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Ma P, Zhu L, Wen R, Lv F, Li Y, Li X, Zhang Z. Revolutionizing vascular imaging: trends and future directions of 4D flow MRI based on a 20-year bibliometric analysis. Quant Imaging Med Surg 2024; 14:1873-1890. [PMID: 38415143 PMCID: PMC10895087 DOI: 10.21037/qims-23-1227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/08/2023] [Indexed: 02/29/2024]
Abstract
Background Four-dimensional flow magnetic resonance imaging (4D flow MRI) is a promising new technology with potential clinical value in hemodynamic quantification. Although an increasing number of articles on 4D flow MRI have been published over the past decades, few studies have statistically analyzed these published articles. In this study, we aimed to perform a systematic and comprehensive bibliometric analysis of 4D flow MRI to explore the current hotspots and potential future directions. Methods The Web of Science Core Collection searched for literature on 4D flow MRI between 2003 and 2022. CiteSpace was utilized to analyze the literature data, including co-citation, cooperative network, cluster, and burst keyword analysis. Results A total of 1,069 articles were extracted for this study. The main research hotspots included the following: quantification and visualization of blood flow in different clinical settings, with keywords such as "cerebral aneurysm", "heart", "great vessel", "tetralogy of Fallot", "portal hypertension", and "stiffness"; optimization of image acquisition schemes, such as "resolution" and "reconstruction"; measurement and analysis of flow components and patterns, as indicated by keywords "pattern", "KE", "WSS", and "fluid dynamics". In addition, international consensus for metrics derived from 4D flow MRI and multimodality imaging may also be the future research direction. Conclusions The global domain of 4D flow MRI has grown over the last 2 decades. In the future, 4D flow MRI will evolve towards becoming a relatively short scan duration with adequate spatiotemporal resolution, expansion into the diagnosis and treatment of vascular disease in other related organs, and a shift in focus from vascular structure to function. In addition, artificial intelligence (AI) will assist in the clinical promotion and application of 4D flow MRI.
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Affiliation(s)
- Peisong Ma
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lishu Zhu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ru Wen
- Department of Radiology, Guizhou Provincial People Hospital, Guiyang, China
| | - Fajin Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yongmei Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xinyou Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhiwei Zhang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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2
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Wieben O, Roberts GS, Corrado PA, Johnson KM, Roldán-Alzate A. Four-Dimensional Flow MR Imaging: Technique and Advances. Magn Reson Imaging Clin N Am 2023; 31:433-449. [PMID: 37414470 DOI: 10.1016/j.mric.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
4D Flow MRI is an advanced imaging technique for comprehensive non-invasive assessment of the cardiovascular system. The capture of the blood velocity vector field throughout the cardiac cycle enables measures of flow, pulse wave velocity, kinetic energy, wall shear stress, and more. Advances in hardware, MRI data acquisition and reconstruction methodology allow for clinically feasible scan times. The availability of 4D Flow analysis packages allows for more widespread use in research and the clinic and will facilitate much needed multi-center, multi-vendor studies in order to establish consistency across scanner platforms and to enable larger scale studies to demonstrate clinical value.
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Affiliation(s)
- Oliver Wieben
- Department of Medical Physics, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Avenue, Suite 1127, Madison, WI 53705-2275, USA; Department of Radiology, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Avenue, Suite 1127, Madison, WI 53705-2275, USA.
| | - Grant S Roberts
- Department of Medical Physics, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Avenue, Madison, WI 53705-2275, USA
| | - Philip A Corrado
- Accuray Incorporated, 1414 Raleigh Road, Suite 330, DurhamChapel Hill, NC 27517, USA
| | - Kevin M Johnson
- Department of Medical Physics, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Avenue, Room 1133, Madison, WI 53705-2275, USA; Department of Radiology, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Avenue, Room 1133, Madison, WI 53705-2275, USA
| | - Alejandro Roldán-Alzate
- Department of Mechanical Engineering, University of Wisconsin-Madison, Room: 3035, 1513 University Avenue, Madison, WI 53706, USA; Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA
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3
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Carroll B, Thanh MTH, Patteson AE. Dynamic remodeling of fiber networks with stiff inclusions under compressive loading. Acta Biomater 2023; 163:106-116. [PMID: 36182057 PMCID: PMC10227767 DOI: 10.1016/j.actbio.2022.09.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022]
Abstract
The ability of tissues to sustain and withstand mechanical stress is critical to tissue development and healthy tissue maintenance. The mechanical properties of tissues are typically considered to be dominated by the fibrous extracellular matrix (ECM) component of tissues. Fiber network mechanics can capture certain mechanical features of tissues, such as shear strain stiffening, but is insufficient in describing the compressive response of certain tissues and blood clots that are rich in extracellular matrix. To understand the mechanical response of tissues, we employ a contemporary mechanical model, a fibrous network of fibrin embedded with inert bead inclusions that preserve the volume-conserving constraints of cells in tissues. Combining bulk mechanical rheology and a custom imaging device, we show that the presence of inclusions alters the local dynamic remodeling of the networks undergoing uniaxial compressive strains and demonstrate non-affine correlated motion within a fiber-bead network, predicted to stretch fibers in the network and lead to the ability of the network to stiffen under compression, a key feature of real tissues. These findings have important implications for understanding how local structural properties of cells and ECM fibers impact the bulk mechanical response of real tissues. STATEMENT OF SIGNIFICANCE: To understand why real tissue stiffens under compression, we study a model tissue system which also stiffens: a fibrin network embedded with stiff beads. We design a device that images compression of both fiber and fiber-bead networks. Distinct from previous imaging studies, this setup can dynamically capture network deformation on scales larger than single fibers. From the videos, we see fluid flow and network remodeling are both critical to compression behavior. The fiber-bead network has faster fluid flow, reduced network recovery, and correlated motion during network relaxation. We hypothesize that the beads hinder network relaxation of stretched fibers, thus retaining the applied stress and exhibiting stiffening. Our findings reveal important details for modeling tissue mechanics towards optimizing healthcare.
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Affiliation(s)
- Bobby Carroll
- Physics Department and BioInspired Institute, Syracuse University, Physics Building, Syracuse, NY 13244, USA
| | - Minh-Tri Ho Thanh
- Physics Department and BioInspired Institute, Syracuse University, Physics Building, Syracuse, NY 13244, USA
| | - Alison E Patteson
- Physics Department and BioInspired Institute, Syracuse University, Physics Building, Syracuse, NY 13244, USA.
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4
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Dong H, Raterman B, White RD, Starr J, Vaccaro P, Haurani M, Go M, Eisner M, Brock G, Kolipaka A. MR Elastography of Abdominal Aortic Aneurysms: Relationship to Aneurysm Events. Radiology 2022; 304:721-729. [PMID: 35638926 PMCID: PMC9434816 DOI: 10.1148/radiol.212323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 03/26/2022] [Accepted: 04/07/2022] [Indexed: 11/11/2022]
Abstract
Background Abdominal aortic aneurysm (AAA) diameter remains the standard clinical parameter to predict growth and rupture. Studies suggest that using solely AAA diameter for risk stratification is insufficient. Purpose To evaluate the use of aortic MR elastography (MRE)-derived AAA stiffness and stiffness ratio at baseline to identify the potential for future aneurysm rupture or need for surgical repair. Materials and Methods Between August 2013 and March 2019, 72 participants with AAA and 56 healthy participants were enrolled in this prospective study. MRE examinations were performed to estimate AAA stiffness and the stiffness ratio between AAA and its adjacent remote normal aorta. Two Cox proportional hazards models were used to assess AAA stiffness and stiffness ratio for predicting aneurysmal events (subsequent repair, rupture, or diameter >5.0 cm). Log-rank tests were performed to determine a critical stiffness ratio suggesting high-risk AAAs. Baseline AAA stiffness and stiffness ratio were studied using Wilcoxon rank-sum tests between participants with and without aneurysmal events. Spearman correlation was used to investigate the relationship between stiffness and other potential imaging markers. Results Seventy-two participants with AAA (mean age, 71 years ± 9 [SD]; 56 men and 16 women) and 56 healthy participants (mean age, 42 years ± 16; 27 men and 29 women) were evaluated. In healthy participants, aortic stiffness positively correlated with age (ρ = 0.44; P < .001). AAA stiffness (event group [n = 21], 50.3 kPa ± 26.5 [SD]; no-event group [n = 21], 86.9 kPa ± 52.6; P = .01) and the stiffness ratio (event group, 0.7 ± 0.4; no-event group, 2.0 ± 1.4; P < .001) were lower in the event group than the no-event group at a mean follow-up of 449 days. AAA stiffness did not correlate with diameter in the event group (ρ = -0.06; P = .68) or the no-event group (ρ = -0.13; P = .32). AAA stiffness was inversely correlated with intraluminal thrombus area (ρ = -0.50; P = .01). Conclusion Lower abdominal aortic aneurysm stiffness and stiffness ratio measured with use of MR elastography was associated with aneurysmal events at a 15-month follow-up. © RSNA, 2022 See also the editorial by Sakuma in this issue.
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Affiliation(s)
- Huiming Dong
- From the Department of Radiology (H.D., B.R., R.D.W., A.K.), Department of Internal Medicine, Division of Cardiovascular Medicine (R.D.W., A.K.), Department of Surgery (J.S., P.V., M.H., M.G.), and Department of Biomedical Informatics and Center for Biostatistics (M.E., G.B.), College of Medicine, The Ohio State University Wexner Medical Center, 395 W 12th Ave, 4th Floor, Columbus, OH 43210; Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, Ohio (H.D., A.K.); and Department of Radiology, Mayo Clinic, Jacksonville, Fla (R.D.W.)
| | - Brian Raterman
- From the Department of Radiology (H.D., B.R., R.D.W., A.K.), Department of Internal Medicine, Division of Cardiovascular Medicine (R.D.W., A.K.), Department of Surgery (J.S., P.V., M.H., M.G.), and Department of Biomedical Informatics and Center for Biostatistics (M.E., G.B.), College of Medicine, The Ohio State University Wexner Medical Center, 395 W 12th Ave, 4th Floor, Columbus, OH 43210; Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, Ohio (H.D., A.K.); and Department of Radiology, Mayo Clinic, Jacksonville, Fla (R.D.W.)
| | - Richard D. White
- From the Department of Radiology (H.D., B.R., R.D.W., A.K.), Department of Internal Medicine, Division of Cardiovascular Medicine (R.D.W., A.K.), Department of Surgery (J.S., P.V., M.H., M.G.), and Department of Biomedical Informatics and Center for Biostatistics (M.E., G.B.), College of Medicine, The Ohio State University Wexner Medical Center, 395 W 12th Ave, 4th Floor, Columbus, OH 43210; Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, Ohio (H.D., A.K.); and Department of Radiology, Mayo Clinic, Jacksonville, Fla (R.D.W.)
| | - Jean Starr
- From the Department of Radiology (H.D., B.R., R.D.W., A.K.), Department of Internal Medicine, Division of Cardiovascular Medicine (R.D.W., A.K.), Department of Surgery (J.S., P.V., M.H., M.G.), and Department of Biomedical Informatics and Center for Biostatistics (M.E., G.B.), College of Medicine, The Ohio State University Wexner Medical Center, 395 W 12th Ave, 4th Floor, Columbus, OH 43210; Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, Ohio (H.D., A.K.); and Department of Radiology, Mayo Clinic, Jacksonville, Fla (R.D.W.)
| | - Patrick Vaccaro
- From the Department of Radiology (H.D., B.R., R.D.W., A.K.), Department of Internal Medicine, Division of Cardiovascular Medicine (R.D.W., A.K.), Department of Surgery (J.S., P.V., M.H., M.G.), and Department of Biomedical Informatics and Center for Biostatistics (M.E., G.B.), College of Medicine, The Ohio State University Wexner Medical Center, 395 W 12th Ave, 4th Floor, Columbus, OH 43210; Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, Ohio (H.D., A.K.); and Department of Radiology, Mayo Clinic, Jacksonville, Fla (R.D.W.)
| | - Mounir Haurani
- From the Department of Radiology (H.D., B.R., R.D.W., A.K.), Department of Internal Medicine, Division of Cardiovascular Medicine (R.D.W., A.K.), Department of Surgery (J.S., P.V., M.H., M.G.), and Department of Biomedical Informatics and Center for Biostatistics (M.E., G.B.), College of Medicine, The Ohio State University Wexner Medical Center, 395 W 12th Ave, 4th Floor, Columbus, OH 43210; Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, Ohio (H.D., A.K.); and Department of Radiology, Mayo Clinic, Jacksonville, Fla (R.D.W.)
| | - Michael Go
- From the Department of Radiology (H.D., B.R., R.D.W., A.K.), Department of Internal Medicine, Division of Cardiovascular Medicine (R.D.W., A.K.), Department of Surgery (J.S., P.V., M.H., M.G.), and Department of Biomedical Informatics and Center for Biostatistics (M.E., G.B.), College of Medicine, The Ohio State University Wexner Medical Center, 395 W 12th Ave, 4th Floor, Columbus, OH 43210; Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, Ohio (H.D., A.K.); and Department of Radiology, Mayo Clinic, Jacksonville, Fla (R.D.W.)
| | - Mariah Eisner
- From the Department of Radiology (H.D., B.R., R.D.W., A.K.), Department of Internal Medicine, Division of Cardiovascular Medicine (R.D.W., A.K.), Department of Surgery (J.S., P.V., M.H., M.G.), and Department of Biomedical Informatics and Center for Biostatistics (M.E., G.B.), College of Medicine, The Ohio State University Wexner Medical Center, 395 W 12th Ave, 4th Floor, Columbus, OH 43210; Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, Ohio (H.D., A.K.); and Department of Radiology, Mayo Clinic, Jacksonville, Fla (R.D.W.)
| | - Guy Brock
- From the Department of Radiology (H.D., B.R., R.D.W., A.K.), Department of Internal Medicine, Division of Cardiovascular Medicine (R.D.W., A.K.), Department of Surgery (J.S., P.V., M.H., M.G.), and Department of Biomedical Informatics and Center for Biostatistics (M.E., G.B.), College of Medicine, The Ohio State University Wexner Medical Center, 395 W 12th Ave, 4th Floor, Columbus, OH 43210; Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, Ohio (H.D., A.K.); and Department of Radiology, Mayo Clinic, Jacksonville, Fla (R.D.W.)
| | - Arunark Kolipaka
- From the Department of Radiology (H.D., B.R., R.D.W., A.K.), Department of Internal Medicine, Division of Cardiovascular Medicine (R.D.W., A.K.), Department of Surgery (J.S., P.V., M.H., M.G.), and Department of Biomedical Informatics and Center for Biostatistics (M.E., G.B.), College of Medicine, The Ohio State University Wexner Medical Center, 395 W 12th Ave, 4th Floor, Columbus, OH 43210; Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, Ohio (H.D., A.K.); and Department of Radiology, Mayo Clinic, Jacksonville, Fla (R.D.W.)
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5
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Oechtering TH, Roberts GS, Panagiotopoulos N, Wieben O, Roldán-Alzate A, Reeder SB. Abdominal applications of quantitative 4D flow MRI. Abdom Radiol (NY) 2022; 47:3229-3250. [PMID: 34837521 PMCID: PMC9135957 DOI: 10.1007/s00261-021-03352-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 01/18/2023]
Abstract
4D flow MRI is a quantitative MRI technique that allows the comprehensive assessment of time-resolved hemodynamics and vascular anatomy over a 3-dimensional imaging volume. It effectively combines several advantages of invasive and non-invasive imaging modalities like ultrasound, angiography, and computed tomography in a single MRI acquisition and provides an unprecedented characterization of velocity fields acquired non-invasively in vivo. Functional and morphological imaging of the abdominal vasculature is especially challenging due to its complex and variable anatomy with a wide range of vessel calibers and flow velocities and the need for large volumetric coverage. Despite these challenges, 4D flow MRI is a promising diagnostic and prognostic tool as many pathologies in the abdomen are associated with changes of either hemodynamics or morphology of arteries, veins, or the portal venous system. In this review article, we will discuss technical aspects of the implementation of abdominal 4D flow MRI ranging from patient preparation and acquisition protocol over post-processing and quality control to final data analysis. In recent years, the range of applications for 4D flow in the abdomen has increased profoundly. Therefore, we will review potential clinical applications and address their clinical importance, relevant quantitative and qualitative parameters, and unmet challenges.
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Affiliation(s)
- Thekla H. Oechtering
- University of Wisconsin, Department of Radiology, Madison, WI, United States,Universität zu Lübeck, Department of Radiology, Luebeck, Germany
| | - Grant S. Roberts
- University of Wisconsin, Department of Medical Physics, Madison, WI, United States
| | - Nikolaos Panagiotopoulos
- University of Wisconsin, Department of Radiology, Madison, WI, United States,Universität zu Lübeck, Department of Radiology, Luebeck, Germany
| | - Oliver Wieben
- University of Wisconsin, Department of Radiology, Madison, WI, United States,University of Wisconsin, Department of Medical Physics, Madison, WI, United States
| | - Alejandro Roldán-Alzate
- University of Wisconsin, Department of Radiology, Madison, WI, United States,University of Wisconsin, Department of Mechanical Engineering, Madison, WI, United States,University of Wisconsin, Department of Biomedical Engineering, Madison, WI, United States
| | - Scott B. Reeder
- University of Wisconsin, Department of Radiology, Madison, WI, United States,University of Wisconsin, Department of Medical Physics, Madison, WI, United States,University of Wisconsin, Department of Mechanical Engineering, Madison, WI, United States,University of Wisconsin, Department of Biomedical Engineering, Madison, WI, United States,University of Wisconsin, Department of Emergency Medicine, Madison, WI, United States
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6
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Mangarova DB, Bertalan G, Jordan J, Brangsch J, Kader A, Möckel J, Adams LC, Sack I, Taupitz M, Hamm B, Braun J, Makowski MR. Microscopic multifrequency magnetic resonance elastography of ex vivo abdominal aortic aneurysms for extracellular matrix imaging in a mouse model. Acta Biomater 2022; 140:389-397. [PMID: 34818577 DOI: 10.1016/j.actbio.2021.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 11/27/2022]
Abstract
An abdominal aortic aneurysm (AAA) is a permanent dilatation of the abdominal aorta, usually accompanied by thrombus formation. The current clinical imaging modalities cannot reliably visualize the thrombus composition. Remodeling of the extracellular matrix (ECM) during AAA development leads to stiffness changes, providing a potential imaging marker. 14 apolipoprotein E-deficient mice underwent surgery for angiotensin II-loaded osmotic minipump implantation. 4 weeks post-op, 5 animals developed an AAA. The aneurysm was imaged ex vivo by microscopic multifrequency magnetic resonance elastography (µMMRE) with an in-plane resolution of 40 microns. Experiments were performed on a 7-Tesla preclinical magnetic resonance imaging scanner with drive frequencies between 1000 Hz and 1400 Hz. Shear wave speed (SWS) maps indicating stiffness were computed based on tomoelastography multifrequency inversion. As control, the aortas of 5 C57BL/6J mice were examined with the same imaging protocol. The regional variation of SWS in the thrombus ranging from 0.44 ± 0.07 to 1.20 ± 0.31 m/s was correlated fairly strong with regional histology-quantified ECM accumulation (R2 = 0.79). Our results suggest that stiffness changes in aneurysmal thrombus reflect ECM remodeling, which is critical for AAA risk assessment. In the future, µMMRE could be used for a mechanics-based clinical characterization of AAAs in patients. STATEMENT OF SIGNIFICANCE: To our knowledge, this is the first study mapping the stiffness of abdominal aortic aneurysms with microscopic resolution of 40 µm. Our work revealed that stiffness critically changes due to extracellular matrix (ECM) remodeling in the aneurysmal thrombus. We were able to image various levels of ECM remodeling in the aneurysm reflected in distinct shear wave speed patterns with a strong correlation to regional histology-quantified ECM accumulation. The generated results are significant for the application of microscopic multifrequency magnetic resonance elastography for quantification of pathological remodeling of the ECM and may be of great interest for detailed characterization of AAAs in patients.
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Affiliation(s)
- Dilyana B Mangarova
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin 10117, Germany; Department of Veterinary Medicine, Institute of Veterinary Pathology, Freie Universität Berlin, Robert-von-Ostertag-Str. 15, Building 12, Berlin 4163, Germany.
| | - Gergely Bertalan
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin 10117, Germany.
| | - Jakob Jordan
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin 10117, Germany.
| | - Julia Brangsch
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin 10117, Germany.
| | - Avan Kader
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin 10117, Germany; Department of Biology, Chemistry and Pharmacy, Institute of Biology, Freie Universität Berlin, Königin-Luise-Str. 1-3, Berlin 14195, Germany.
| | - Jana Möckel
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin 10117, Germany.
| | - Lisa C Adams
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin 10117, Germany.
| | - Ingolf Sack
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin 10117, Germany.
| | - Matthias Taupitz
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin 10117, Germany.
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin 10117, Germany.
| | - Jürgen Braun
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin 10117, Germany; Institute for Medical Informatics, Charité - Universitätsmedizin Berlin, Berlin, Germany, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Hindenburgdamm 30, Berlin 12200, Germany.
| | - Marcus R Makowski
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin 10117, Germany; Department of Diagnostic and Interventional Radiology, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany.
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7
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Moravia A, Simoëns S, El Hajem M, Bou-Saïd B, Kulisa P, Della-Schiava N, Lermusiaux P. In vitro flow study in a compliant abdominal aorta phantom with a non-Newtonian blood-mimicking fluid. J Biomech 2021; 130:110899. [PMID: 34923186 DOI: 10.1016/j.jbiomech.2021.110899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
Abstract
In vitro aortic flow simulators allow studying hemodynamics with a wider range of flow visualization techniques compared to in vivo medical imaging and without the limitations of invasive examinations. This work aims to develop an experimental bench to emulate the pulsatile circulation in a realistic aortic phantom. To mimic the blood shear thinning behavior, a non-Newtonian aqueous solution is prepared with glycerin and xanthan gum polymer. The flow is compared to a reference flow of Newtonian fluid. Particle image velocimetry is carried out to visualize 2D velocity fields in a phantom section. The experimental loop accurately recreates flowrates and pressure conditions and preserves the shear-thinning properties of the non-Newtonian fluid. Velocity profiles, shear rate, and shear stress distribution maps show that the Newtonian fluid tends to dampen the observed velocities. Preferential asymmetrical flow paths are observed in a diameter narrowing region and amplified in the non-Newtonian case. Wall shear stresses are about twice higher in the non-Newtonian case. This study shows new insights on flow patterns, velocity and shear stress distributions compared to rigid and simplified geometry aorta phantom with Newtonian fluid flows studies. The use of a non-Newtonian blood analog shows clear differences in flows compared to the Newtonian one in this compliant patient-specific geometry. The development of this aortic simulator is a promising tool to better analyze and understand aortic hemodynamics and to aid in clinical decision-making.
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Affiliation(s)
- Anaïs Moravia
- Université de Lyon, INSA de Lyon, Ecole Centrale de Lyon, Université Claude Bernard Lyon 1, CNRS, LMFA UMR 5509, Villeurbanne, France.
| | - Serge Simoëns
- Université de Lyon, INSA de Lyon, Ecole Centrale de Lyon, Université Claude Bernard Lyon 1, CNRS, LMFA UMR 5509, Villeurbanne, France
| | - Mahmoud El Hajem
- Université de Lyon, INSA de Lyon, Ecole Centrale de Lyon, Université Claude Bernard Lyon 1, CNRS, LMFA UMR 5509, Villeurbanne, France
| | - Benyebka Bou-Saïd
- Université de Lyon, CNRS, INSA de Lyon, LaMCoS UMR5259, Villeurbanne, France
| | - Pascale Kulisa
- Université de Lyon, INSA de Lyon, Ecole Centrale de Lyon, Université Claude Bernard Lyon 1, CNRS, LMFA UMR 5509, Villeurbanne, France
| | | | - Patrick Lermusiaux
- Vascular and Endovascular Department, Hospices Civils de Lyon, Lyon, France
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8
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Vessel structural stress mediates aortic media degeneration in bicuspid aortopathy: New insights based on patient-specific fluid-structure interaction analysis. J Biomech 2021; 129:110805. [PMID: 34678623 DOI: 10.1016/j.jbiomech.2021.110805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 10/06/2021] [Accepted: 10/06/2021] [Indexed: 11/22/2022]
Abstract
This study aimed to assess the relationship between local mechanical stimuli and regional aortic tissue degeneration using fluid-structure interaction (FSI) analysis in patients with bicuspid aortic valve (BAV) disease. Nine patients underwent ascending aortic replacement were recruited. Tissues were collected to evaluate the pathology features in four regions, greater curvature (GC-region), posterior (P-region), anterior (A-region), and lesser curvature (LC-region). FSI analysis was performed to quantify vessel structural stress (VSS) and flow-induced parameters, including wall shear stress (WSS), oscillatory shear index (OSI), and particle relative residence time (RRT). The correlation between these biomechanical metrics and tissue degeneration was analyzed. Elastin in the medial layer and media thickness were thinnest and the gap between fibers was biggest in the GC-region, followed by the P-region and A-region, while the elastin and media thickness were thickest and the gap smallest in the LC-region. The collagen deposition followed a pattern with the biggest in the GC-region and least in the LC-region. There is a strong negative correlation between mean or peak VSS and elastin thickness in the arterial wall in the GC-region (r = -0.917; p = 0.001 and r = -0.899; p = 0.001), A-region (r = -0.748; p = 0.020 and r = -0.700; p = 0.036) and P-region (r = -0.773; p = 0.014 and r = -0.769; p = 0.015), and between mean VSS and fiber distance in the A-region (r = -0.702, p = 0.035). Moreover, strong negative correlation between mean or peak VSS and media thickness was also observed. No correlation was found between WSS, OSI, and RRT and aortic tissue degeneration in these four regions. These findings indicate that increased VSS correlated with local elastin degradation and aortic media degeneration, implying that it could be a potential biomechanical parameter for a refined risk stratification for patients with BAV.
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In Vivo Aortic Magnetic Resonance Elastography in Abdominal Aortic Aneurysm: A Validation in an Animal Model. Invest Radiol 2021; 55:463-472. [PMID: 32520516 DOI: 10.1097/rli.0000000000000660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Using maximum diameter of an abdominal aortic aneurysm (AAA) alone for management can lead to delayed interventions or unnecessary urgent repairs. Abdominal aortic aneurysm stiffness plays an important role in its expansion and rupture. In vivo aortic magnetic resonance elastography (MRE) was developed to spatially measure AAA stiffness in previous pilot studies and has not been thoroughly validated and evaluated for its potential clinical value. This study aims to evaluate noninvasive in vivo aortic MRE-derived stiffness in an AAA porcine model and investigate the relationships between MRE-derived AAA stiffness and (1) histopathology, (2) uniaxial tensile test, and (3) burst testing for assessing MRE's potential in evaluating AAA rupture risk. MATERIALS AND METHODS Abdominal aortic aneurysm was induced in 31 Yorkshire pigs (n = 226 stiffness measurements). Animals were randomly divided into 3 cohorts: 2-week, 4-week, and 4-week-burst. Aortic MRE was sequentially performed. Histopathologic analyses were performed to quantify elastin, collagen, and mineral densities. Uniaxial tensile test and burst testing were conducted to measure peak stress and burst pressure for assessing the ultimate wall strength. RESULTS Magnetic resonance elastography-derived AAA stiffness was significantly higher than the normal aorta. Significant reduction in elastin and collagen densities as well as increased mineralization was observed in AAAs. Uniaxial tensile test and burst testing revealed reduced ultimate wall strength. Magnetic resonance elastography-derived aortic stiffness correlated to elastin density (ρ = -0.68; P < 0.0001; n = 60) and mineralization (ρ = 0.59; P < 0.0001; n = 60). Inverse correlations were observed between aortic stiffness and peak stress (ρ = -0.32; P = 0.0495; n = 38) as well as burst pressure (ρ = -0.55; P = 0.0116; n = 20). CONCLUSIONS Noninvasive in vivo aortic MRE successfully detected aortic wall stiffening, confirming the extracellular matrix remodeling observed in the histopathologic analyses. These mural changes diminished wall strength. Inverse correlation between MRE-derived aortic stiffness and aortic wall strength suggests that MRE-derived stiffness can be a potential biomarker for clinically assessing AAA wall status and rupture potential.
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Shokina N, Teschner G, Bauer A, Tropea C, Egger H, Hennig J, Krafft AJ. Parametric Sequential Method for MRI-Based Wall Shear Stress Quantification. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:1105-1112. [PMID: 33347405 DOI: 10.1109/tmi.2020.3046331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Wall shear stress (WSS) has been suggested as a potential biomarker in various cardiovascular diseases and it can be estimated from phase-contrast Magnetic Resonance Imaging (PC-MRI) velocity measurements. We present a parametric sequential method for MRI-based WSS quantification consisting of a geometry identification and a subsequent approximation of the velocity field. This work focuses on its validation, investigating well controlled high-resolution in vitro measurements of turbulent stationary flows and physiological pulsatile flows in phantoms. Initial tests for in vivo 2D PC-MRI data of the ascending aorta of three volunteers demonstrate basic applicability of the method to in vivo.
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Dong H, Jin N, Kannengiesser S, Raterman B, White RD, Kolipaka A. Magnetic resonance elastography for estimating in vivo stiffness of the abdominal aorta using cardiac-gated spin-echo echo-planar imaging: a feasibility study. NMR IN BIOMEDICINE 2021; 34:e4420. [PMID: 33021342 DOI: 10.1002/nbm.4420] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/02/2020] [Accepted: 09/10/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Magnetic resonance elastography (MRE)-derived aortic stiffness is a potential biomarker for multiple cardiovascular diseases. Currently, gradient-recalled echo (GRE) MRE is a widely accepted technique to estimate aortic stiffness. However, multi-slice GRE MRE requires multiple breath-holds (BHs), which can be challenging for patients who cannot consistently hold their breath. The aim of this study was to investigate the feasibility of a multi-slice spin-echo echo-planar imaging (SE-EPI) MRE sequence for quantifying in vivo aortic stiffness using a free-breathing (FB) protocol and a single-BH protocol. METHOD On Scanner 1, 25 healthy subjects participated in the validation of FB SE-EPI against FB GRE. On Scanner 2, another 15 healthy subjects were recruited to compare FB SE-EPI with single-BH SE-EPI. Among all volunteers, five participants were studied on both scanners to investigate the inter-scanner reproducibility of FB SE-EPI aortic MRE. Bland-Altman analysis, Lin's concordance correlation coefficient (LCCC) and coefficient of variation (COV) were evaluated. The phase-difference signal-to-noise ratios (PD SNR) were compared. RESULTS Aortic MRE using FB SE-EPI and FB GRE yielded similar stiffnesses (paired t-test, P = 0.19), with LCCC = 0.97. The FB SE-EPI measurements were reproducible (intra-scanner LCCC = 0.96) and highly repeatable (LCCC = 0.99). The FB SE-EPI MRE was also reproducible across different scanners (inter-scanner LCCC = 0.96). Single-BH SE-EPI scans yielded similar stiffness to FB SE-EPI scans (LCCC = 0.99) and demonstrated a low COV of 2.67% across five repeated measurements. CONCLUSION Multi-slice SE-EPI aortic MRE using an FB protocol or a single-BH protocol is reproducible and repeatable with advantage over multi-slice FB GRE in reducing acquisition time. Additionally, FB SE-EPI MRE provides a potential alternative to BH scans for patients who have challenges in holding their breath.
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Affiliation(s)
- Huiming Dong
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA
| | - Ning Jin
- Siemens Medical Solution, Columbus, Ohio, USA
| | | | - Brian Raterman
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Richard D White
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA
- Department of Internal Medicine-Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Arunark Kolipaka
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA
- Department of Internal Medicine-Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Steady-State Multifrequency Magnetic Resonance Elastography of the Thoracic and Abdominal Human Aorta-Validation and Reference Values. Invest Radiol 2020; 55:451-456. [PMID: 32520515 DOI: 10.1097/rli.0000000000000654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the potential of stroboscopic-wavefield-sampling-based multifrequency magnetic resonance elastography (sMRE) for quantifying the stiffness of the human thoracic and abdominal aorta in vivo. MATERIALS AND METHODS The sMRE of the thoracic and abdominal aorta was performed at 1.5 T field strength in 20 healthy volunteers aged 27 to 77 years (3 women; median age, 33 years; interquartile range [IQR], 16 years). Compound maps of shear wave speed (SWS) were reconstructed and evaluated during the diastolic phase in 3 anatomical regions: ascending thoracic aorta (AA), descending thoracic aorta (AD), and abdominal aorta (AAb). The SWS maps were read by 2 readers. Blood pressure and pulse wave velocity were determined noninvasively before sMRE. Data are given as median (IQR) and were compared using the Kruskal-Wallis and Wilcoxon rank sum tests. Intraclass correlation was used to determine interobserver and intraobserver agreement, as well as reproducibility. Multiple linear regression analysis was performed to evaluate effects of age, sex, vessel diameter, blood pressure, pulse wave velocity, and aortic segment on measured SWS. RESULTS All 20 participants underwent successful sMRE, resulting in a total of 60 aortic segments. The median SWS (IQR) of AA, AD, and AAb was 1.62 (0.16) m/s, 2.40 (0.24) m/s, and 2.48 (0.58) m/s, respectively. The SWS in AA was significantly lower (P < 0.001), and no differences in SWS (P = 0.67) were found between AD and AAb. Interobserver and intraobserver agreement, as well as reproducibility, was excellent, with intraclass correlation coefficients ranging between 0.957 and 0.998. A significant but weak influence of age on measured SWS was found, which increased from AA to AD and AAb (R = 0.229, 0.275, 0.377, respectively; P = 0.001-0.005). CONCLUSIONS Quantification of aortic stiffness in different segments of the human aorta is possible with sMRE. Our results correlate well with known aortic stiffness differences in different anatomical locations and demonstrate the potential of sMRE for clinical stiffness measurement of the thoracoabdominal aorta, which may allow detection of physiological variation and cardiovascular diseases.
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Abstract
Magnetic resonance imaging (MRI) has become an important tool for the clinical evaluation of patients with cardiac and vascular diseases. Since its introduction in the late 1980s, quantitative flow imaging with MRI has become a routine part of standard-of-care cardiothoracic and vascular MRI for the assessment of pathological changes in blood flow in patients with cardiovascular disease. More recently, time-resolved flow imaging with velocity encoding along all three flow directions and three-dimensional (3D) anatomic coverage (4D flow MRI) has been developed and applied to enable comprehensive 3D visualization and quantification of hemodynamics throughout the human circulatory system. This article provides an overview of the use of 4D flow applications in different cardiac and vascular regions in the human circulatory system, with a focus on using 4D flow MRI in cardiothoracic and cerebrovascular diseases.
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Affiliation(s)
- Gilles Soulat
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA
| | - Patrick McCarthy
- Division of Cardiac Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA
- Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, Illinois 60208, USA
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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] [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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Dux-Santoy L, Guala A, Teixidó-Turà G, Ruiz-Muñoz A, Maldonado G, Villalva N, Galian L, Valente F, Gutiérrez L, González-Alujas T, Sao-Avilés A, Johnson KM, Wieben O, Huguet M, García-Dorado D, Evangelista A, Rodríguez-Palomares JF. Increased rotational flow in the proximal aortic arch is associated with its dilation in bicuspid aortic valve disease. Eur Heart J Cardiovasc Imaging 2019; 20:1407-1417. [DOI: 10.1093/ehjci/jez046] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 02/28/2019] [Indexed: 12/11/2022] Open
Abstract
Abstract
Aims
Aortic dilation in bicuspid aortic valve (BAV) might extend to the proximal arch. Arch flow dynamics and their relationship with this segment dilation are still unexplored. Using 4D-flow cardiovascular magnetic resonance, we analysed flow dynamics in the arch for each BAV morphotype and their association with this segment dilation.
Methods and results
One hundred and eleven BAV patients (aortic diameters ≤55 mm, non-severe valvular disease), 21 age-matched tricuspid aortic valve (TAV) patients with dilated arch and 24 healthy volunteers (HV) underwent 4D-flow. BAV were classified per fusion morphotype: 75% right-left (RL-BAV), and per arch dilation: 57% dilated, mainly affecting the right-noncoronary (RN) BAV (86% dilated vs. 47% in RL-BAV). Peak velocity, jet angle, normalized displacement, in-plane rotational flow (IRF), wall shear stress, and systolic flow reversal ratio (SFRR) were calculated along the thoracic aorta. ANCOVA and multivariate linear regression analyses were used to identify correlates of arch dilation. BAV had higher rotational flow and eccentricity than TAV in the proximal arch. Dilated compared with non-dilated BAV had higher IRF being more pronounced in the RN-morphotype. RN-BAV, IRF, and SFRR were independently associated with arch dilation. Aortic stenosis and male sex were independently associated with arch dilation in RL-BAV. Flow parameters associated with dilation converged to the values found in HV in the distal arch.
Conclusion
Increased rotational flow could explain dilation of the proximal arch in RN-BAV and in RL-BAV patients of male sex and with valvular stenosis. These patients may benefit from a closer follow-up with cardiac magnetic resonance or computed tomography.
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Affiliation(s)
- Lydia Dux-Santoy
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Andrea Guala
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Gisela Teixidó-Turà
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Aroa Ruiz-Muñoz
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Giuliana Maldonado
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Nicolás Villalva
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Laura Galian
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Filipa Valente
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Laura Gutiérrez
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Teresa González-Alujas
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Augusto Sao-Avilés
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Kevin M Johnson
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705-2275, USA
- Department of Radiology, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, USA
| | - Oliver Wieben
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705-2275, USA
- Department of Radiology, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, USA
| | - Marina Huguet
- Cardiac Imaging Unit, Pilar-Quirón Hospital, Carrer de Balmes 271, 08006 Barcelona, Spain
| | - David García-Dorado
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Arturo Evangelista
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - José F Rodríguez-Palomares
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
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Ko S, Yang B, Cho JH, Lee J, Song S. Novel and facile criterion to assess the accuracy of WSS estimation by 4D flow MRI. Med Image Anal 2019; 53:95-103. [PMID: 30743192 DOI: 10.1016/j.media.2019.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 01/15/2019] [Accepted: 01/26/2019] [Indexed: 11/26/2022]
Abstract
Four-dimensional flow magnetic resonance imaging (4D flow MRI) is a versatile tool to obtain hemodynamic information and anatomic information simultaneously. The wall shear stress (WSS), a force exerted on a vessel wall in parallel, is one of the hemodynamic parameters available with 4D flow MRI and is thought to play an important role in clinical applications such as assessing the development of atherosclerosis. Nevertheless, the accuracy of WSS obtained with 4D flow MRI is rarely evaluated or reported in literature, especially in the in vivo studies. We propose a novel and facile criterion called Reynolds resolution to assess the accuracy of WSS estimation in 4D flow MRI studies. Reynolds resolution consists of a spatial resolution, encoding velocity, kinematic viscosity of a working fluid, and signal-to-noise ratio, which are readily accessible information in 4D flow MRI measurements. We explored the relationship between Reynolds resolution and the WSS error. To include diverse and extensive cases, we measured three circular tubing flows with a diameter of 40, 8, and 2 mm. The 40 mm tubing flow was measured by 3 Tesla (T) human MR scanner with a knee coil and spatial resolution of 0.5 mm. The 8 and 2 mm tubing flows were both measured by 4.7 T MR scanner, but the scans were performed with a conventional birdcage coil (8 mm tubing) and a custom-made solenoid coil (2 mm tubing), respectively. The spatial resolution was varied from 0.2, 0.4 or 0.8 mm for the 8 mm tubing flow, but was fixed at 0.090 mm for 2 mm tubing flow. In addition, the near-wall velocity gradient, required to be determined prior to the WSS, was calculated using two methods; these included assuming a linear velocity profile or quadratic velocity profile near wall. The accuracy of WSS obtained using each method and tubing flow was evaluated against the theoretical WSS value. As a result, we found that Reynolds resolution is in logarithmic relation to the WSS error.
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Affiliation(s)
- Seungbin Ko
- Department of Mechanical Engineering, Hanyang University, Seoul, 04763, South Korea
| | - Byungkuen Yang
- Department of Mechanical Engineering, Hanyang University, Seoul, 04763, South Korea
| | - Jee-Hyun Cho
- Bioimaging Research Team, Korea Basic Science Institute, Cheongju, 28119, South Korea
| | - Jeesoo Lee
- Department of Mechanical Engineering, Hanyang University, Seoul, 04763, South Korea; Institute of Nano Science and Technology, Hanyang University, Seoul, 04763, South Korea.
| | - Simon Song
- Department of Mechanical Engineering, Hanyang University, Seoul, 04763, South Korea; Institute of Nano Science and Technology, Hanyang University, Seoul, 04763, South Korea.
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Hwuang E, Vidorreta M, Schwartz N, Moon BF, Kochar K, Tisdall MD, Detre JA, Witschey WRT. Assessment of uterine artery geometry and hemodynamics in human pregnancy with 4d flow mri and its correlation with doppler ultrasound. J Magn Reson Imaging 2018; 49:59-68. [PMID: 30390347 DOI: 10.1002/jmri.26229] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 05/31/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Uterine artery (UtA) hemodynamics might be used to predict risk of hypertensive pregnancy disorders, including preeclampsia and intrauterine growth restriction. PURPOSE OR HYPOTHESIS To determine the feasibility of 4D flow MRI in pregnant subjects by characterizing UtA anatomy, computing UtA flow, and comparing UtA velocity, and pulsatility and resistivity indices (PI, RI) with transabdominal Doppler ultrasound (US). STUDY TYPE Prospective cross-sectional study from June 6, 2016, to May 2, 2018. POPULATION OR SUBJECTS OR PHANTOM OR SPECIMEN OR ANIMAL MODEL Forty-one singleton pregnant subjects (age [range] = 27.0 ± 5.9 [18-41] years) in their second or third trimester. We additionally scanned three subjects who had prepregnancy diabetes or chronic hypertension. FIELD STRENGTH/SEQUENCE The subjects underwent UtA and placenta MRI using noncontrast angiography and 4D flow at 1.5T. ASSESSMENT UtA anatomy was described based on 4D flow-derived noncontrast angiography, while UtA flow properties were characterized by net flow, systolic/mean/diastolic velocity, PI and RI through examination of 4D flow data. PI and RI are standard hemodynamic parameters routinely reported on Doppler US. STATISTICAL TESTS Spearman's rank correlation, Wilcoxon signed rank tests, and Bland-Altman plots were used to preliminarily investigate the relationships between flow parameters, gestational age, and Doppler US. or RESULTS: 4D flow MRI and UtA flow quantification was feasible in all subjects. There was considerable heterogeneity in UtA geometry in each subject between left and right UtAs and between subjects. Mean 4D flow-based parameters were: mean bilateral flow rate = 605.6 ± 220.5 mL/min, PI = 0.72 ± 0.2, and RI = 0.47 ± 0.1. Bilateral flow did not change with gestational age. We found that MRI differed from US in terms of lower PI (mean difference -0.1) and RI (mean difference < -0.1) with Wilcoxon signed rank test P = 0.05 and P = 0.13, respectively. DATA CONCLUSION 4D flow MRI is a feasible approach for describing UtA anatomy and flow in pregnant subjects. LEVEL OF EVIDENCE Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:59-68.
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Affiliation(s)
- Eileen Hwuang
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Marta Vidorreta
- Siemens Healthineers, Tarrytown, New York, USA.,Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nadav Schwartz
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Brianna F Moon
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kirpal Kochar
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Matthew Dylan Tisdall
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John A Detre
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Walter R T Witschey
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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19
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Khan S, Fakhouri F, Majeed W, Kolipaka A. Cardiovascular magnetic resonance elastography: A review. NMR IN BIOMEDICINE 2018; 31:e3853. [PMID: 29193358 PMCID: PMC5975119 DOI: 10.1002/nbm.3853] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/25/2017] [Accepted: 09/29/2017] [Indexed: 05/19/2023]
Abstract
Cardiovascular diseases are the leading cause of death worldwide. These cardiovascular diseases are associated with mechanical changes in the myocardium and aorta. It is known that stiffness is altered in many diseases, including the spectrum of ischemia, diastolic dysfunction, hypertension and hypertrophic cardiomyopathy. In addition, the stiffness of the aortic wall is altered in multiple diseases, including hypertension, coronary artery disease and aortic aneurysm formation. For example, in diastolic dysfunction in which the ejection fraction is preserved, stiffness can potentially be an important biomarker. Similarly, in aortic aneurysms, stiffness can provide valuable information with regard to rupture potential. A number of studies have addressed invasive and non-invasive approaches to test and measure the mechanical properties of the myocardium and aorta. One of the non-invasive approaches is magnetic resonance elastography (MRE). MRE is a phase-contrast magnetic resonance imaging technique that measures tissue stiffness non-invasively. This review article highlights the technical details and application of MRE in the quantification of myocardial and aortic stiffness in different disease states.
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Affiliation(s)
- Saad Khan
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
| | - Faisal Fakhouri
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, 43210, USA
| | - Waqas Majeed
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
| | - Arunark Kolipaka
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, 43210, USA
- Department of Internal Medicine-Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
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Guidetti M, Royston TJ. Analytical solution for converging elliptic shear wave in a bounded transverse isotropic viscoelastic material with nonhomogeneous outer boundary. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2018; 144:2312. [PMID: 30404507 PMCID: PMC6197985 DOI: 10.1121/1.5064372] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 08/25/2018] [Accepted: 09/28/2018] [Indexed: 05/17/2023]
Abstract
Dynamic elastography methods-based on optical, ultrasonic, or magnetic resonance imaging-are being developed for quantitatively mapping the shear viscoelastic properties of biological tissues, which are often altered by disease and injury. These diagnostic imaging methods involve analysis of shear wave motion in order to estimate or reconstruct the tissue's shear viscoelastic properties. Most reconstruction methods to date have assumed isotropic tissue properties. However, application to tissues like skeletal muscle and brain white matter with aligned fibrous structure resulting in local transverse isotropic mechanical properties would benefit from analysis that takes into consideration anisotropy. A theoretical approach is developed for the elliptic shear wave pattern observed in transverse isotropic materials subjected to axisymmetric excitation creating radially converging shear waves normal to the fiber axis. This approach, utilizing Mathieu functions, is enabled via a transformation to an elliptic coordinate system with isotropic properties and a ratio of minor and major axes matching the ratio of shear wavelengths perpendicular and parallel to the plane of isotropy in the transverse isotropic material. The approach is validated via numerical finite element analysis case studies. This strategy of coordinate transformation to equivalent isotropic systems could aid in analysis of other anisotropic tissue structures.
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Affiliation(s)
- Martina Guidetti
- Richard and Loan Hill Department of Bioengineering, 851 South Morgan Street, MC 063, University of Illinois at Chicago, Chicago, Illinois 60607, USA
| | - Thomas J Royston
- Richard and Loan Hill Department of Bioengineering, 851 South Morgan Street, MC 063, University of Illinois at Chicago, Chicago, Illinois 60607, USA
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Zimmermann J, Demedts D, Mirzaee H, Ewert P, Stern H, Meierhofer C, Menze B, Hennemuth A. Wall shear stress estimation in the aorta: Impact of wall motion, spatiotemporal resolution, and phase noise. J Magn Reson Imaging 2018; 48:718-728. [PMID: 29607574 DOI: 10.1002/jmri.26007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 02/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Wall shear stress (WSS) presents an important parameter for assessing blood flow characteristics and evaluating flow-mediated lesions in the aorta. PURPOSE To investigate the robustness of WSS and oscillatory shear index (OSI) estimation based on 4D flow MRI against vessel wall motion, spatiotemporal resolution, and velocity encoding (VENC). STUDY TYPE Simulated and prospective. POPULATION Synthetic 4D flow MRI data of the aorta, simulated using the Lattice-Boltzmann method; in vivo 4D flow MRI data of the aorta from healthy volunteers (n = 11) and patients with congenital heart defects (n = 17). FIELD STRENGTH/SEQUENCE 1.5T; 4D flow MRI with PEAK-GRAPPA acceleration and prospective electrocardiogram triggering. ASSESSMENT Predicated upon 3D cubic B-splines interpolation of the image velocity field, WSS was estimated in mid-systole, early-diastole, and late-diastole and OSI was derived. We assessed the impact of spatiotemporal resolution and phase noise, and compared results based on tracked-using deformable registration-and static vessel wall location. STATISTICAL TESTS Bland-Altman analysis to assess WSS/OSI differences; Hausdorff distance (HD) to assess wall motion; and Pearson's correlation coefficient (PCC) to assess correlation of HD with WSS. RESULTS Synthetic data results show systematic over-/underestimation of WSS when different spatial resolution (mean ± 1.96 SD up to -0.24 ± 0.40 N/m2 and 0.5 ± 1.38 N/m2 for 8-fold and 27-fold voxel size, respectively) and VENC-depending phase noise (mean ± 1.96 SD up to 0.31 ± 0.12 N/m2 and 0.94 ± 0.28 N/m2 for 2-fold and 4-fold VENC increase, respectively) are given. Neglecting wall motion when defining the vessel wall perturbs WSS estimates to a considerable extent (1.96 SD up to 1.21 N/m2 ) without systematic over-/underestimation (Bland-Altman mean range -0.06 to 0.05). DATA CONCLUSION In addition to sufficient spatial resolution and velocity to noise ratio, accurate tracking of the vessel wall is essential for reliable image-based WSS estimation and should not be neglected if wall motion is present. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
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Affiliation(s)
- Judith Zimmermann
- Department of Computer Science, Technical University of Munich, Munich, Germany
- Department of Pediatric Cardiology and Congenital Heart Defects, German Heart Center at Technical University of Munich, Munich, Germany
| | - Daniel Demedts
- Fraunhofer MEVIS Institute for Medical Image Computing, Bremen, Germany
| | - Hanieh Mirzaee
- Fraunhofer MEVIS Institute for Medical Image Computing, Bremen, Germany
- Institute for Computational and Imaging Science in Cardiovascular Medicine, Charité Universitätsmedizin, Berlin, Germany
| | - Peter Ewert
- Department of Pediatric Cardiology and Congenital Heart Defects, German Heart Center at Technical University of Munich, Munich, Germany
| | - Heiko Stern
- Department of Pediatric Cardiology and Congenital Heart Defects, German Heart Center at Technical University of Munich, Munich, Germany
| | - Christian Meierhofer
- Department of Pediatric Cardiology and Congenital Heart Defects, German Heart Center at Technical University of Munich, Munich, Germany
| | - Bjoern Menze
- Department of Computer Science, Technical University of Munich, Munich, Germany
| | - Anja Hennemuth
- Fraunhofer MEVIS Institute for Medical Image Computing, Bremen, Germany
- Institute for Computational and Imaging Science in Cardiovascular Medicine, Charité Universitätsmedizin, Berlin, Germany
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Weir-McCall JR, Lambert M, Gandy SJ, Belch JJF, Cavin I, Henderson SA, Littleford R, Macfarlane JA, Matthew SZ, Stephen Nicholas R, Struthers AD, Sullivan F, White RD, Graeme Houston J. Systemic arteriosclerosis is associated with left ventricular remodeling but not atherosclerosis: a TASCFORCE study. J Cardiovasc Magn Reson 2018; 20:7. [PMID: 29382349 PMCID: PMC5791244 DOI: 10.1186/s12968-018-0428-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 01/15/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Arteriosclerosis (arterial stiffening) is associated with future cardiovascular events, with this effect postulated to be due to its effect on cardiac afterload, atherosclerosis (plaque formation) progression or both, but with limited evidence examining these early in disease formation. The aim of the current study is to examine the association between arteriosclerosis, atherosclerosis and ventricular remodelling in a population at low-intermediate cardiovascular risk. METHODS One thousand six hundred fifty-one subjects free of clinical cardiovascular disease and with a < 20% 10 year cardiovascular risk score underwent a cardiovascular magnetic resonance (CMR) study and whole body CMR angiogram. Arteriosclerosis was measured using total arterial compliance (TAC) - calculated as the indexed stroke volume divided by the pulse pressure. Atherosclerosis was quantified using a standardised atheroma score (SAS) which was calculated by scoring 30 arterial segments within the body based on the degree of stenosis, summating these scores and normalising it to the number of assessable segments. Left ventricular remodelling was measured using left ventricular mass to volume ratio (LVMVR). RESULTS One thousand five hundred fifteen (38% male, 53.8 ± 8.2 years old) completed the study. On univariate analysis TAC was associated with SAS but this was lost after accounting for cardiovascular risk factors in both males (B = - 0.001 (- 0.004-0.002),p = 0.62) and females (B = 0.000(95%CI -0.002--0.002),p = 0.78). In contrast compliance correlated with LVMVR after accounting for cardiovascular risk factors (B = - 0.12(95%CI -0.16--0.091),p < 0.001 in males; B = - 0.12(95%CI -0.15--0.086),p < 0.001 in females). CONCLUSION Systemic arteriosclerosis is associated with left ventricular remodelling but not atherosclerosis. Future efforts in cardiovascular risk prevention should thus seek to address both arteriosclerosis and atherosclerosis individually.
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Affiliation(s)
- Jonathan R. Weir-McCall
- Division of Molecular and Clinical Medicine, College of Medicine, University of Dundee, Level 7, Dundee, DD1 9SY UK
| | - Matthew Lambert
- Division of Molecular and Clinical Medicine, College of Medicine, University of Dundee, Level 7, Dundee, DD1 9SY UK
| | | | - Jill J. F. Belch
- Division of Molecular and Clinical Medicine, College of Medicine, University of Dundee, Level 7, Dundee, DD1 9SY UK
| | - Ian Cavin
- NHS Tayside Medical Physics, Ninewells Hospital, Dundee, UK
| | | | - Roberta Littleford
- Division of Molecular and Clinical Medicine, College of Medicine, University of Dundee, Level 7, Dundee, DD1 9SY UK
| | | | - Shona Z. Matthew
- Division of Molecular and Clinical Medicine, College of Medicine, University of Dundee, Level 7, Dundee, DD1 9SY UK
| | | | - Allan D. Struthers
- Division of Molecular and Clinical Medicine, College of Medicine, University of Dundee, Level 7, Dundee, DD1 9SY UK
| | - Frank Sullivan
- Department of Research and Innovation, North York General Hospital, University of Toronto, Toronto, Canada
| | - Richard D. White
- Department of Clinical Radiology, University Hospital of Wales, Cardiff, CF14 4XW UK
| | - J. Graeme Houston
- Division of Molecular and Clinical Medicine, College of Medicine, University of Dundee, Level 7, Dundee, DD1 9SY UK
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Cardiovascular MRI in Thoracic Aortopathy: A Focused Review of Recent Literature Updates. CURRENT RADIOLOGY REPORTS 2017. [DOI: 10.1007/s40134-017-0246-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hawley JR, Kalra P, Mo X, Raterman B, Yee LD, Kolipaka A. Quantification of breast stiffness using MR elastography at 3 Tesla with a soft sternal driver: A reproducibility study. J Magn Reson Imaging 2017; 45:1379-1384. [PMID: 27779802 PMCID: PMC5395339 DOI: 10.1002/jmri.25511] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 09/27/2016] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Previous studies of breast MR elastography (MRE) evaluated the technique at magnetic field strengths of 1.5 Tesla (T) with the breast in contact with the driver. The aim of this study is to evaluate breast stiffness measurements and their reproducibility using a soft sternal driver at 3T and compare the results with qualitative measures of breast density. MATERIALS AND METHODS Twenty-two healthy volunteers each underwent two separate breast MRE scans in a 3T MRI. MRE vibrations were introduced into the breasts at 60 Hz using a soft sternal driver and axial slices were collected using a gradient echo MRE sequence. Mean stiffness measurements were calculated for each volunteer as well as a measure of reproducibility using concordance correlation between scans. Mean stiffness values for each volunteer were assessed and related to amounts of fibroglandular tissue (i.e., breast lobules, ducts, and fibrous connective tissue). RESULTS The stiffness values were reproducible with a significant P-value < 0.0001 between two scans with concordance correlation of 0.87 and 0.91 for center slice and grouping all slices, respectively. Volunteers with dense breasts (i.e., higher grades of fibroglandular tissue) had mean stiffness values of 0.96 kPa (center slice) and 0.92 kPa (all slices) while those without dense breasts had mean stiffness values of 0.85 kPa (center slice) and 0.83 kPa (all slices) (P ≤ 0.05). CONCLUSION Breast MRE is a reproducible technique at 3T using a soft sternal driver. Dense breasts had significantly higher stiffness measurements compared with nondense breasts. LEVEL OF EVIDENCE 2 J. MAGN. RESON. IMAGING 2017;45:1379-1384.
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Affiliation(s)
- Jeffrey R. Hawley
- Department of Radiology, The Ohio State University Wexner Medical Center Columbus, Ohio
| | - Prateek Kalra
- Department of Radiology, The Ohio State University Wexner Medical Center Columbus, Ohio
| | - Xiaokui Mo
- Department of Radiology, The Ohio State University Wexner Medical Center Columbus, Ohio
| | - Brian Raterman
- Department of Radiology, The Ohio State University Wexner Medical Center Columbus, Ohio
| | - Lisa D. Yee
- Department of Surgical Oncology, The Ohio State University Wexner Medical Center Columbus, Ohio
| | - Arunark Kolipaka
- Department of Radiology, The Ohio State University Wexner Medical Center Columbus, Ohio
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