Skip to main content
SpringerLink
Log in

Highly accelerated compressed sensing 4D flow MRI in congenital and acquired heart disease: comparison of aorta and main pulmonary artery flow parameters with conventional 4D flow MRI in children and young adults

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Background

Four-dimensional flow (4D flow) MRI has become a clinically utilized cardiovascular flow assessment tool. However, scans can be lengthy and may require anesthesia in younger children. Adding compressed sensing can decrease scan time, but its impact on hemodynamic data accuracy needs additional assessment.

Objective

To compare 4D flow hemodynamics acquired with and without compressed sensing.

Materials and methods

Twenty-seven patients (median age: 13 [IQR: 9.5] years) underwent conventional and compressed sensing cardiovascular 4D flow following informed consent. Conventional 4D flow was performed using parallel imaging and an acceleration factor of 2. Compressed sensing 4D flow was performed with an acceleration factor of 7.7. Regions of interest were placed to compare flow parameters in the ascending aorta and main pulmonary artery. Paired Student’s t-tests, Wilcoxon signed-rank tests, Bland–Altman plots, and intraclass correlation coefficients were conducted. A P-value of < 0.05 was considered statistically significant.

Results

Mean scan acquisition time was reduced by 59% using compressed sensing (3.4 vs. 8.2 min, P < 0.001). Flow quantification was similar for compressed sensing and conventional 4D flow for the ascending aorta net flow: 47 vs. 49 ml/beat (P = 0.28); forward flow: 49 vs. 50 ml/beat (P = 0.07), and main pulmonary artery net flow: 49 vs. 51 ml/beat (P = 0.18); forward flow: 50 vs. 55 ml/beat (P = 0.07). Peak systolic velocity was significantly underestimated by compressed sensing 4D flow in the ascending aorta: 114 vs. 128 cm/s (P < 0.001) and main pulmonary artery: 106 vs. 112 cm/s (P = 0.02).

Conclusion

For both the aorta and main pulmonary artery, compressed sensing 4D flow provided equivalent net and forward flow values compared to conventional 4D flow but underestimated peak systolic velocity. By reducing scan time, compressed sensing 4D flow may decrease the need for anesthesia and increase scanner output without significantly compromising data integrity.

Graphical Abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Data availability

The datasets that support the finding of this study are available from the corresponding author upon request.

References

  1. Dyverfeldt P, Bissell M, Barker AJ et al (2015) 4D flow cardiovascular magnetic resonance consensus statement. J Cardiovasc Magn Reson 17(1):72. https://doi.org/10.1186/s12968-015-0174-5

    Article  PubMed  PubMed Central  Google Scholar 

  2. Markl M, Frydrychowicz A, Kozerke S et al (2012) 4D flow MRI. J Magn Reson Imaging 36(5):1015–1036. https://doi.org/10.1002/jmri.23632

    Article  PubMed  Google Scholar 

  3. Gorecka M, Bissell MM, Higgins DM et al (2022) Rationale and clinical applications of 4D flow cardiovascular magnetic resonance in assessment of valvular heart disease: a comprehensive review. J Cardiovasc Magn Reson 24(1):49. https://doi.org/10.1186/s12968-022-00882-0

    Article  PubMed  PubMed Central  Google Scholar 

  4. Gabbour M, Schnell S, Jarvis K et al (2015) 4-D flow magnetic resonance imaging: blood flow quantification compared to 2-D phase-contrast magnetic resonance imaging and Doppler echocardiography. Pediatr Radiol 45(6):804–813. https://doi.org/10.1007/s00247-014-3246-z

    Article  PubMed  Google Scholar 

  5. Bollache E, van Ooij P, Powell A et al (2016) Comparison of 4D flow and 2D velocity-encoded phase contrast MRI sequences for the evaluation of aortic hemodynamics. Int J Cardiovasc Imaging 32(10):1529–1541. https://doi.org/10.1007/s10554-016-0938-5

    Article  PubMed  PubMed Central  Google Scholar 

  6. Binter C, Gotschy A, Sündermann SH et al (2017) Turbulent kinetic energy assessed by multipoint 4-dimensional flow magnetic resonance imaging provides additional information relative to echocardiography for the determination of aortic stenosis severity. Circ Cardiovasc Imaging 10(6):e005486. https://doi.org/10.1161/CIRCIMAGING.116.005486

    Article  PubMed  Google Scholar 

  7. Barker AJ, van Ooij P, Bandi K et al (2014) Viscous energy loss in the presence of abnormal aortic flow. Magn Reson Med 72(3):620–628. https://doi.org/10.1002/mrm.24962

    Article  PubMed  Google Scholar 

  8. Hope MD, Sigovan M, Wrenn SJ et al (2014) MRI hemodynamic markers of progressive bicuspid aortic valve-related aortic disease. J Magn Reson Imaging 40(1):140–145. https://doi.org/10.1002/jmri.24362

    Article  PubMed  Google Scholar 

  9. Lewandowski AJ, Raman B, Banerjee R, Milanesi M (2017) Novel insights into complex cardiovascular pathologies using 4D flow analysis by cardiovascular magnetic resonance imaging. Curr Pharm Des 23(22):3262–3267. https://doi.org/10.2174/1381612823666170317144257

    Article  CAS  PubMed  Google Scholar 

  10. Galian-Gay L, Rodríguez-Palomares J, Guala A et al (2020) Multimodality imaging in bicuspid aortic valve. Prog Cardiovasc Dis 63(4):442–451. https://doi.org/10.1016/j.pcad.2020.06.003

    Article  PubMed  Google Scholar 

  11. Stankovic Z, Allen BD, Garcia J et al (2014) 4D flow imaging with MRI. Cardiovasc Diagn Ther 4(2):173–192. https://doi.org/10.3978/j.issn.2223-3652.2014.01.02

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bock J, Töger J, Bidhult S et al (2019) Validation and reproducibility of cardiovascular 4D-flow MRI from two vendors using 2 × 2 parallel imaging acceleration in pulsatile flow phantom and in vivo with and without respiratory gating. Acta Radiol 60(3):327–337. https://doi.org/10.1177/0284185118784981

    Article  PubMed  Google Scholar 

  13. Baltes C, Kozerke S, Hansen MS et al (2005) Accelerating cine phase-contrast flow measurements using k-t BLAST and k-t SENSE. Magn Reson Med 54(6):1430–1438. https://doi.org/10.1002/mrm.20730

    Article  PubMed  Google Scholar 

  14. Ma LE, Markl M, Chow K et al (2019) Aortic 4D flow MRI in 2 minutes using compressed sensing, respiratory controlled adaptive k-space reordering, and inline reconstruction. Magn Reson Med 81(6):3675–3690. https://doi.org/10.1002/mrm.27684

    Article  PubMed  PubMed Central  Google Scholar 

  15. Pathrose A, Ma L, Berhane H et al (2021) Highly accelerated aortic 4D flow MRI using compressed sensing: performance at different acceleration factors in patients with aortic disease. Magn Reson Med 85(4):2174–2187. https://doi.org/10.1002/mrm.28561

    Article  PubMed  Google Scholar 

  16. Neuhaus E, Weiss K, Bastkowski R et al (2019) Accelerated aortic 4D flow cardiovascular magnetic resonance using compressed sensing: applicability, validation and clinical integration. J Cardiovasc Magn Reson 21(1):65. https://doi.org/10.1186/s12968-019-0573-0

    Article  PubMed  PubMed Central  Google Scholar 

  17. Peper ES, Gottwald LM, Zhang Q et al (2020) Highly accelerated 4D flow cardiovascular magnetic resonance using a pseudo-spiral Cartesian acquisition and compressed sensing reconstruction for carotid flow and wall shear stress. J Cardiovasc Magn Reson 22:7. https://doi.org/10.1186/s12968-019-0582-z

    Article  PubMed  PubMed Central  Google Scholar 

  18. Vasanawala SS, Hanneman K, Alley MT, Hsiao A (2015) Congenital heart disease assessment with 4D flow MRI. J Magn Reson Imaging 42(4):870–886. https://doi.org/10.1002/jmri.24856

    Article  PubMed  Google Scholar 

  19. Alphonso N, Angelini A, Barron DJ, Chaiman HLHS Guidelines Task Force et al (2020) Guidelines for the management of neonates and infants with hypoplastic left heart syndrome: the European Association for Cardio-Thoracic Surgery (EACTS) and the Association for European Pediatric and Congenital Cardiology (AEPC) Hypoplastic Left Heart Syndrome Guidelines Task Force. Eur J Cardiothorac Surg 58(3):416–499. https://doi.org/10.1093/ejcts/ezaa188

    Article  PubMed  Google Scholar 

  20. Hsiao A, Yousaf U, Alley MT et al (2015) Improved quantification and mapping of anomalous pulmonary venous flow with four-dimensional phase-contrast MRI and interactive streamline rendering. J Magn Reson Imaging 42(6):1765–1776. https://doi.org/10.1002/jmri.24928

    Article  PubMed  PubMed Central  Google Scholar 

  21. Hsiao A, Lustig M, Alley MT et al (2012) Evaluation of valvular insufficiency and shunts with parallel-imaging compressed-sensing 4D phase-contrast MR imaging with stereoscopic 3D velocity-fusion volume-rendered visualization. Radiology 265(1):87–95. https://doi.org/10.1148/radiol.12120055

    Article  PubMed  PubMed Central  Google Scholar 

  22. Hsiao A, Lustig M, Alley MT et al (2012) Rapid pediatric cardiac assessment of flow and ventricular volume with compressed sensing parallel imaging volumetric cine phase-contrast MRI. AJR Am J Roentgenol 198(3):W250–W259. https://doi.org/10.2214/AJR.11.6969

    Article  PubMed  PubMed Central  Google Scholar 

  23. Chelu RG, van den Bosch AE, van Kranenburg M et al (2016) Qualitative grading of aortic regurgitation: a pilot study comparing CMR 4D flow and echocardiography. Int J Cardiovasc Imaging 32(2):301–307. https://doi.org/10.1007/s10554-015-0779-7

    Article  PubMed  Google Scholar 

  24. Spampinato RA, Jahnke C, Crelier G et al (2021) Quantification of regurgitation in mitral valve prolapse with four-dimensional flow cardiovascular magnetic resonance. J Cardiovasc Magn Reson 23:87. https://doi.org/10.1186/s12968-021-00783-8

    Article  PubMed  PubMed Central  Google Scholar 

  25. Adriaans BP, Westenberg JJM, van Cauteren YJM et al (2020) Clinical assessment of aortic valve stenosis: comparison between 4D flow MRI and transthoracic echocardiography. J Magn Reson Imaging 51(2):472–480. https://doi.org/10.1002/jmri.26847

    Article  PubMed  Google Scholar 

  26. Kilinc O, Chu S, Baraboo J et al (2022) Hemodynamic evaluation of type B aortic dissection using compressed sensing accelerated 4D flow MRI. J Magn Reson Imaging JMRI. https://doi.org/10.1002/jmri.28432

    Article  PubMed  Google Scholar 

  27. Kollar SE, Udine ML, Mandell JG et al (2022) Impact of ferumoxytol vs gadolinium on 4D flow cardiovascular magnetic resonance measurements in small children with congenital heart disease. J Cardiovasc Magn Reason 24:58. https://doi.org/10.1186/s12968-022-00886

    Article  Google Scholar 

  28. Soulat G, McCarthy P (2020) Markl M (2020) 4D flow with MRI. Annu Rev Biomed Eng 22:103–126. https://doi.org/10.1146/annurev-bioeng-100219-110055

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors express sincere gratitude to the patients who participated in this research study. We also acknowledge the contribution of Wenya Chen from the Quantitative Science Pillar within Stanley Manne Children’s Research Institute for assistance with statistical analysis and results interpretation.

Funding

This work was supported by National Institutes of Health R01 HL115828 grant.

Author information

Authors and Affiliations

  1. Department of Medical Imaging, Ann and Robert H. Lurie Children’s Hospital of Chicago, 225 East Chicago Avenue #9, Chicago, IL, 60611, USA

    Aparna Sodhi, Andrada R. Popescu, Lindsay M. Griffin & Cynthia K. Rigsby

  2. Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Michael Markl, Andrada R. Popescu, Lindsay M. Griffin, Joshua D. Robinson & Cynthia K. Rigsby

  3. Department of Biomedical Engineering, McCormick School of Engineering, Evanston, IL, USA

    Michael Markl

  4. Division of Cardiology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    Joshua D. Robinson

  5. Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Joshua D. Robinson & Cynthia K. Rigsby

Authors
  1. Aparna Sodhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Markl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrada R. Popescu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lindsay M. Griffin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joshua D. Robinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Cynthia K. Rigsby
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors were involved in conception and design of study. Data acquisition was performed through protocols designed by Dr. Cynthia Rigsby and Dr. Michael Markl. Data analysis and interpretation of data were done by Aparna Sodhi and Dr. Cynthia Rigsby. The first draft of the manuscript was written by Aparna Sodhi and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Aparna Sodhi.

Ethics declarations

Conflicts of interest

None

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sodhi, A., Markl, M., Popescu, A.R. et al. Highly accelerated compressed sensing 4D flow MRI in congenital and acquired heart disease: comparison of aorta and main pulmonary artery flow parameters with conventional 4D flow MRI in children and young adults. Pediatr Radiol 53, 2597–2607 (2023). https://doi.org/10.1007/s00247-023-05788-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-023-05788-2

Keywords

Search

Navigation