of Cardiology and Radiology, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
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13
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Blanken CPS, Schrauben EM, Peper ES, Gottwald LM, Coolen BF, van Wijk DF, Piek JJ, Strijkers GJ, Planken RN, van Ooij P, Nederveen AJ. Coronary Flow Assessment Using Accelerated 4D Flow MRI With Respiratory Motion Correction. Front Bioeng Biotechnol 2021; 9:725833. [PMID: 34869250 PMCID: PMC8634777 DOI: 10.3389/fbioe.2021.725833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/02/2021] [Indexed: 11/29/2022] Open
Abstract
Magnetic resonance imaging (MRI) can potentially be used for non-invasive screening of patients with stable angina pectoris to identify probable obstructive coronary artery disease. MRI-based coronary blood flow quantification has to date only been performed in a 2D fashion, limiting its clinical applicability. In this study, we propose a framework for coronary blood flow quantification using accelerated 4D flow MRI with respiratory motion correction and compressed sensing image reconstruction. We investigate its feasibility and repeatability in healthy subjects at rest. Fourteen healthy subjects received 8 times-accelerated 4D flow MRI covering the left coronary artery (LCA) with an isotropic spatial resolution of 1.0 mm3. Respiratory motion correction was performed based on 1) lung-liver navigator signal, 2) real-time monitoring of foot-head motion of the liver and LCA by a separate acquisition, and 3) rigid image registration to correct for anterior-posterior motion. Time-averaged diastolic LCA flow was determined, as well as time-averaged diastolic maximal velocity (VMAX) and diastolic peak velocity (VPEAK). 2D flow MRI scans of the LCA were acquired for reference. Scan-rescan repeatability and agreement between 4D flow MRI and 2D flow MRI were assessed in terms of concordance correlation coefficient (CCC) and coefficient of variation (CV). The protocol resulted in good visibility of the LCA in 11 out of 14 subjects (six female, five male, aged 28 ± 4 years). The other 3 subjects were excluded from analysis. Time-averaged diastolic LCA flow measured by 4D flow MRI was 1.30 ± 0.39 ml/s and demonstrated good scan-rescan repeatability (CCC/CV = 0.79/20.4%). Time-averaged diastolic VMAX (17.2 ± 3.0 cm/s) and diastolic VPEAK (24.4 ± 6.5 cm/s) demonstrated moderate repeatability (CCC/CV = 0.52/19.0% and 0.68/23.0%, respectively). 4D flow- and 2D flow-based diastolic LCA flow agreed well (CCC/CV = 0.75/20.1%). Agreement between 4D flow MRI and 2D flow MRI was moderate for both diastolic VMAX and VPEAK (CCC/CV = 0.68/20.3% and 0.53/27.0%, respectively). In conclusion, the proposed framework of accelerated 4D flow MRI equipped with respiratory motion correction and compressed sensing image reconstruction enables repeatable diastolic LCA flow quantification that agrees well with 2D flow MRI.
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Affiliation(s)
- Carmen P S Blanken
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Eric M Schrauben
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Eva S Peper
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Lukas M Gottwald
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Bram F Coolen
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | | | - Jan J Piek
- Department of Cardiology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Gustav J Strijkers
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - R Nils Planken
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands
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14
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Wu X, Gürzing S, Schinkel C, Toussaint M, Perinajová R, van Ooij P, Kenjereš S. Hemodynamic Study of a Patient-Specific Intracranial Aneurysm: Comparative Assessment of Tomographic PIV, Stereoscopic PIV, In Vivo MRI and Computational Fluid Dynamics. Cardiovasc Eng Technol 2021; 13:428-442. [PMID: 34750782 PMCID: PMC9197918 DOI: 10.1007/s13239-021-00583-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/11/2021] [Indexed: 11/20/2022]
Abstract
Introduction Wall shear stress (WSS) is associated with the growth and rupture of an intracranial aneurysm. To reveal their underlying connections, many image-based computational fluid dynamics (CFD) studies have been conducted. However, the methodological validations using both in vivo medical imaging and in vitro optical flow measurements were rarely accompanied in such studies. Methods In the present study, we performed a comparative assessment on the hemodynamics of a patient-specific intracranial saccular aneurysm using in vivo 4D Flow MRI, in silico CFD, in vitro stereoscopic and tomographic particle imaging velocimetry (Stereo-PIV and Tomo-PIV) techniques. PIV experiments and CFD were conducted under steady state corresponding to the peak systole of 4D Flow MRI. Results The results showed that all modalities provided similar flow features and overall surface distribution of WSS. However, a large variation in the absolute WSS values was found. 4D Flow MRI estimated a 2- to 4-fold lower peak WSS (3.99 Pa) and a 1.6- to 2-fold lower mean WSS (0.94 Pa) than Tomo-PIV, Stereo-PIV, and CFD. Bland-Altman plots of WSS showed that the differences between PIV-/CFD-based WSS and 4D Flow MRI-based WSS increase with higher WSS magnitude. Such proportional trend was absent in the Bland-Altman comparison of velocity where the resolutions of PIV and CFD datasets were matched to 4D Flow MRI. We also found that because of superior resolution in the out-of-plane direction, WSS estimation by Tomo-PIV was higher than Stereo-PIV. Conclusions Our results indicated that the differences in spatial resolution could be the main contributor to the discrepancies between each modality. The findings of this study suggest that with current techniques, care should be taken when using absolute WSS values to perform a quantitative risk analysis of aneurysm rupture. Supplementary Information The online version contains supplementary material available at 10.1007/s13239-021-00583-2.
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Affiliation(s)
- Xiaolin Wu
- Department of Chemical Engineering, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands.,J. M. Burgerscentrum Research School for Fluid Mechanics, Delft, The Netherlands
| | - Stefanie Gürzing
- Department of Chemical Engineering, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - Christiaan Schinkel
- Department of Chemical Engineering, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - Merel Toussaint
- Department of Chemical Engineering, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - Romana Perinajová
- Department of Chemical Engineering, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands.,J. M. Burgerscentrum Research School for Fluid Mechanics, Delft, The Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Saša Kenjereš
- Department of Chemical Engineering, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands. .,J. M. Burgerscentrum Research School for Fluid Mechanics, Delft, The Netherlands.
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15
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Blanken CPS, Gottwald LM, Westenberg JJM, Peper ES, Coolen BF, Strijkers GJ, Nederveen AJ, Planken RN, van Ooij P. Whole-Heart 4D Flow MRI for Evaluation of Normal and Regurgitant Valvular Flow: A Quantitative Comparison Between Pseudo-Spiral Sampling and EPI Readout. J Magn Reson Imaging 2021; 55:1120-1130. [PMID: 34510612 PMCID: PMC9290924 DOI: 10.1002/jmri.27905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 01/23/2023] Open
Abstract
Background Pseudo‐spiral Cartesian sampling with compressed sensing reconstruction has facilitated highly accelerated 4D flow magnetic resonance imaging (MRI) in various cardiovascular structures. However, unlike echo planar imaging (EPI)‐accelerated 4D flow MRI, it has not been validated in whole‐heart applications. Hypothesis Pseudo‐spiral 4D flow MRI (PROUD [PROspective Undersampling in multiple Dimensions]) is comparable to EPI in robustness of valvular flow measurements and remains comparable as the undersampling factor is increased and scan time reduced. Study Type Prospective. Population Twelve healthy subjects and eight patients with valvular regurgitation. Field Strength/Sequence 3.0 T; PROUD and EPI 4D flow sequences, 2D flow and balanced steady‐state free precession sequences. Assessment Valvular blood flow was quantified using valve tracking. PROUD‐ and EPI‐based measurements of aortic (AV) and pulmonary (PV) flow volumes and left and right ventricular stroke volumes were tested for agreement with 2D MRI‐based measurements. PROUD reconstructions with undersampling factors (R) of 9, 14, 28, and 56 were tested for intervalve consistency (per valve, compared to the other valves) and preservation of peak velocities and E/A ratios. Statistical Tests We used repeated measures ANOVA, Bland‐Altman, Wilcoxon signed rank, and intraclass correlation coefficients. P < 0.05 was considered statistically significant. Results PROUD and EPI intervalve consistencies were not significantly different both in healthy subjects (valve‐averaged mean difference [limits of agreement width]: 3.2 ± 0.8 [8.7 ± 1.1] mL/beat for PROUD, 5.5 ± 2.9 [13.7 ± 2.3] mL/beat for EPI, P = 0.07) and in patients with valvular regurgitation (2.3 ± 1.2 [15.3 ± 5.9] mL/beat for PROUD, 0.6 ± 0.6 [19.3 ± 2.9] mL/beat for EPI, P = 0.47). Agreement between EPI and PROUD was higher than between 4D flow (EPI or PROUD) and 2D MRI for forward flow, stroke volumes, and regurgitant volumes. Up to R = 28 in healthy subjects and R = 14 in patients with valvular regurgitation, PROUD intervalve consistency remained comparable to that of EPI. Peak velocities and E/A ratios were preserved up to R = 9. Conclusion PROUD is comparable to EPI in terms of intervalve consistency and may be used with higher undersampling factors to shorten scan times further. Level of Evidence 1 Technical Efficacy Stage 2
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Affiliation(s)
- Carmen P S Blanken
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Lukas M Gottwald
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | | | - Eva S Peper
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Bram F Coolen
- Department of Biomedical Engineering and Physics, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Gustav J Strijkers
- Department of Biomedical Engineering and Physics, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - R Nils Planken
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
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16
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Demirkiran A, van Ooij P, Westenberg JJM, Hofman MBM, van Assen HC, Schoonmade LJ, Asim U, Blanken CPS, Nederveen AJ, van Rossum AC, Götte MJW. Clinical intra-cardiac 4D flow CMR: acquisition, analysis, and clinical applications. Eur Heart J Cardiovasc Imaging 2021; 23:154-165. [PMID: 34143872 PMCID: PMC8787996 DOI: 10.1093/ehjci/jeab112] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/25/2021] [Indexed: 12/13/2022] Open
Abstract
Identification of flow patterns within the heart has long been recognized as a potential contribution to the understanding of physiological and pathophysiological processes of cardiovascular diseases. Although the pulsatile flow itself is multi-dimensional and multi-directional, current available non-invasive imaging modalities in clinical practice provide calculation of flow in only 1-direction and lack 3-dimensional volumetric velocity information. Four-dimensional flow cardiovascular magnetic resonance imaging (4D flow CMR) has emerged as a novel tool that enables comprehensive and critical assessment of flow through encoding velocity in all 3 directions in a volume of interest resolved over time. Following technical developments, 4D flow CMR is not only capable of visualization and quantification of conventional flow parameters such as mean/peak velocity and stroke volume but also provides new hemodynamic parameters such as kinetic energy. As a result, 4D flow CMR is being extensively exploited in clinical research aiming to improve understanding of the impact of cardiovascular disease on flow and vice versa. Of note, the analysis of 4D flow data is still complex and accurate analysis tools that deliver comparable quantification of 4D flow values are a necessity for a more widespread adoption in clinic. In this article, the acquisition and analysis processes are summarized and clinical applications of 4D flow CMR on the heart including conventional and novel hemodynamic parameters are discussed. Finally, clinical potential of other emerging intra-cardiac 4D flow imaging modalities is explored and a near-future perspective on 4D flow CMR is provided.
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Affiliation(s)
- Ahmet Demirkiran
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Pim van Ooij
- Department of Radiology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Jos J M Westenberg
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Mark B M Hofman
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Hans C van Assen
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Linda J Schoonmade
- Medical Library, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Usman Asim
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Carmen P S Blanken
- Department of Radiology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Department of Radiology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Albert C van Rossum
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Marco J W Götte
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
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17
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Gottwald LM, Blanken CPS, Tourais J, Smink J, Planken RN, Boekholdt SM, Meijboom LJ, Coolen BF, Strijkers GJ, Nederveen AJ, van Ooij P. Retrospective Camera-Based Respiratory Gating in Clinical Whole-Heart 4D Flow MRI. J Magn Reson Imaging 2021; 54:440-451. [PMID: 33694310 PMCID: PMC8359364 DOI: 10.1002/jmri.27564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 12/17/2022] Open
Abstract
Background Respiratory gating is generally recommended in 4D flow MRI of the heart to avoid blurring and motion artifacts. Recently, a novel automated contact‐less camera‐based respiratory motion sensor has been introduced. Purpose To compare camera‐based respiratory gating (CAM) with liver‐lung‐navigator‐based gating (NAV) and no gating (NO) for whole‐heart 4D flow MRI. Study Type Retrospective. Subjects Thirty two patients with a spectrum of cardiovascular diseases. Field Strength/Sequence A 3T, 3D‐cine spoiled‐gradient‐echo‐T1‐weighted‐sequence with flow‐encoding in three spatial directions. Assessment Respiratory phases were derived and compared against each other by cross‐correlation. Three radiologists/cardiologist scored images reconstructed with camera‐based, navigator‐based, and no respiratory gating with a 4‐point Likert scale (qualitative analysis). Quantitative image quality analysis, in form of signal‐to‐noise ratio (SNR) and liver‐lung‐edge (LLE) for sharpness and quantitative flow analysis of the valves were performed semi‐automatically. Statistical Tests One‐way repeated measured analysis of variance (ANOVA) with Wilks's lambda testing and follow‐up pairwise comparisons. Significance level of P ≤ 0.05. Krippendorff's‐alpha‐test for inter‐rater reliability. Results The respiratory signal analysis revealed that CAM and NAV phases were highly correlated (C = 0.93 ± 0.09, P < 0.01). Image scoring showed poor inter‐rater reliability and no significant differences were observed (P ≥ 0.16). The image quality comparison showed that NAV and CAM were superior to NO with higher SNR (P = 0.02) and smaller LLE (P < 0.01). The quantitative flow analysis showed significant differences between the three respiratory‐gated reconstructions in the tricuspid and pulmonary valves (P ≤ 0.05), but not in the mitral and aortic valves (P > 0.05). Pairwise comparisons showed that reconstructions without respiratory gating were different in flow measurements to either CAM or NAV or both, but no differences were found between CAM and NAV reconstructions. Data Conclusion Camera‐based respiratory gating performed as well as conventional liver‐lung‐navigator‐based respiratory gating. Quantitative image quality analysis showed that both techniques were equivalent and superior to no‐gating‐reconstructions. Quantitative flow analysis revealed local flow differences (tricuspid/pulmonary valves) in images of no‐gating‐reconstructions, but no differences were found between images reconstructed with camera‐based and navigator‐based respiratory gating. Level of Evidence 3 Technical Efficacy Stage 2
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Affiliation(s)
- Lukas M Gottwald
- Radiology and Nuclear Medicine, Amsterdam, Amsterdam University Medical Centers, location AMC, The Netherlands
| | - Carmen P S Blanken
- Radiology and Nuclear Medicine, Amsterdam, Amsterdam University Medical Centers, location AMC, The Netherlands
| | - João Tourais
- MR R&D-Clinical Science, Philips Healthcare, Best, The Netherlands.,Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Magnetic Resonance Systems Lab, Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Jouke Smink
- MR R&D-Clinical Science, Philips Healthcare, Best, The Netherlands
| | - R Nils Planken
- Cardiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Lilian J Meijboom
- Radiology and Nuclear Medicine, Amsterdam, Amsterdam University Medical Centers, location AMC, The Netherlands
| | - Bram F Coolen
- Biomedical Engineering and Physics, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Gustav J Strijkers
- Biomedical Engineering and Physics, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Radiology and Nuclear Medicine, Amsterdam, Amsterdam University Medical Centers, location AMC, The Netherlands
| | - Pim van Ooij
- Radiology and Nuclear Medicine, Amsterdam, Amsterdam University Medical Centers, location AMC, The Netherlands
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van Ooij P, Farag ES, Blanken CPS, Nederveen AJ, Groenink M, Planken RN, Boekholdt SM. Fully quantitative mapping of abnormal aortic velocity and wall shear stress direction in patients with bicuspid aortic valves and repaired coarctation using 4D flow cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2021; 23:9. [PMID: 33588887 PMCID: PMC7885343 DOI: 10.1186/s12968-020-00703-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 12/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Helices and vortices in thoracic aortic blood flow measured with 4D flow cardiovascular magnetic resonance (CMR) have been associated with aortic dilation and aneurysms. Current approaches are semi-quantitative or when fully quantitative based on 2D plane placement. In this study, we present a fully quantitative and three-dimensional approach to map and quantify abnormal velocity and wall shear stress (WSS) at peak systole in patients with a bicuspid aortic valve (BAV) of which 52% had a repaired coarctation. METHODS 4D flow CMR was performed in 48 patients with BAV and in 25 healthy subjects at a spatiotemporal resolution of 2.5 × 2.5 × 2.5mm3/ ~ 42 ms and TE/TR/FA of 2.1 ms/3.4 ms/8° with k-t Principal Component Analysis factor R = 8. A 3D average of velocity and WSS direction was created for the normal subjects. Comparing BAV patient data with the 3D average map and selecting voxels deviating between 60° and 120° and > 120° yielded 3D maps and volume (in cm3) and surface (in cm2) quantification of abnormally directed velocity and WSS, respectively. Linear regression with Bonferroni corrected significance of P < 0.0125 was used to compare abnormally directed velocity volume and WSS surface in the ascending aorta with qualitative helicity and vorticity scores, with local normalized helicity (LNH) and quantitative vorticity and with patient characteristics. RESULTS The velocity volumes > 120° correlated moderately with the vorticity scores (R ~ 0.50, P < 0.001 for both observers). For WSS surface these results were similar. The velocity volumes between 60° and 120° correlated moderately with LNH (R = 0.66) but the velocity volumes > 120° did not correlate with quantitative vorticity. For abnormal velocity and WSS deviating between 60° and 120°, moderate correlations were found with aortic diameters (R = 0.50-0.70). For abnormal velocity and WSS deviating > 120°, additional moderate correlations were found with age and with peak velocity (stenosis severity) and a weak correlation with gender. Ensemble maps showed that more than 60% of the patients had abnormally directed velocity and WSS. Additionally, abnormally directed velocity and WSS was higher in the proximal descending aorta in the patients with repaired coarctation than in the patients where coarctation was never present. CONCLUSION The possibility to reveal directional abnormalities of velocity and WSS in 3D provides a new tool for hemodynamic characterization in BAV disease.
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Affiliation(s)
- Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Emile S. Farag
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands
| | - Carmen P. S. Blanken
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Aart J. Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Maarten Groenink
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Department of Cardiology, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands
| | - R. Nils Planken
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - S. Matthijs Boekholdt
- Department of Cardiology, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands
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Juffermans JF, Minderhoud SCS, Wittgren J, Kilburg A, Ese A, Fidock B, Zheng YC, Zhang JM, Blanken CPS, Lamb HJ, Goeman JJ, Carlsson M, Zhao S, Planken RN, van Ooij P, Zhong L, Chen X, Garg P, Emrich T, Hirsch A, Töger J, Westenberg JJM. Multicenter Consistency Assessment of Valvular Flow Quantification With Automated Valve Tracking in 4D Flow CMR. JACC Cardiovasc Imaging 2021; 14:1354-1366. [PMID: 33582060 DOI: 10.1016/j.jcmg.2020.12.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/18/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study determined: 1) the interobserver agreement; 2) valvular flow variation; and 3) which variables independently predicted the variation of valvular flow quantification from 4-dimensional (4D) flow cardiac magnetic resonance (CMR) with automated retrospective valve tracking at multiple sites. BACKGROUND Automated retrospective valve tracking in 4D flow CMR allows consistent assessment of valvular flow through all intracardiac valves. However, due to the variance of CMR scanners and protocols, it remains uncertain if the published consistency holds for other clinical centers. METHODS Seven sites each retrospectively or prospectively selected 20 subjects who underwent whole heart 4D flow CMR (64 patients and 76 healthy volunteers; aged 32 years [range 24 to 48 years], 47% men, from 2014 to 2020), which was acquired with locally used CMR scanners (scanners from 3 vendors; 2 1.5-T and 5 3-T scanners) and protocols. Automated retrospective valve tracking was locally performed at each site to quantify the valvular flow and repeated by 1 central site. Interobserver agreement was evaluated with intraclass correlation coefficients (ICCs). Net forward volume (NFV) consistency among the valves was evaluated by calculating the intervalvular variation. Multiple regression analysis was performed to assess the predicting effect of local CMR scanners and protocols on the intervalvular inconsistency. RESULTS The interobserver analysis demonstrated strong-to-excellent agreement for NFV (ICC: 0.85 to 0.96) and moderate-to-excellent agreement for regurgitation fraction (ICC: 0.53 to 0.97) for all sites and valves. In addition, all observers established a low intervalvular variation (≤10.5%) in their analysis. The availability of 2 cine images per valve for valve tracking compared with 1 cine image predicted a decreasing variation in NFV among the 4 valves (beta = -1.3; p = 0.01). CONCLUSIONS Independently of locally used CMR scanners and protocols, valvular flow quantification can be performed consistently with automated retrospective valve tracking in 4D flow CMR.
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Affiliation(s)
- Joe F Juffermans
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Savine C S Minderhoud
- Department of Cardiology and Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Johan Wittgren
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden
| | - Anton Kilburg
- Department of Radiology, University Medical Center Mainz, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Amir Ese
- Department of Radiology, University Medical Center Mainz, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Benjamin Fidock
- Department of Infection, Immunity, and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Yu-Cong Zheng
- Department of MRI, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun-Mei Zhang
- National Heart Centre Singapore; Duke-NUS Medical School Singapore, National University of Singapore, Singapore
| | - Carmen P S Blanken
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jelle J Goeman
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Marcus Carlsson
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden
| | - Shihua Zhao
- Department of MRI, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - R Nils Planken
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Liang Zhong
- National Heart Centre Singapore; Duke-NUS Medical School Singapore, National University of Singapore, Singapore
| | - Xiuyu Chen
- Department of MRI, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Pankaj Garg
- Department of Infection, Immunity, and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Tilman Emrich
- Department of Radiology, University Medical Center Mainz, Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Alexander Hirsch
- Department of Cardiology and Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Johannes Töger
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden
| | - Jos J M Westenberg
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
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20
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Blanken CPS, Westenberg JJM, Aben JP, Bijvoet GP, Chamuleau SAJ, Boekholdt SM, Nederveen AJ, Leiner T, van Ooij P, Planken RN. Quantification of Mitral Valve Regurgitation from 4D Flow MRI Using Semiautomated Flow Tracking. Radiol Cardiothorac Imaging 2020; 2:e200004. [PMID: 33778618 DOI: 10.1148/ryct.2020200004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 11/11/2022]
Abstract
Purpose To compare the accuracy of semiautomated flow tracking with that of semiautomated valve tracking in the quantification of mitral valve (MV) regurgitation from clinical four-dimensional (4D) flow MRI data obtained in patients with mild, moderate, or severe MV regurgitation. Materials and Methods The 4D flow MRI data were retrospectively collected from 30 patients (21 men; mean age, 61 years ± 10 [standard deviation]) who underwent 4D flow MRI from 2006 to 2016. Ten patients had mild MV regurgitation, nine had moderate MV regurgitation, and 11 had severe MV regurgitation, as diagnosed by using semiquantitative echocardiography. The regurgitant volume (Rvol) across the MV was obtained using three methods: indirect quantification of Rvol (RvolINDIRECT), semiautomated quantification of Rvol using valve tracking (RvolVALVE), and semiautomated quantification of Rvol using flow tracking (RvolFLOW). A second observer repeated the measurements. Aortic valve flow was quantified as well to test for intervalve consistency. The Wilcoxon signed rank test, orthogonal regression, Bland-Altman analysis, and coefficients of variation were used to assess agreement among measurements and between observers. Results RvolFLOW was higher (median, 24.8 mL; interquartile range [IQR], 14.3-45.7 mL) than RvolVALVE (median, 9.9 mL; IQR, 6.0-16.9 mL; P < .001). Both RvolFLOW and RvolVALVE differed significantly from RvolINDIRECT (median, 19.1 mL; IQR, 4.1-47.5 mL; P = .03). RvolFLOW agreed more with RvolINDIRECT (ŷ = 0.78x + 12, r = 0.88) than with RvolVALVE (ŷ = 0.16x + 8.1, r = 0.53). Bland-Altman analysis revealed underestimation of RvolVALVE in severe MV regurgitation. Interobserver agreement was excellent for RvolFLOW (r = 0.95, coefficient of variation = 27%) and moderate for RvolVALVE (r = 0.72, coefficient of variation = 57%). Orthogonal regression demonstrated better intervalve consistency for flow tracking (ŷ = 1.2x - 13.4, r = 0.82) than for valve tracking (ŷ = 2.7x - 92.4, r = 0.67). Conclusion Flow tracking enables more accurate 4D flow MRI-derived MV regurgitation quantification than valve tracking in terms of agreement with indirect quantification and intervalve consistency, particularly in severe MV regurgitation.Supplemental material is available for this article.© RSNA, 2020.
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Affiliation(s)
- Carmen P S Blanken
- Departments of Radiology and Nuclear Medicine (C.P.S.B., A.J.N., P.v.O., R.N.P.) and Cardiology (S.M.B.), Amsterdam University Medical Centers, Location Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.M.W.); Department of Research and Development, Pie Medical Imaging BV, Maastricht, the Netherlands (J.P.A.); and Departments of Cardiology (G.P.B., S.A.J.C.) and Radiology (T.L.), University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jos J M Westenberg
- Departments of Radiology and Nuclear Medicine (C.P.S.B., A.J.N., P.v.O., R.N.P.) and Cardiology (S.M.B.), Amsterdam University Medical Centers, Location Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.M.W.); Department of Research and Development, Pie Medical Imaging BV, Maastricht, the Netherlands (J.P.A.); and Departments of Cardiology (G.P.B., S.A.J.C.) and Radiology (T.L.), University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jean-Paul Aben
- Departments of Radiology and Nuclear Medicine (C.P.S.B., A.J.N., P.v.O., R.N.P.) and Cardiology (S.M.B.), Amsterdam University Medical Centers, Location Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.M.W.); Department of Research and Development, Pie Medical Imaging BV, Maastricht, the Netherlands (J.P.A.); and Departments of Cardiology (G.P.B., S.A.J.C.) and Radiology (T.L.), University Medical Center Utrecht, Utrecht, the Netherlands
| | - Geertruida P Bijvoet
- Departments of Radiology and Nuclear Medicine (C.P.S.B., A.J.N., P.v.O., R.N.P.) and Cardiology (S.M.B.), Amsterdam University Medical Centers, Location Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.M.W.); Department of Research and Development, Pie Medical Imaging BV, Maastricht, the Netherlands (J.P.A.); and Departments of Cardiology (G.P.B., S.A.J.C.) and Radiology (T.L.), University Medical Center Utrecht, Utrecht, the Netherlands
| | - Steven A J Chamuleau
- Departments of Radiology and Nuclear Medicine (C.P.S.B., A.J.N., P.v.O., R.N.P.) and Cardiology (S.M.B.), Amsterdam University Medical Centers, Location Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.M.W.); Department of Research and Development, Pie Medical Imaging BV, Maastricht, the Netherlands (J.P.A.); and Departments of Cardiology (G.P.B., S.A.J.C.) and Radiology (T.L.), University Medical Center Utrecht, Utrecht, the Netherlands
| | - S Matthijs Boekholdt
- Departments of Radiology and Nuclear Medicine (C.P.S.B., A.J.N., P.v.O., R.N.P.) and Cardiology (S.M.B.), Amsterdam University Medical Centers, Location Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.M.W.); Department of Research and Development, Pie Medical Imaging BV, Maastricht, the Netherlands (J.P.A.); and Departments of Cardiology (G.P.B., S.A.J.C.) and Radiology (T.L.), University Medical Center Utrecht, Utrecht, the Netherlands
| | - Aart J Nederveen
- Departments of Radiology and Nuclear Medicine (C.P.S.B., A.J.N., P.v.O., R.N.P.) and Cardiology (S.M.B.), Amsterdam University Medical Centers, Location Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.M.W.); Department of Research and Development, Pie Medical Imaging BV, Maastricht, the Netherlands (J.P.A.); and Departments of Cardiology (G.P.B., S.A.J.C.) and Radiology (T.L.), University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tim Leiner
- Departments of Radiology and Nuclear Medicine (C.P.S.B., A.J.N., P.v.O., R.N.P.) and Cardiology (S.M.B.), Amsterdam University Medical Centers, Location Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.M.W.); Department of Research and Development, Pie Medical Imaging BV, Maastricht, the Netherlands (J.P.A.); and Departments of Cardiology (G.P.B., S.A.J.C.) and Radiology (T.L.), University Medical Center Utrecht, Utrecht, the Netherlands
| | - Pim van Ooij
- Departments of Radiology and Nuclear Medicine (C.P.S.B., A.J.N., P.v.O., R.N.P.) and Cardiology (S.M.B.), Amsterdam University Medical Centers, Location Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.M.W.); Department of Research and Development, Pie Medical Imaging BV, Maastricht, the Netherlands (J.P.A.); and Departments of Cardiology (G.P.B., S.A.J.C.) and Radiology (T.L.), University Medical Center Utrecht, Utrecht, the Netherlands
| | - R Nils Planken
- Departments of Radiology and Nuclear Medicine (C.P.S.B., A.J.N., P.v.O., R.N.P.) and Cardiology (S.M.B.), Amsterdam University Medical Centers, Location Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.M.W.); Department of Research and Development, Pie Medical Imaging BV, Maastricht, the Netherlands (J.P.A.); and Departments of Cardiology (G.P.B., S.A.J.C.) and Radiology (T.L.), University Medical Center Utrecht, Utrecht, the Netherlands
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Rajabzadeh-Oghaz H, van Ooij P, Veeturi SS, Tutino VM, Zwanenburg JJ, Meng H. Inter-patient variations in flow boundary conditions at middle cerebral artery from 7T PC-MRI and influence on Computational Fluid Dynamics of intracranial aneurysms. Comput Biol Med 2020; 120:103759. [PMID: 32421656 DOI: 10.1016/j.compbiomed.2020.103759] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/03/2020] [Accepted: 04/08/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Computational fluid dynamics(CFD) of intracranial aneurysms requires flow boundary conditions(BCs) as inputs. Patient-specific BCs are usually unavailable and substituted by literature-derived generic BCs. Therefore, we investigated inter-patient BC variations and their influence on middle cerebral artery aneurysmal hemodynamics. METHOD We retrospectively collected CT angiography and 7-T Phase-Contrast(PC)-MRI data from eight middle-cerebral-artery bifurcation aneurysms to reconstruct the geometry and measure the arterial flowrates, respectively. The coefficient of variation(CoV) was calculated for the inlet flowrate and the pulsatility index(PI). The outflow split estimated by Murray's law was compared with PC-MRI measurements. For each aneurysm, we performed seven simulations: "baseline" using PC-MRI-derived BCs and the other six with changing BCs to explore the influence of BC variations on hemodynamics. RESULTS From PC-MRI, the inlet flowrate was 1.94 ± 0.71 cm3/s(CoV = 36%) and PI was 0.37 ± 0.13(CoV = 34%). The outflow split estimated by Murray's law deviated by 15.3% compared to PC-MRI. Comparing to "baseline" models, ±36% variations in inlet flowrate caused -61% to +89% changes in time-averaged wall shear stress(WSS), -37% to +32% in normalized WSS(NWSS; by parent-artery), and -42% to +126% in oscillatory shear index(OSI). The ±34% variations in PI caused, -46% to +67% in OSI. Applying ±15% variations in outflow split led to inflow jet deflection and -41% to +52% changes in WSS, -41% to +47% in NWSS, and -44% to +144% in OSI. CONCLUSION Inflow rate and outflow split have a drastic impact on hemodynamics of intracranial aneurysms. Inlet waveform has a negligible impact on WSS and NWSS but major impact on OSI. CFD-based models need to consider such sensitivity.
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Affiliation(s)
- Hamidreza Rajabzadeh-Oghaz
- Department of Mechanical and Aerospace Engineering, University at Buffalo, The State University of New York, Buffalo, NY, USA; Canon Stroke and Vascular Research Center, University at Buffalo, The State University of New York, Buffalo, NY, USA; Department of Neurosurgery, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Pim van Ooij
- Department of Radiology& Nuclear Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Sricharan S Veeturi
- Department of Mechanical and Aerospace Engineering, University at Buffalo, The State University of New York, Buffalo, NY, USA; Canon Stroke and Vascular Research Center, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Vincent M Tutino
- Department of Mechanical and Aerospace Engineering, University at Buffalo, The State University of New York, Buffalo, NY, USA; Canon Stroke and Vascular Research Center, University at Buffalo, The State University of New York, Buffalo, NY, USA; Department of Neurosurgery, University at Buffalo, The State University of New York, Buffalo, NY, USA; Department of Pathology and Anatomical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA; Department of Biomedical Engineering, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Jaco Jm Zwanenburg
- Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hui Meng
- Department of Mechanical and Aerospace Engineering, University at Buffalo, The State University of New York, Buffalo, NY, USA; Canon Stroke and Vascular Research Center, University at Buffalo, The State University of New York, Buffalo, NY, USA.
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Gottwald LM, Peper ES, Zhang Q, Coolen BF, Strijkers GJ, Nederveen AJ, van Ooij P. Pseudo-spiral sampling and compressed sensing reconstruction provides flexibility of temporal resolution in accelerated aortic 4D flow MRI: A comparison with k-t principal component analysis. NMR Biomed 2020; 33:e4255. [PMID: 31957927 PMCID: PMC7079056 DOI: 10.1002/nbm.4255] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Time-resolved three-dimensional phase contrast MRI (4D flow) of aortic blood flow requires acceleration to reduce scan time. Two established techniques for highly accelerated 4D flow MRI are k-t principal component analysis (k-t PCA) and compressed sensing (CS), which employ either regular or random k-space undersampling. The goal of this study was to gain insights into the quantitative differences between k-t PCA- and CS-derived aortic blood flow, especially for high temporal resolution CS 4D flow MRI. METHODS The scan protocol consisted of both k-t PCA and CS accelerated 4D flow MRI, as well as a 2D flow reference scan through the ascending aorta acquired in 15 subjects. 4D flow scans were accelerated with factor R = 8. For CS accelerated scans, we used a pseudo-spiral Cartesian sampling scheme, which could additionally be reconstructed at higher temporal resolution, resulting in R = 13. 4D flow data were compared with the 2D flow scan in terms of flow, peak flow and stroke volume. A 3D peak systolic voxel-wise velocity and wall shear stress (WSS) comparison between k-t PCA and CS 4D flow was also performed. RESULTS The mean difference in flow/peak flow/stroke volume between the 2D flow scan and the 4D flow CS with R = 8 and R = 13 was 4.2%/9.1%/3.0% and 5.3%/7.1%/1.9%, respectively, whereas for k-t PCA with R = 8 the difference was 9.7%/25.8%/10.4%. In the voxel-by-voxel 4D flow comparison we found 13.6% and 3.5% lower velocity and WSS values of k-t PCA compared with CS with R = 8, and 15.9% and 5.5% lower velocity and WSS values of k-t PCA compared with CS with R = 13. CONCLUSION Pseudo-spiral accelerated 4D flow acquisitions in combination with CS reconstruction provides a flexible choice of temporal resolution. We showed that our proposed strategy achieves better agreement in flow values with 2D reference scans compared with using k-t PCA accelerated acquisitions.
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Affiliation(s)
- Lukas M. Gottwald
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical CentersUniversity of Amsterdamthe Netherlands
| | - Eva S. Peper
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical CentersUniversity of Amsterdamthe Netherlands
| | - Qinwei Zhang
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical CentersUniversity of Amsterdamthe Netherlands
| | - Bram F. Coolen
- Department of Biomedical Engineering and Physics, Amsterdam University Medical CentersUniversity of Amsterdamthe Netherlands
| | - Gustav J. Strijkers
- Department of Biomedical Engineering and Physics, Amsterdam University Medical CentersUniversity of Amsterdamthe Netherlands
| | - Aart J. Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical CentersUniversity of Amsterdamthe Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical CentersUniversity of Amsterdamthe Netherlands
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23
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Scott MB, Huh H, van Ooij P, Chen V, Herrera B, Elbaz M, McCarthy P, Malaisrie SC, Carr J, Fedak PWM, Markl M, Barker AJ. Impact of age, sex, and global function on normal aortic hemodynamics. Magn Reson Med 2020; 84:2088-2102. [PMID: 32162416 DOI: 10.1002/mrm.28250] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/10/2020] [Accepted: 02/14/2020] [Indexed: 02/01/2023]
Abstract
PURPOSE To examine the effects of age, sex, and left ventricular global function on velocity, helicity, and 3D wall shear stress (3D-WSS) in the aorta of N = 100 healthy controls. METHODS Fifty female and 50 male volunteers with no history of cardiovascular disease, with 10 volunteers per age group (18-30, 31-40, 41-50, 51-60, and 61-80 years) underwent aortic 4D-flow MRI. Quantification of systolic aortic peak velocity, helicity, and 3D-WSS distribution and the calculation of age group-averaged peak systolic velocity and 3D-WSS maps ("atlases") were computed. Age-related and sex-related changes in peak velocity, helicity, and 3D-WSS were computed and correlated with standard metrics of left ventricular function derived from short-axis cine MRI. RESULTS No significant differences were found in peak systolic velocity or 3D-WSS based on sex except for the 18- to 30-year-old group (males 8% higher velocity volume and 3D-WSS surface area). Between successively older groups, systolic velocity decreased (13%, <1%, 7%, and 55% of the aorta volume) and 3D-WSS decreased (21%, 2%, 30%, and 62% of the aorta surface area). Mean velocity, mean 3D-3D-WSS, and median helicity increased with cardiac output (r = 0.27-0.43, all P < .01), and mean velocity and 3D-WSS decreased with increasing diameter (r > 0.35, P < .001). Arch and descending aorta systolic mean velocity, mean 3D-WSS, and median helicity increased with normalized left ventricular volumes: end diastolic volume (r = 0.31-0.37, P < .01), end systolic volume (r = 0.27-0.35, P < .01), and stroke volume (r = 0.28-0.35, P < .01). CONCLUSION Healthy aortic hemodynamics are dependent on subject age, and correlate with vessel diameter and cardiac function.
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Affiliation(s)
- Michael B Scott
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA
| | - Hyungkyu Huh
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Academic Medical Centre, Amsterdam, the Netherlands
| | - Vincent Chen
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Brenda Herrera
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mohammed Elbaz
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Patrick McCarthy
- Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - S Chris Malaisrie
- Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Paul W M Fedak
- Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA
| | - Alex J Barker
- Department of Radiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
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24
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Pruijssen JT, Allen BD, Barker AJ, Bonow RO, Choudhury L, Carr JC, Markl M, van Ooij P. Hypertrophic Cardiomyopathy Is Associated with Altered Left Ventricular 3D Blood Flow Dynamics. Radiol Cardiothorac Imaging 2020; 2:e190038. [PMID: 33778534 DOI: 10.1148/ryct.2020190038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 08/28/2019] [Accepted: 09/16/2019] [Indexed: 11/11/2022]
Abstract
Purpose To employ four-dimensional (4D) flow MRI to investigate associations between hemodynamic parameters with systolic anterior motion (SAM), mitral regurgitation (MR), stroke volume, and cardiac mass in patients with hypertrophic cardiomyopathy (HCM). Materials and Methods A total of 13 patients with HCM (51 years ± 16 [standard deviation]; 10 men) and 11 age-matched healthy control subjects (54 years ± 15; eight men) underwent cardiac 4D flow MRI data analysis including calculation of peak systolic and diastolic control-averaged left ventricular (LV) velocity maps to quantify volumes of elevated velocity (EVV) in the left ventricle. Standard-of-care cine imaging was performed in short-axis, LV outflow tract (LVOT), and two-, three-, and four-chamber views on which the presence of SAM, presence of MR, total stroke volume, and cardiac mass were assessed. Results Systolic EVV in patients with HCM was 7 mL ± 5, which was significantly associated with elevated aortic peak velocity (R = 0.87; P < .001), decreased LVOT diameter (R = 0.68; P = .01), and increased cardiac mass (R = 0.62; P = .02). In addition, EVV differed significantly between patients with and those without SAM (10 mL ± 4.7 vs 3 mL ± 2.3; P = .03) and those with and those without MR (9.9 mL ± 4.8 vs 4.0 mL ± 3.2; P < .05). In the atrial systolic phase, peak diastolic velocity in the LV correlated with septal thickness (R = 0.66; P = .01). Conclusion Quantification and visualization of EVV in the LV is feasible and may provide further insight into the clinical manifestations of altered hemodynamics in HCM.© RSNA, 2020.
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Affiliation(s)
- Judith T Pruijssen
- Department of Biomedical Engineering and Physics (J.T.P.) and Department of Radiology & Nuclear Medicine (P.v.O.), Academic Medical Center, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology (B.D.A., J.C.C., M.M.), Department of Medicine-Cardiology (R.O.B., L.C.), and Department of Biomedical Engineering (M.M.), Northwestern University, Chicago, Ill; and Department of Radiology & Bioengineering, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Denver, Colo (A.J.B.)
| | - Bradley D Allen
- Department of Biomedical Engineering and Physics (J.T.P.) and Department of Radiology & Nuclear Medicine (P.v.O.), Academic Medical Center, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology (B.D.A., J.C.C., M.M.), Department of Medicine-Cardiology (R.O.B., L.C.), and Department of Biomedical Engineering (M.M.), Northwestern University, Chicago, Ill; and Department of Radiology & Bioengineering, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Denver, Colo (A.J.B.)
| | - Alex J Barker
- Department of Biomedical Engineering and Physics (J.T.P.) and Department of Radiology & Nuclear Medicine (P.v.O.), Academic Medical Center, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology (B.D.A., J.C.C., M.M.), Department of Medicine-Cardiology (R.O.B., L.C.), and Department of Biomedical Engineering (M.M.), Northwestern University, Chicago, Ill; and Department of Radiology & Bioengineering, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Denver, Colo (A.J.B.)
| | - Robert O Bonow
- Department of Biomedical Engineering and Physics (J.T.P.) and Department of Radiology & Nuclear Medicine (P.v.O.), Academic Medical Center, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology (B.D.A., J.C.C., M.M.), Department of Medicine-Cardiology (R.O.B., L.C.), and Department of Biomedical Engineering (M.M.), Northwestern University, Chicago, Ill; and Department of Radiology & Bioengineering, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Denver, Colo (A.J.B.)
| | - Lubna Choudhury
- Department of Biomedical Engineering and Physics (J.T.P.) and Department of Radiology & Nuclear Medicine (P.v.O.), Academic Medical Center, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology (B.D.A., J.C.C., M.M.), Department of Medicine-Cardiology (R.O.B., L.C.), and Department of Biomedical Engineering (M.M.), Northwestern University, Chicago, Ill; and Department of Radiology & Bioengineering, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Denver, Colo (A.J.B.)
| | - James C Carr
- Department of Biomedical Engineering and Physics (J.T.P.) and Department of Radiology & Nuclear Medicine (P.v.O.), Academic Medical Center, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology (B.D.A., J.C.C., M.M.), Department of Medicine-Cardiology (R.O.B., L.C.), and Department of Biomedical Engineering (M.M.), Northwestern University, Chicago, Ill; and Department of Radiology & Bioengineering, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Denver, Colo (A.J.B.)
| | - Michael Markl
- Department of Biomedical Engineering and Physics (J.T.P.) and Department of Radiology & Nuclear Medicine (P.v.O.), Academic Medical Center, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology (B.D.A., J.C.C., M.M.), Department of Medicine-Cardiology (R.O.B., L.C.), and Department of Biomedical Engineering (M.M.), Northwestern University, Chicago, Ill; and Department of Radiology & Bioengineering, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Denver, Colo (A.J.B.)
| | - Pim van Ooij
- Department of Biomedical Engineering and Physics (J.T.P.) and Department of Radiology & Nuclear Medicine (P.v.O.), Academic Medical Center, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology (B.D.A., J.C.C., M.M.), Department of Medicine-Cardiology (R.O.B., L.C.), and Department of Biomedical Engineering (M.M.), Northwestern University, Chicago, Ill; and Department of Radiology & Bioengineering, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Denver, Colo (A.J.B.)
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25
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Peper ES, Gottwald LM, Zhang Q, Coolen BF, van Ooij P, Nederveen AJ, Strijkers GJ. Highly accelerated 4D flow cardiovascular magnetic resonance using a pseudo-spiral Cartesian acquisition and compressed sensing reconstruction for carotid flow and wall shear stress. J Cardiovasc Magn Reson 2020; 22:7. [PMID: 31959203 PMCID: PMC6971939 DOI: 10.1186/s12968-019-0582-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 10/18/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND 4D flow cardiovascular magnetic resonance (CMR) enables visualization of complex blood flow and quantification of biomarkers for vessel wall disease, such as wall shear stress (WSS). Because of the inherently long acquisition times, many efforts have been made to accelerate 4D flow acquisitions, however, no detailed analysis has been made on the effect of Cartesian compressed sensing accelerated 4D flow CMR at different undersampling rates on quantitative flow parameters and WSS. METHODS We implemented a retrospectively triggered 4D flow CMR acquisition with pseudo-spiral Cartesian k-space filling, which results in incoherent undersampling of k-t space. Additionally, this strategy leads to small jumps in k-space thereby minimizing eddy current related artifacts. The pseudo-spirals were rotated in a tiny golden-angle fashion, which provides optimal incoherence and a variable density sampling pattern with a fully sampled center. We evaluated this 4D flow protocol in a carotid flow phantom with accelerations of R = 2-20, as well as in carotids of 7 healthy subjects (27 ± 2 years, 4 male) for R = 10-30. Fully sampled 2D flow CMR served as a flow reference. Arteries were manually segmented and registered to enable voxel-wise comparisons of both velocity and WSS using a Bland-Altman analysis. RESULTS Magnitude images, velocity images, and pathline reconstructions from phantom and in vivo scans were similar for all accelerations. For the phantom data, mean differences at peak systole for the entire vessel volume in comparison to R = 2 ranged from - 2.3 to - 5.3% (WSS) and - 2.4 to - 2.2% (velocity) for acceleration factors R = 4-20. For the in vivo data, mean differences for the entire vessel volume at peak systole in comparison to R = 10 were - 9.9, - 13.4, and - 16.9% (WSS) and - 8.4, - 10.8, and - 14.0% (velocity), for R = 20, 25, and 30, respectively. Compared to single slice 2D flow CMR acquisitions, peak systolic flow rates of the phantom showed no differences, whereas peak systolic flow rates in the carotid artery in vivo became increasingly underestimated with increasing acceleration. CONCLUSION Acquisition of 4D flow CMR of the carotid arteries can be highly accelerated by pseudo-spiral k-space sampling and compressed sensing reconstruction, with consistent data quality facilitating velocity pathline reconstructions, as well as quantitative flow rate and WSS estimations. At an acceleration factor of R = 20 the underestimation of peak velocity and peak WSS was acceptable (< 10%) in comparison to an R = 10 accelerated 4D flow CMR reference scan. Peak flow rates were underestimated in comparison with 2D flow CMR and decreased systematically with higher acceleration factors.
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Affiliation(s)
- Eva S Peper
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Lukas M Gottwald
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Qinwei Zhang
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Bram F Coolen
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Gustav J Strijkers
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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26
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Indrakusuma R, Jalalzadeh H, van der Laan M, Koelemay M, Nederveen A, Planken R, van Ooij P, Balm R. 4D Flow MRI in Patients with Asymptomatic Abdominal Aortic Aneurysms: Reproducibility and Clinical Analysis. Eur J Vasc Endovasc Surg 2019. [DOI: 10.1016/j.ejvs.2019.09.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Peper ES, Leopaldi AM, van Tuijl S, Coolen BF, Strijkers GJ, Baan J, Planken RN, de Weger A, Nederveen AJ, Marquering HA, van Ooij P. An isolated beating pig heart platform for a comprehensive evaluation of intracardiac blood flow with 4D flow MRI: a feasibility study. Eur Radiol Exp 2019; 3:40. [PMID: 31650367 PMCID: PMC6813403 DOI: 10.1186/s41747-019-0114-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/02/2019] [Indexed: 12/25/2022] Open
Abstract
Background Cardiac magnetic resonance imaging (MRI) in large animals is cumbersome for various reasons, including ethical considerations, costs of housing and maintenance, and need for anaesthesia. Our primary purpose was to show the feasibility of an isolated beating pig heart model for four-dimensional (4D) flow MRI for investigating intracardiac blood flow patterns and flow parameters using slaughterhouse side products. In addition, the feasibility of evaluating transcatheter aortic valve replacement (TAVR) in the model was investigated. Methods Seven slaughterhouse pig hearts were installed in the MRI-compatible isolated beating pig heart platform. First, Langendorff perfusion mode was established; then, the system switched to working mode, in which blood was actively pumped by the left ventricle. A pacemaker ensured a stable HR during 3-T MRI scanning. All hearts were submitted to human physiological conditions of cardiac output and stayed vital for several hours. Aortic flow was measured from which stroke volume, cardiac output, and regurgitation fraction were calculated. Results 4D flow MRI acquisitions were successfully conducted in all hearts. Stroke volume was 31 ± 6 mL (mean ± standard deviation), cardiac output 3.3 ± 0.9 L/min, and regurgitation fraction 16% ± 9%. With 4D flow, intracardiac and coronary flow patterns could be visualised in all hearts. In addition, we could study valve function and regurgitation in two hearts after TAVR. Conclusions The feasibility of 4D flow MRI in an isolated beating pig heart loaded to physiological conditions was demonstrated. The platform is promising for preclinical assessment of cardiac blood flow and function. Electronic supplementary material The online version of this article (10.1186/s41747-019-0114-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eva S Peper
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | | | | | - Bram F Coolen
- Department of Biomedical Engineering & Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Gustav J Strijkers
- Department of Biomedical Engineering & Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Baan
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - R Nils Planken
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Arend de Weger
- Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Henk A Marquering
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Biomedical Engineering & Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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28
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Blanken CPS, Farag ES, Boekholdt SM, Leiner T, Kluin J, Nederveen AJ, van Ooij P, Planken RN. Advanced cardiac MRI techniques for evaluation of left-sided valvular heart disease. J Magn Reson Imaging 2019; 48:318-329. [PMID: 30134000 PMCID: PMC6667896 DOI: 10.1002/jmri.26204] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 04/19/2018] [Indexed: 01/06/2023] Open
Abstract
The most common types of left‐sided valvular heart disease (VHD) in the Western world are aortic valve stenosis, aortic valve regurgitation, and mitral valve regurgitation. Comprehensive clinical evaluation entails both hemodynamic analysis and structural as well as functional characterization of the left ventricle. Cardiac magnetic resonance imaging (MRI) is an established diagnostic modality for assessment of left‐sided VHD and is progressively gaining ground in modern‐day clinical practice. Detailed flow visualization and quantification of flow‐related biomarkers in VHD can be obtained using 4D flow MRI, an imaging technique capable of measuring blood flow in three orthogonal directions over time. In addition, recent MRI sequences enable myocardial tissue characterization and strain analysis. In this review we discuss the emerging potential of state‐of‐the‐art MRI including 4D flow MRI, tissue mapping, and strain quantification for the diagnosis and prognosis of left‐sided VHD. Level of Evidence: 1 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2018. J. MAGN. RESON. IMAGING 2018;48:318–329.
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Affiliation(s)
- Carmen P S Blanken
- Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Emile S Farag
- Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, the Netherlands
| | | | - Tim Leiner
- Department of Radiology, University Medical Center, Utrecht, the Netherlands
| | - Jolanda Kluin
- Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, the Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - R Nils Planken
- Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, the Netherlands
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29
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Bollache E, Knott KD, Jarvis K, Boubertakh R, Dolan RS, Camaioni C, Collins L, Scully P, Rabin S, Treibel T, Carr JC, van Ooij P, Collins JD, Geiger J, Moon JC, Barker AJ, Petersen SE, Markl M. Two-Minute k-Space and Time-accelerated Aortic Four-dimensional Flow MRI: Dual-Center Study of Feasibility and Impact on Velocity and Wall Shear Stress Quantification. Radiol Cardiothorac Imaging 2019; 1:e180008. [PMID: 32076666 DOI: 10.1148/ryct.2019180008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 03/12/2019] [Accepted: 04/23/2019] [Indexed: 01/12/2023]
Abstract
Purpose To investigate the two-center feasibility of highly k-space and time (k-t)-accelerated 2-minute aortic four-dimensional (4D) flow MRI and to evaluate its performance for the quantification of velocities and wall shear stress (WSS). Materials and Methods This cross-sectional study prospectively included 68 participants (center 1, 11 healthy volunteers [mean age ± standard deviation, 61 years ± 15] and 16 patients with aortic disease [mean age, 60 years ± 10]; center 2, 14 healthy volunteers [mean age, 38 years ± 13] and 27 patients with aortic or cardiac disease [mean age, 78 years ± 18]). Each participant underwent highly accelerated 4D flow MRI (k-t acceleration, acceleration factor of 5) of the thoracic aorta. For comparison, conventional 4D flow MRI (acceleration factor of 2) was acquired in the participants at center 1 (n = 27). Regional aortic peak systolic velocities and three-dimensional WSS were quantified. Results k-t-accelerated scan times (center 1, 2:03 minutes ± 0:29; center 2, 2:06 minutes ± 0:20) were significantly reduced compared with conventional 4D flow MRI (center 1, 12:38 minutes ± 2:25; P < .0001). Overall good agreement was found between the two techniques (absolute differences ≤15%), but proximal aortic WSS was significantly underestimated in patients by using k-t-accelerated 4D flow when compared with conventional 4D flow (P ≤ .03). k-t-accelerated 4D flow MRI was reproducible (intra- and interobserver intraclass correlation coefficient ≥0.98) and identified significantly increased peak velocities and WSS in patients with stenotic (P ≤ .003) or bicuspid (P ≤ .04) aortic valves compared with healthy volunteers. In addition, k-t-accelerated 4D flow MRI-derived velocities and WSS were inversely related to age (r ≥-0.53; P ≤ .03) over all healthy volunteers. Conclusion k-t-accelerated aortic 4D flow MRI providing 2-minute scan times was feasible and reproducible at two centers. Although consistent healthy aging- and disease-related changes in aortic hemodynamics were observed, care should be taken when considering WSS, which can be underestimated in patients.© RSNA, 2019See also the commentary by François in this issue.
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Affiliation(s)
- Emilie Bollache
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Kristopher D Knott
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Kelly Jarvis
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Redha Boubertakh
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Ryan Scott Dolan
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Claudia Camaioni
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Louise Collins
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Paul Scully
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Sydney Rabin
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Thomas Treibel
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - James C Carr
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Pim van Ooij
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Jeremy D Collins
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Julia Geiger
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - James C Moon
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Alex J Barker
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Steffen E Petersen
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
| | - Michael Markl
- Department of Radiology, Northwestern University, Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611 (E.B., K.J., R.S.D., L.C., S.R., J.C.C., J.D.C., A.J.B., M.M.); Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (E.B.); Barts Heart Centre, London, England (K.D.K., R.B., C.C., P.S., T.T., J.C.M., S.E.P.); Institute of Cardiovascular Science, University College London, London, England (K.D.K., P.S., T.T., J.C.M.); Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands (P.v.O.); Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland (J.G.); NIHR Barts Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, England (S.E.P.); and Department of Biomedical Engineering, Northwestern University, McCormick School of Engineering, Evanston, Ill (M.M.)
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Farag ES, Peroni L, Gottwald LM, Vendrik J, Boekholdt SM, Nederveen AJ, van Ooij P, AJM de Mol B, Kluin J. Bileaflet Mechanical Aortic Valve Prosthesis Orientation Influences Ascending Aortic Blood Flow Patterns. Structural Heart 2019. [DOI: 10.1080/24748706.2019.1587948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Farag ES, Schade EL, van Ooij P, Boekholdt SM, Planken RN, van Kimmenade R, Nederveen AJ, de Mol BAJM, Kluin J. Bileaflet mechanical aortic valves do not alter ascending aortic wall shear stress. Int J Cardiovasc Imaging 2019; 35:703-710. [PMID: 30741363 PMCID: PMC6482125 DOI: 10.1007/s10554-018-1508-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 11/22/2018] [Indexed: 01/12/2023]
Abstract
Progressive ascending aortic dilatation has been observed after mechanical aortic valve replacement (mAVR), possibly due to altered blood flow and wall shear stress (WSS) patterns induced by their bileaflet design. We examined the effect of mAVR on WSS in the ascending aorta using time-resolved 4D flow MRI. Fifteen patients with mechanical aortic valve prostheses, 10 patients with bicuspid aortic valve disease and 10 healthy individuals underwent thoracic 4D flow MRI. Peak systolic hemodynamic parameters (velocity and WSS) and vessel diameters were assessed in the ascending aorta. In addition, three-dimensional per-voxel analysis was used to compare velocity and WSS between patient groups and healthy controls. Peak aortic diameters were significantly higher in mAVR and BAV patients compared to healthy controls (p = 0.011). Mean aortic diameters were comparable between mAVR and BAV patients. No differences in 4D flow MRI-derived mean blood flow velocity and peak WSS were found between the three groups. Compared to healthy controls, mean WSS was significantly lower in mAVR patients (p = 0.031). Per-voxel analysis revealed no increased WSS in the ascending aortic wall and significantly lower velocity and WSS values in mAVR patients compared to healthy controls. In contrast, regions of significantly increased outer lumen velocities and WSS in BAV patients compared to healthy controls were found. This study shows that there is no increased ascending aortic WSS after mAVR. Our results suggest that, in contrast to BAV patients, there is no indication for intensified follow-up of the ascending aorta after mAVR.
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Affiliation(s)
- Emile S Farag
- Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands.
| | - Emilio L Schade
- Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Pim van Ooij
- Department of Radiology and nuclear medicine, Academic Medical Center, Amsterdam, The Netherlands
| | | | - R Nils Planken
- Department of Radiology and nuclear medicine, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Aart J Nederveen
- Department of Radiology and nuclear medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Bas A J M de Mol
- Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Jolanda Kluin
- Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands
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Farag ES, van Ooij P, Boekholdt SM, Planken RN, Dukker KC, Bouma BJ, Groenink M, Koolbergen DR, Sojak V, Nederveen AJ, Hazekamp MG, de Mol BA, Kluin J. Abnormal blood flow and wall shear stress are present in corrected aortic coarctation despite successful surgical repair. J Cardiovasc Surg (Torino) 2019; 60:152-154. [PMID: 30648829 DOI: 10.23736/s0021-9509.18.10522-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Emile S Farag
- Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Pim van Ooij
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | | | - R Nils Planken
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Kayleigh C Dukker
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Berto J Bouma
- Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Maarten Groenink
- Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
| | - David R Koolbergen
- Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands.,Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Vladimir Sojak
- Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands.,Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Aart J Nederveen
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Mark G Hazekamp
- Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands.,Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Bas A de Mol
- Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Jolanda Kluin
- Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands - .,Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
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Peper ES, Strijkers GJ, Gazzola K, Potters WV, Motaal AG, Luirink IK, Hutten BA, Wiegman A, van Ooij P, van den Born BJH, Nederveen AJ, Coolen BF. Regional assessment of carotid artery pulse wave velocity using compressed sensing accelerated high temporal resolution 2D CINE phase contrast cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2018; 20:86. [PMID: 30567566 PMCID: PMC6300923 DOI: 10.1186/s12968-018-0499-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 10/23/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance (CMR) allows for non-invasive assessment of arterial stiffness by means of measuring pulse wave velocity (PWV). PWV can be calculated from the time shift between two time-resolved flow curves acquired at two locations within an arterial segment. These flow curves can be derived from two-dimensional CINE phase contrast CMR (2D CINE PC CMR). While CMR-derived PWV measurements have proven to be accurate for the aorta, this is more challenging for smaller arteries such as the carotids due to the need for both high spatial and temporal resolution. In this work, we present a novel method that combines retrospectively gated 2D CINE PC CMR, high temporal binning of data and compressed sensing (CS) reconstruction to accomplish a temporal resolution of 4 ms. This enables accurate flow measurements and assessment of PWV in regional carotid artery segments. METHODS Retrospectively gated 2D CINE PC CMR data acquired in the carotid artery was binned into cardiac frames of 4 ms length, resulting in an incoherently undersampled ky-t-space with a mean undersampling factor of 5. The images were reconstructed by a non-linear CS reconstruction using total variation over time as a sparsifying transform. PWV values were calculated from flow curves by using foot-to-foot and cross-correlation methods. Our method was validated against ultrasound measurements in a flow phantom setup representing the carotid artery. Additionally, PWV values of two groups of 23 young (30 ± 3 years, 12 [52%] women) and 10 elderly (62 ± 10 years, 5 [50%] women) healthy subjects were compared using the Wilcoxon rank-sum test. RESULTS Our proposed method produced very similar flow curves as those measured using ultrasound at 1 ms temporal resolution. Reliable PWV estimation proved possible for transit times down to 7.5 ms. Furthermore, significant differences in PWV values between healthy young and elderly subjects were found (4.7 ± 1.0 m/s and 7.9 ± 2.4 m/s, respectively; p < 0.001) in accordance with literature. CONCLUSIONS Retrospectively gated 2D CINE PC CMR with CS allows for high spatiotemporal resolution flow measurements and accurate regional carotid artery PWV calculations. We foresee this technique will be valuable in protocols investigating early development of carotid atherosclerosis.
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Affiliation(s)
- Eva S Peper
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Gustav J Strijkers
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Katja Gazzola
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Wouter V Potters
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Ilse K Luirink
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Pediatrics Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Barbara A Hutten
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Albert Wiegman
- Department of Pediatrics Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Bert-Jan H van den Born
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Bram F Coolen
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
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van Ooij P, Cibis M, Rowland EM, Vernooij MW, van der Lugt A, Weinberg PD, Wentzel JJ, Nederveen AJ. Spatial correlations between MRI-derived wall shear stress and vessel wall thickness in the carotid bifurcation. Eur Radiol Exp 2018; 2:27. [PMID: 30302598 PMCID: PMC6177500 DOI: 10.1186/s41747-018-0058-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 06/29/2018] [Indexed: 11/17/2022] Open
Abstract
Background To explore the possibility of creating three-dimensional (3D) estimation models for patient-specific wall thickness (WT) maps using patient-specific and cohort-averaged WT, wall shear stress (WSS), and vessel diameter maps in asymptomatic atherosclerotic carotid bifurcations. Methods Twenty subjects (aged 75 ± 6 years [mean ± standard deviation], eight women) underwent a 1.5-T MRI examination. Non-gated 3D phase-contrast gradient-echo images and proton density-weighted echo-planar images were retrospectively assessed for WSS, diameter estimation, and WT measurements. Spearman’s ρ and scatter plots were used to determine correlations between individual WT, WSS, and diameter maps. A bootstrapping technique was used to determine correlations between 3D cohort-averaged WT, WSS, and diameter maps. Linear regression between the cohort-averaged WT, WSS, and diameter maps was used to predict individual 3D WT. Results Spearman’s ρ averaged over the subjects was − 0.24 ± 0.18 (p < 0.001) and 0.07 ± 0.28 (p = 0.413) for WT versus WSS and for WT versus diameter relations, respectively. Cohort-averaged ρ, averaged over 1000 bootstraps, was − 0.56 (95% confidence interval [− 0.74,− 0.38]) for WT versus WSS and 0.23 (95% confidence interval [− 0.06, 0.52]) for WT versus diameter. Scatter plots did not reveal relationships between individual WT and WSS or between WT and diameter data. Linear relationships between these parameters became apparent after averaging over the cohort. Spearman’s ρ between the original and predicted WT maps was 0.21 ± 0.22 (p < 0.001). Conclusions With a combination of bootstrapping and cohort-averaging methods, 3D WT maps can be predicted from the individual 3D WSS and diameter maps. The methodology may help to elucidate pathological processes involving WSS in carotid atherosclerosis. Electronic supplementary material The online version of this article (10.1186/s41747-018-0058-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pim van Ooij
- Department of Radiology & Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - Merih Cibis
- Department of Biomedical Engineering, Erasmus MC, Rotterdam, the Netherlands
| | - Ethan M Rowland
- Departments of Bioengineering, Imperial College London, London, UK
| | - Meike W Vernooij
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands
| | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - Peter D Weinberg
- Departments of Bioengineering, Imperial College London, London, UK
| | - Jolanda J Wentzel
- Department of Biomedical Engineering, Erasmus MC, Rotterdam, the Netherlands
| | - Aart J Nederveen
- Department of Radiology & Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Blanken CP, Farag ES, Boekholdt SM, Leiner T, Kluin J, Nederveen AJ, van Ooij P, Planken RN. Advanced cardiac MRI techniques for evaluation of left-sided valvular heart disease. J Magn Reson Imaging 2018. [DOI: 10.1002/jmri.26263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Carmen P.S. Blanken
- Department of Radiology and Nuclear Medicine; Academic Medical Center; Amsterdam the Netherlands
| | - Emile S. Farag
- Department of Cardiothoracic Surgery; Academic Medical Center; Amsterdam the Netherlands
| | | | - Tim Leiner
- Department of Radiology; University Medical Center; Utrecht the Netherlands
| | - Jolanda Kluin
- Department of Cardiothoracic Surgery; Academic Medical Center; Amsterdam the Netherlands
| | - Aart J. Nederveen
- Department of Radiology and Nuclear Medicine; Academic Medical Center; Amsterdam the Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine; Academic Medical Center; Amsterdam the Netherlands
| | - R. Nils Planken
- Department of Radiology and Nuclear Medicine; Academic Medical Center; Amsterdam the Netherlands
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36
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Farag ES, van Ooij P, Planken RN, Dukker KC, de Heer F, Bouma BJ, Robbers‐Visser D, Groenink M, Nederveen AJ, de Mol BA, Kluin J, Boekholdt SM. Aortic valve stenosis and aortic diameters determine the extent of increased wall shear stress in bicuspid aortic valve disease. J Magn Reson Imaging 2018; 48:522-530. [PMID: 29451963 PMCID: PMC6099246 DOI: 10.1002/jmri.25956] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/05/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Use of 4-dimensional flow magnetic resonance imaging (4D-flow MRI) derived wall shear stress (WSS) heat maps enables identification of regions in the ascending aorta with increased WSS. These regions are subject to dysregulation of the extracellular matrix and elastic fiber degeneration, which is associated with aortic dilatation and dissection. PURPOSE To evaluate the effect of the presence of aortic valve stenosis and the aortic diameter on the peak WSS and surface area of increased WSS in the ascending aorta. STUDY TYPE Prospective. SUBJECTS In all, 48 bicuspid aortic valve (BAV) patients (38.1 ± 12.4 years) and 25 age- and gender-matched healthy individuals. FIELD STRENGTH/SEQUENCE Time-resolved 3D phase contrast MRI with three-directional velocity encoding at 3.0T. ASSESSMENT Peak systolic velocity, WSS, and aortic diameters were assessed in the ascending aorta and 3D heat maps were used to identify regions with elevated WSS. STATISTICAL TESTS Comparisons between groups were performed by t-tests. Correlations were investigated by univariate and multivariate regression analysis. RESULTS Elevated WSS was present in 15 ± 11% (range; 1-35%) of the surface area of the ascending aorta of BAV patients with aortic valve stenosis (AS) (n = 10) and in 6 ± 8% (range; 0-31%) of the ascending aorta of BAV patients without AS (P = 0.005). The mid-ascending aortic diameter negatively correlated with the peak ascending aortic WSS (R = -0.413, P = 0.004) and the surface area of elevated WSS (R = -0.419, P = 0.003). Multivariate linear regression analysis yielded that the height of peak WSS and the amount of elevated WSS depended individually on the presence of aortic valve stenosis and the diameter of the ascending aorta. DATA CONCLUSION The extent of increased WSS in the ascending aorta of BAV patients depends on the presence of aortic valve stenosis and aortic dilatation and is most pronounced in the presence of AS and a nondilated ascending aorta. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2018;48:522-530.
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Affiliation(s)
- Emile S. Farag
- Department of Cardiothoracic SurgeryAcademic Medical CenterAmsterdamthe Netherlands
| | - Pim van Ooij
- Department of RadiologyAcademic Medical CenterAmsterdamthe Netherlands
| | - R. Nils Planken
- Department of RadiologyAcademic Medical CenterAmsterdamthe Netherlands
| | | | - Frederiek de Heer
- Department of Cardiothoracic SurgeryAcademic Medical CenterAmsterdamthe Netherlands
| | - Berto J. Bouma
- Department of CardiologyAcademic Medical CenterAmsterdamthe Netherlands
| | | | - Maarten Groenink
- Department of RadiologyAcademic Medical CenterAmsterdamthe Netherlands
- Department of CardiologyAcademic Medical CenterAmsterdamthe Netherlands
| | - Aart J. Nederveen
- Department of RadiologyAcademic Medical CenterAmsterdamthe Netherlands
| | - Bas A.J.M. de Mol
- Department of Cardiothoracic SurgeryAcademic Medical CenterAmsterdamthe Netherlands
| | - Jolanda Kluin
- Department of Cardiothoracic SurgeryAcademic Medical CenterAmsterdamthe Netherlands
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37
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Bollache E, Guzzardi DG, Sattari S, Olsen KE, Di Martino ES, Malaisrie SC, van Ooij P, Collins J, Carr J, McCarthy PM, Markl M, Barker AJ, Fedak PWM. Aortic valve-mediated wall shear stress is heterogeneous and predicts regional aortic elastic fiber thinning in bicuspid aortic valve-associated aortopathy. J Thorac Cardiovasc Surg 2018; 156:2112-2120.e2. [PMID: 30060930 DOI: 10.1016/j.jtcvs.2018.05.095] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 05/03/2018] [Accepted: 05/26/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The objectives of this study were to investigate an association between the magnitude of flow-mediated aortic wall shear stress (WSS) and medial wall histopathology in patients with bicuspid aortic valve (BAV) with aortopathy. METHODS Patients with BAV (n = 27; 52 ± 15 years; 3 women; proximal thoracic aorta diameter = 4.4 ± 0.7 and 4.6 ± 0.5 cm) who underwent prophylactic aortic resection received preoperative 3-dimensional time-resolved phase-contrast magnetic resonance imaging with 3-dimensional velocity encoding to quantify WSS relative to a population of healthy age- and sex-matched tricuspid aortic valve control participants (n = 20). Quantitative histopathology was conducted on BAV aorta tissue samples resected at surgery (n = 93), and correlation was performed between elastic fiber thickness and in vivo aortic WSS as continuous variables. Validation of elastic fiber thickness was achieved by correlation relative to tissue stiffness determined using biaxial biomechanical testing (n = 22 samples). RESULTS Elastic fibers were thinner and WSS was higher along the greater curvature compared with other circumferential regions (vs anterior wall: P = .003 and P = .0001, respectively; lesser curvature: both P = .001). Increased regional WSS was associated with decreased elastic fiber thickness (r = -0.25; P = .02). Patient stratification with subanalysis showed an increase in the correlation between WSS and histopathology with aortic valve stenosis (r = -0.36; P = .002) and smaller aortic diameters (<4.5 cm: r = -0.39; P = .03). Elastic fiber thinning was associated with circumferential stiffness (r = -0.41; P = .06). CONCLUSIONS For patients with BAV, increased aortic valve-mediated WSS is significantly associated with elastic fiber thinning, particularly with aortic valve stenosis and in earlier stages of aortopathy. Elastic fiber thinning correlates with impaired tissue biomechanics. These novel findings further implicate valve-mediated hemodynamics in the progression of BAV aortopathy.
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Affiliation(s)
- Emilie Bollache
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - David G Guzzardi
- Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Samaneh Sattari
- Graduate Program in Biomedical Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Katherine E Olsen
- Graduate Program in Biomedical Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Elena S Di Martino
- Department of Civil Engineering, Schulich School of Engineering, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - S Chris Malaisrie
- Division of Surgery-Cardiac Surgery, Northwestern University, Bluhm Cardiovascular Institute, Chicago, Ill
| | - Pim van Ooij
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Jeremy Collins
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Patrick M McCarthy
- Division of Surgery-Cardiac Surgery, Northwestern University, Bluhm Cardiovascular Institute, Chicago, Ill
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill; Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, Ill
| | - Alex J Barker
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Paul W M Fedak
- Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada; Division of Surgery-Cardiac Surgery, Northwestern University, Bluhm Cardiovascular Institute, Chicago, Ill.
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Václavů L, Baldew ZAV, Gevers S, Mutsaerts HJMM, Fijnvandraat K, Cnossen MH, Majoie CB, Wood JC, VanBavel E, Biemond BJ, van Ooij P, Nederveen AJ. Intracranial 4D flow magnetic resonance imaging reveals altered haemodynamics in sickle cell disease. Br J Haematol 2017; 180:432-442. [PMID: 29270975 DOI: 10.1111/bjh.15043] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/30/2017] [Indexed: 11/28/2022]
Abstract
Stroke risk in children with sickle cell disease (SCD) is currently assessed with routine transcranial Doppler ultrasound (TCD) measurements of blood velocity in the Circle of Willis (CoW). However, there is currently no biomarker with proven prognostic value in adult patients. Four-dimensional (4D) flow magnetic resonance imaging (MRI) may improve risk profiling based on intracranial haemodynamics. We conducted neurovascular 4D flow MRI and blood sampling in 69 SCD patients [median age 15 years (interquartile range, IQR: 12-50)] and 14 healthy controls [median age 21 years (IQR: 18-43)]. We measured velocity, flow, lumen area and endothelial shear stress (ESS) in the CoW. SCD patients had lower haematocrit and viscosity, and higher velocity, flow and lumen area, with lower ESS compared to healthy controls. We observed significant age-related decline in haemodynamic 4D flow parameters; velocity (Spearman's ρ = -0·36 to -0·61), flow (ρ = -0·26 to -0·52) and ESS (ρ = -0·14 to -0·54) in SCD patients. Further analysis in only adults showed that velocity values were similar in SCD patients compared to healthy controls, but that the additional 4D flow parameters, flow and lumen area, were higher, and ESS lower, in the SCD group. Our data suggest that 4D flow MRI may identify adult patients with an increased stroke risk more accurately than current TCD-based velocity.
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Affiliation(s)
- Lena Václavů
- Radiology & Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Zelonna A V Baldew
- Radiology & Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Sanna Gevers
- Radiology & Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Henri J M M Mutsaerts
- Radiology & Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Karin Fijnvandraat
- Paediatric Haematology, Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Marjon H Cnossen
- Paediatric Haematology, Erasmus University Hospital-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Charles B Majoie
- Radiology & Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - John C Wood
- Paediatric Cardiology, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Ed VanBavel
- Biomedical Engineering and Physics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Bart J Biemond
- Haematology, Internal Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Pim van Ooij
- Radiology & Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Radiology & Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Bollache E, Fedak PWM, van Ooij P, Rahman O, Malaisrie SC, McCarthy PM, Carr JC, Powell A, Collins JD, Markl M, Barker AJ. Perioperative evaluation of regional aortic wall shear stress patterns in patients undergoing aortic valve and/or proximal thoracic aortic replacement. J Thorac Cardiovasc Surg 2017; 155:2277-2286.e2. [PMID: 29248286 DOI: 10.1016/j.jtcvs.2017.11.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/11/2017] [Accepted: 11/06/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To assess in patients with aortopathy perioperative changes in thoracic aortic wall shear stress (WSS), which is known to affect arterial remodeling, and the effects of specific surgical interventions. METHODS Presurgical and postsurgical aortic 4D flow MRI were performed in 33 patients with aortopathy (54 ± 14 years; 5 women; sinus of Valsalva (d_SOV)/midascending aortic (d_MAA) diameters = 44 ± 5/45 ± 6 mm) scheduled for aortic valve (AVR) and/or root (ARR) replacement. Control patients with aortopathy who did not have surgery were matched for age, sex, body size, and d_MAA (n = 20: 52 ± 14 years; 3 women; d_SOV/d_MAA = 42 ± 4/42 ± 4 mm). Regional aortic 3D systolic peak WSS was calculated. An atlas of WSS normal values was used to quantify the percentage of at-risk tissue area with abnormally high WSS, excluding the area to be resected/graft. RESULTS Peak WSS and at-risk area showed low interobserver variability (≤0.09 [-0.3; 0.5] Pa and 1.1% [-7%; 9%], respectively). In control patients, WSS was stable over time (follow-up-baseline differences ≤0.02 Pa and 0.0%, respectively). Proximal aortic WSS decreased after AVR (n = 5; peak WSS difference ≤-0.41 Pa and at-risk area ≤-10%, P < .05 vs controls). WSS was increased after ARR in regions distal to the graft (peak WSS difference ≥0.16 Pa and at-risk area ≥4%, P < .05 vs AVR). Follow-up duration had no significant effects on these WSS changes, except when comparing ascending aortic peak WSS between ARR and AVR (P = .006). CONCLUSIONS Serial perioperative 4D flow MRI investigations showed distinct patterns of postsurgical changes in aortic WSS, which included both reductions and translocations. Larger longitudinal studies are warranted to validate these findings with clinical outcomes and prediction of risk of future aortic events.
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Affiliation(s)
- Emilie Bollache
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Paul W M Fedak
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Division of Surgery-Cardiac Surgery, Northwestern University, Chicago, Ill
| | - Pim van Ooij
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Ozair Rahman
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - S Chris Malaisrie
- Division of Surgery-Cardiac Surgery, Northwestern University, Chicago, Ill
| | - Patrick M McCarthy
- Division of Surgery-Cardiac Surgery, Northwestern University, Chicago, Ill
| | - James C Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Alex Powell
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Jeremy D Collins
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill; Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, Ill
| | - Alex J Barker
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
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van Ooij P, Markl M, Collins JD, Carr JC, Rigsby C, Bonow RO, Malaisrie SC, McCarthy PM, Fedak PWM, Barker AJ. Aortic Valve Stenosis Alters Expression of Regional Aortic Wall Shear Stress: New Insights From a 4-Dimensional Flow Magnetic Resonance Imaging Study of 571 Subjects. J Am Heart Assoc 2017; 6:JAHA.117.005959. [PMID: 28903936 PMCID: PMC5634265 DOI: 10.1161/jaha.117.005959] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Wall shear stress (WSS) is a stimulus for vessel wall remodeling. Differences in ascending aorta (AAo) hemodynamics have been reported between bicuspid aortic valve (BAV) and tricuspid aortic valve patients with aortic dilatation, but the confounding impact of aortic valve stenosis (AS) is unknown. Methods and Results Five hundred seventy‐one subjects underwent 4‐dimensional flow magnetic resonance imaging in the thoracic aorta (210 right‐left BAV cusp fusions, 60 right‐noncoronary BAV cusp fusions, 245 tricuspid aortic valve patients with aortic dilatation, and 56 healthy controls). There were 166 of 515 (32%) patients with AS. WSS atlases were created to quantify group‐specific WSS patterns in the AAo as a function of AS severity. In BAV patients without AS, the different cusp fusion phenotypes resulted in distinct differences in eccentric WSS elevation: right‐left BAV patients exhibited increased WSS by 9% to 34% (P<0.001) at the aortic root and along the entire outer curvature of the AAo whereas right‐noncoronary BAV patients showed 30% WSS increase (P<0.001) at the distal portion of the AAo. WSS in tricuspid aortic valve patients with aortic dilatation patients with no AS was significantly reduced by 21% to 33% (P<0.01) in 4 of 6 AAo regions. In all patient groups, mild, moderate, and severe AS resulted in a marked increase in regional WSS (P<0.001). Moderate‐to‐severe AS further increased WSS magnitude and variability in the AAo. Differences between valve phenotypes were no longer apparent. Conclusions AS significantly alters aortic hemodynamics and WSS independent of aortic valve phenotype and over‐rides previously described flow patterns associated with BAV and tricuspid aortic valve with aortic dilatation. Severity of AS must be considered when investigating valve‐mediated aortopathy.
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Affiliation(s)
- Pim van Ooij
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.,Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Michael Markl
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL.,Department of Biomedical Engineering, Northwestern University, Chicago, IL
| | - Jeremy D Collins
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - James C Carr
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Cynthia Rigsby
- Department of Medical Imaging, Ann & Robert H Lurie Children's Hospital of Chicago, IL
| | - Robert O Bonow
- Department of Medicine-Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - S Chris Malaisrie
- Division of Surgery-Cardiac Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Patrick M McCarthy
- Division of Surgery-Cardiac Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Paul W M Fedak
- Division of Surgery-Cardiac Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.,Department of Cardiac Sciences, University of Calgary, Canada
| | - Alex J Barker
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
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41
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Coolen BF, Calcagno C, van Ooij P, Fayad ZA, Strijkers GJ, Nederveen AJ. Vessel wall characterization using quantitative MRI: what's in a number? MAGMA 2017; 31:201-222. [PMID: 28808823 PMCID: PMC5813061 DOI: 10.1007/s10334-017-0644-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 07/04/2017] [Accepted: 07/18/2017] [Indexed: 12/15/2022]
Abstract
The past decade has witnessed the rapid development of new MRI technology for vessel wall imaging. Today, with advances in MRI hardware and pulse sequences, quantitative MRI of the vessel wall represents a real alternative to conventional qualitative imaging, which is hindered by significant intra- and inter-observer variability. Quantitative MRI can measure several important morphological and functional characteristics of the vessel wall. This review provides a detailed introduction to novel quantitative MRI methods for measuring vessel wall dimensions, plaque composition and permeability, endothelial shear stress and wall stiffness. Together, these methods show the versatility of non-invasive quantitative MRI for probing vascular disease at several stages. These quantitative MRI biomarkers can play an important role in the context of both treatment response monitoring and risk prediction. Given the rapid developments in scan acceleration techniques and novel image reconstruction, we foresee the possibility of integrating the acquisition of multiple quantitative vessel wall parameters within a single scan session.
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Affiliation(s)
- Bram F Coolen
- Department of Biomedical Engineering and Physics, Academic Medical Center, PO BOX 22660, 1100 DD, Amsterdam, The Netherlands. .,Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.
| | - Claudia Calcagno
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pim van Ooij
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Zahi A Fayad
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gustav J Strijkers
- Department of Biomedical Engineering and Physics, Academic Medical Center, PO BOX 22660, 1100 DD, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
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42
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van Kesteren F, Wollersheim LW, Baan J, Nederveen AJ, Kaya A, Boekholdt SM, de Mol BA, van Ooij P, Planken RN. Four-dimensional flow MRI of stented versus stentless aortic valve bioprostheses. Eur Radiol 2017; 28:257-264. [PMID: 28710578 PMCID: PMC5717112 DOI: 10.1007/s00330-017-4953-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/14/2017] [Accepted: 06/19/2017] [Indexed: 11/27/2022]
Abstract
Objectives To evaluate aortic velocity, wall shear stress (WSS) and viscous energy loss (EL) of stented and stentless bioprostheses using 4D flow MRI 1 year after surgical aortic valve replacement. Methods For this cross-sectional study 28 patients with stented (n = 14) or stentless (n = 14) bioprosthesis underwent non-contrast-enhanced 4D-flow MRI at 1.5 T. Analyses included a comparison of velocity, WSS and EL in the ascending aorta during peak systole for both spatially averaged values and a comparison of local differences using per-voxel analysis. Results No significant differences were found in peak and mean velocity (stented vs. stentless: 2.45 m/s vs. 2.11 m/s; p = 0.09 and 0.60 m/s vs. 0.62 m/s; p = 0.89), WSS (0.60 Pa vs. 0.59 Pa; p = 0.55) and EL (10.17 mW vs. 7.82 mW; p = 0.10). Per-voxel analysis revealed significantly higher central lumen velocity, and lower outer lumen velocity, WSS and EL for stentless versus stented prostheses. Conclusion One year after aortic valve implantation with stented and stentless bioprostheses, velocity, WSS and EL were comparable when assessed for averaged values in the ascending aorta. However, the flow profile described with local analysis for stentless prosthesis is potentially favourable with a significantly higher central velocity profile and lower values for outer lumen velocity, WSS and EL. Key Points • Stentless bioprostheses can be implanted instead of stented aortic valve bioprostheses. • Haemodynamic performance of valve prosthesis can be assessed using 4D flow MRI. • Averaged ascending aorta PSV, WSS and EL are comparable 1 year post-implantation. • Centreline velocity is highest, WSS and EL is lowest for stentless prosthesis.
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Affiliation(s)
- Floortje van Kesteren
- Department of Radiology and Nuclear Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Department of Cardiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Laurens W Wollersheim
- Department of Cardiothoracic Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Baan
- Department of Cardiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Abdullah Kaya
- Department of Cardiothoracic Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - S Matthijs Boekholdt
- Department of Cardiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Bas A de Mol
- Department of Cardiothoracic Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Pim van Ooij
- Department of Radiology and Nuclear Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - R Nils Planken
- Department of Radiology and Nuclear Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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van der Palen RLF, Barker AJ, Bollache E, Garcia J, Rose MJ, van Ooij P, Young LT, Roest AAW, Markl M, Robinson JD, Rigsby CK. Altered aortic 3D hemodynamics and geometry in pediatric Marfan syndrome patients. J Cardiovasc Magn Reson 2017; 19:30. [PMID: 28302143 PMCID: PMC5356404 DOI: 10.1186/s12968-017-0345-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 02/16/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Blood flow dynamics make it possible to better understand the development of aortopathy and cardiovascular events in patients with Marfan syndrome (MFS). Aortic 3D blood flow characteristics were investigated in relation to aortic geometry in children and adolescents with MFS. METHODS Twenty-five MFS patients (age 15.6 ± 4.0 years; 11 females) and 21 healthy controls (age 16.0 ± 2.6 years; 12 females) underwent magnetic resonance angiography and 4D flow CMR for assessment of thoracic aortic size and 3D blood flow velocities. Data analysis included calculation of aortic diameter and BSA-indexed aortic dimensions (Z-score) along the thoracic aorta, 3D mean systolic wall shear stress (WSSmean) in ten aortic segments and assessment of aortic blood flow patterns. RESULTS Aortic root (root), ascending (AAo) and descending (DAo) aortic size was significantly larger in MFS patients than healthy controls (Root Z-score: 3.56 ± 1.45 vs 0.49 ± 0.78, p < 0.001; AAo Z-score 0.21 ± 0.95 vs -0.54 ± 0.64, p = 0.004; proximal DAo Z-score 2.02 ± 1.60 vs 0.56 ± 0.66, p < 0.001). A regional variation in prevalence and severity of flow patterns (vortex and helix flow patterns) was observed, with the aortic root and the proximal DAo (pDAo) being more frequently affected in MFS. MFS patients had significantly reduced WSSmean in the proximal AAo (pAAo) outer segment (0.65 ± 0.12 vs. 0.73 ± 0.14 Pa, p = 0.029) and pDAo inner segment (0.74 ± 0.17 vs. 0.87 ± 0.21 Pa, p = 0.021), as well as higher WSSmean in the inner segment of the distal AAo (0.94 ± 0.14 vs. 0.84 ± 0.15 Pa, p = 0.036) compared to healthy subjects. An inverse relationship existed between pDAo WSSmean and both pDAo diameter (R = -0.53, p < 0.001) and % diameter change along the pDAo segment (R = -0.64, p < 0.001). CONCLUSIONS MFS children and young adults have altered aortic flow patterns and differences in aortic WSS that were most pronounced in the pAAo and pDAo, segments where aortic dissection or rupture often originate. The presence of vortex flow patterns and abnormal WSS correlated with regional size of the pDAo and are potentially valuable additional markers of disease severity.
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Affiliation(s)
- Roel L. F. van der Palen
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
- Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Alex J. Barker
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
| | - Emilie Bollache
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
| | - Julio Garcia
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
- Department of Cardiac Sciences, Stephenson Cardiac Imaging Centre, University of Calgary - Cumming School of Medicine, Calgary, AB Canada
| | - Michael J. Rose
- Department of Medical Imaging, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
| | - Pim van Ooij
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Luciana T. Young
- Department of Pediatrics, Division of Pediatric Cardiology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
| | - Arno A. W. Roest
- Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
- Department of Biomedical Engineering, McCormick School; of Engineering, Northwestern University, Chicago, IL USA
| | - Joshua D. Robinson
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
- Department of Pediatrics, Division of Pediatric Cardiology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Cynthia K. Rigsby
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL USA
- Department of Medical Imaging, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
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Bollache E, Barker AJ, Dolan RS, Carr JC, van Ooij P, Ahmadian R, Powell A, Collins JD, Geiger J, Markl M. k-t accelerated aortic 4D flow MRI in under two minutes: Feasibility and impact of resolution, k-space sampling patterns, and respiratory navigator gating on hemodynamic measurements. Magn Reson Med 2017; 79:195-207. [PMID: 28266062 DOI: 10.1002/mrm.26661] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 02/08/2017] [Accepted: 02/08/2017] [Indexed: 01/29/2023]
Abstract
PURPOSE To assess the performance of highly accelerated free-breathing aortic four-dimensional (4D) flow MRI acquired in under 2 minutes compared to conventional respiratory gated 4D flow. METHODS Eight k-t accelerated nongated 4D flow MRI (parallel MRI with extended and averaged generalized autocalibrating partially parallel acquisition kernels [PEAK GRAPPA], R = 5, TRes = 67.2 ms) using four ky -kz Cartesian sampling patterns (linear, center-out, out-center-out, random) and two spatial resolutions (SRes1 = 3.5 × 2.3 × 2.6 mm3 , SRes2 = 4.5 × 2.3 × 2.6 mm3 ) were compared in vitro (aortic coarctation flow phantom) and in 10 healthy volunteers, to conventional 4D flow (16 mm-navigator acceptance window; R = 2; TRes = 39.2 ms; SRes = 3.2 × 2.3 × 2.4 mm3 ). The best k-t accelerated approach was further assessed in 10 patients with aortic disease. RESULTS The k-t accelerated in vitro aortic peak flow (Qmax), net flow (Qnet), and peak velocity (Vmax) were lower than conventional 4D flow indices by ≤4.7%, ≤ 11%, and ≤22%, respectively. In vivo k-t accelerated acquisitions were significantly shorter but showed a trend to lower image quality compared to conventional 4D flow. Hemodynamic indices for linear and out-center-out k-space samplings were in agreement with conventional 4D flow (Qmax ≤ 13%, Qnet ≤ 13%, Vmax ≤ 17%, P > 0.05). CONCLUSION Aortic 4D flow MRI in under 2 minutes is feasible with moderate underestimation of flow indices. Differences in k-space sampling patterns suggest an opportunity to mitigate image artifacts by an optimal trade-off between scan time, acceleration, and k-space sampling. Magn Reson Med 79:195-207, 2018. © 2018 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Emilie Bollache
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Alex J Barker
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Ryan Scott Dolan
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - James C Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Pim van Ooij
- Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Rouzbeh Ahmadian
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Alex Powell
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Jeremy D Collins
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Julia Geiger
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.,Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.,Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, Illinois, USA
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Bollache E, Ooij PV, Powell AL, Carr JC, Markl M, Barker AJ. 4D Flow and 2D PC MRI: impact of volumetric coverage and three-directional velocity encoding on quantification of aortic hemodynamics. J Cardiovasc Magn Reson 2016. [PMCID: PMC5032784 DOI: 10.1186/1532-429x-18-s1-p357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Cibis M, Potters WV, Gijsen FJ, Marquering H, van Ooij P, vanBavel E, Wentzel JJ, Nederveen AJ. The Effect of Spatial and Temporal Resolution of Cine Phase Contrast MRI on Wall Shear Stress and Oscillatory Shear Index Assessment. PLoS One 2016; 11:e0163316. [PMID: 27669568 PMCID: PMC5036833 DOI: 10.1371/journal.pone.0163316] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 09/07/2016] [Indexed: 11/21/2022] Open
Abstract
Introduction Wall shear stress (WSS) and oscillatory shear index (OSI) are associated with atherosclerotic disease. Both parameters are derived from blood velocities, which can be measured with phase-contrast MRI (PC-MRI). Limitations in spatiotemporal resolution of PC-MRI are known to affect these measurements. Our aim was to investigate the effect of spatiotemporal resolution using a carotid artery phantom. Methods A carotid artery phantom was connected to a flow set-up supplying pulsatile flow. MRI measurement planes were placed at the common carotid artery (CCA) and internal carotid artery (ICA). Two-dimensional PC-MRI measurements were performed with thirty different spatiotemporal resolution settings. The MRI flow measurement was validated with ultrasound probe measurements. Mean flow, peak flow, flow waveform, WSS and OSI were compared for these spatiotemporal resolutions using regression analysis. The slopes of the regression lines were reported in %/mm and %/100ms. The distribution of low and high WSS and OSI was compared between different spatiotemporal resolutions. Results The mean PC-MRI CCA flow (2.5±0.2mL/s) agreed with the ultrasound probe measurements (2.7±0.02mL/s). Mean flow (mL/s) depended only on spatial resolution (CCA:-13%/mm, ICA:-49%/mm). Peak flow (mL/s) depended on both spatial (CCA:-13%/mm, ICA:-17%/mm) and temporal resolution (CCA:-19%/100ms, ICA:-24%/100ms). Mean WSS (Pa) was in inverse relationship only with spatial resolution (CCA:-19%/mm, ICA:-33%/mm). OSI was dependent on spatial resolution for CCA (-26%/mm) and temporal resolution for ICA (-16%/100ms). The regions of low and high WSS and OSI matched for most of the spatiotemporal resolutions (CCA:30/30, ICA:28/30 cases for WSS; CCA:23/30, ICA:29/30 cases for OSI). Conclusion We show that both mean flow and mean WSS are independent of temporal resolution. Peak flow and OSI are dependent on both spatial and temporal resolution. However, the magnitude of mean and peak flow, WSS and OSI, and the spatial distribution of OSI and WSS did not exhibit a strong dependency on spatiotemporal resolution.
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Affiliation(s)
- Merih Cibis
- Biomedical Engineering Department, Erasmus MC, Rotterdam, The Netherlands
- * E-mail:
| | - Wouter V. Potters
- Radiology Department, Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Frank J. Gijsen
- Biomedical Engineering Department, Erasmus MC, Rotterdam, The Netherlands
| | - Henk Marquering
- Radiology Department, Academic Medical Center (AMC), Amsterdam, The Netherlands
- Biomedical Engineering and Physics Department, AMC, Amsterdam, The Netherlands
| | - Pim van Ooij
- Radiology Department, Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Ed vanBavel
- Biomedical Engineering and Physics Department, AMC, Amsterdam, The Netherlands
| | - Jolanda J. Wentzel
- Biomedical Engineering Department, Erasmus MC, Rotterdam, The Netherlands
| | - Aart J. Nederveen
- Radiology Department, Academic Medical Center (AMC), Amsterdam, The Netherlands
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Bollache E, van Ooij P, Powell A, Carr J, Markl M, Barker AJ. Comparison of 4D flow and 2D velocity-encoded phase contrast MRI sequences for the evaluation of aortic hemodynamics. Int J Cardiovasc Imaging 2016; 32:1529-41. [PMID: 27435230 DOI: 10.1007/s10554-016-0938-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 07/09/2016] [Indexed: 01/08/2023]
Abstract
The purpose of this study was to compare aortic flow and velocity quantification using 4D flow MRI and 2D CINE phase-contrast (PC)-MRI with either one-directional (2D-1dir) or three-directional (2D-3dir) velocity encoding. 15 healthy volunteers (51 ± 19 years) underwent MRI including (1) breath-holding 2D-1dir and (2) free breathing 2D-3dir PC-MRI in planes orthogonal to the ascending (AA) and descending (DA) aorta, as well as (3) free breathing 4D flow MRI with full thoracic aorta coverage. Flow quantification included the co-registration of the 2D PC acquisition planes with 4D flow MRI data, AA and DA segmentation, and calculation of AA and DA peak systolic velocity, peak flow and net flow volume for all sequences. Additionally, the 2D-3dir velocity taking into account the through-plane component only was used to obtain results analogous to a free breathing 2D-1dir acquisition. Good agreement was found between 4D flow and 2D-3dir peak velocity (differences = -3 to 6 %), peak flow (-7 %) and net volume (-14 to -9 %). In contrast, breath-holding 2D-1dir measurements exhibited indices significantly lower than free breathing 2D-3dir and 2D-1dir (differences = -35 to -7 %, p < 0.05). Finally, high correlations (r ≥ 0.97) were obtained for indices estimated with or without eddy current correction, with the lowest correlation observed for net volume. 4D flow and 2D-3dir aortic hemodynamic indices were in concordance. However, differences between respiration state and 2D-1dir and 2D-3dir measurements indicate that reference values should be established according to the PC-MRI sequence, especially for the widely used net flow (e.g. stroke volume in the AA).
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Affiliation(s)
- Emilie Bollache
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan ave-Suite 1600, Chicago, IL, 60611, USA.
| | - Pim van Ooij
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan ave-Suite 1600, Chicago, IL, 60611, USA
| | - Alex Powell
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan ave-Suite 1600, Chicago, IL, 60611, USA
| | - James Carr
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan ave-Suite 1600, Chicago, IL, 60611, USA
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan ave-Suite 1600, Chicago, IL, 60611, USA.,Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, USA
| | - Alex J Barker
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan ave-Suite 1600, Chicago, IL, 60611, USA
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van Ooij P, Garcia J, Potters WV, Malaisrie SC, Collins JD, Carr JC, Markl M, Barker AJ. Age-related changes in aortic 3D blood flow velocities and wall shear stress: Implications for the identification of altered hemodynamics in patients with aortic valve disease. J Magn Reson Imaging 2016; 43:1239-49. [PMID: 26477691 PMCID: PMC4836971 DOI: 10.1002/jmri.25081] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 10/06/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To investigate age-related changes in peak systolic aortic 3D velocity and wall shear stress (WSS) in healthy controls and to investigate the importance of age-matching for 3D mapping of abnormal aortic hemodynamics in bicuspid aortic valve disease (BAV). MATERIALS AND METHODS 4D flow MRI (fields strengths = 1.5-3T; resolution = 2.2-3.9 × 1.7-2.6 × 2.2-4.0 mm(3) ; Venc = 150-250 cm/s; TE/TR/FA = 2.3-2.8/4.7-5.4msec/7-15°) was performed in 56 controls (age range: 19-78 years) and in two BAV patient groups each consisting of 10 subjects (group 1: 20-29 years, group 2: 52-57 years). Heat maps showing abnormal 3D velocity and WSS were created for the BAV patients by comparison with an age-matched and with an unmatched control group. The fraction of the aorta exposed to abnormal velocity/WSS was calculated relative to the total aortic volume/surface. RESULTS Significant inverse relationships between age and healthy velocity/WSS were found (R(2) = 0.32/0.39, P < 0.001). For BAV group 1, abnormally elevated velocity/WSS was overestimated when compared with older controls (51-60 years) than when correctly age-matched (∼25 ± 14% vs. ∼8 ± 5%). For BAV group 2, abnormally decreased velocity/WSS was overestimated when compared with younger controls (21-30 years) than when correctly age-matched (∼9 ± 7% vs. 1 ± 1%). CONCLUSION Significant correlations exist between age and peak systolic velocity and WSS. Therefore, robust age-matching is important when creating abnormal 3D aortic velocity and WSS maps for patients with BAV.
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Affiliation(s)
- Pim van Ooij
- Department of Radiology, Northwestern University, Chicago, IL, USA
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Julio Garcia
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Wouter V. Potters
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | | | | | - James C. Carr
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Michael Markl
- Department of Radiology, Northwestern University, Chicago, IL, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, USA
| | - Alex J. Barker
- Department of Radiology, Northwestern University, Chicago, IL, USA
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Keller EJ, Malaisrie SC, Kruse J, Ooij PV, Semaan E, McCarthy P, Carr JC, Markl M, Barker AJ, Collins JD. Restoration of physiologic hemodynamics in the ascending aorta following aortic valve Rreplacement: a 4D flow MR study. J Cardiovasc Magn Reson 2016. [PMCID: PMC5032619 DOI: 10.1186/1532-429x-18-s1-p346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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van Ooij P, Powell AL, Potters WV, Barker AJ, Markl M. Reproducibility and inter-observer variability of velocity and 3D wall shear stress derived from 4D flow MRI in the healthy aorta. J Cardiovasc Magn Reson 2015. [PMCID: PMC4328390 DOI: 10.1186/1532-429x-17-s1-p74] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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