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In vivo and in vitro validation of aortic flow quantification by time-resolved three-dimensional velocity-encoded MRI

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Abstract

Three-dimensional velocity-encoded cine magnetic resonance imaging (3D VEC MRI) allows for calculation of secondary flow parameters that may be used to estimate prognosis of individual cardiovascular diseases. However, its accuracy has not been fully investigated yet. The purpose of this study was to validate aortic flow quantification by 3D VEC MRI in vitro and in vivo using stacked two-dimensional acquisitions. Time-resolved stacks of two-dimensional planes with three-directional velocity-encoding (stacked-2D-3dir-MRI) were acquired in an elastic tube phantom with pulsatile flow simulating aortic flow as well as in 11 healthy volunteers (23 ± 2 years). Previously validated two-dimensional through-plane VEC MRI at six equidistant levels in vitro and three locations in vivo (ascending aorta/aortic arch/descending aorta) was used as reference standard. The percentage difference of the stacked-2D-3dir-MRI measurement to the reference standard was defined as the parameter for accuracy. For in vitro aortic flow, stacked-2D-3dir-MRI underestimated average velocity by −6.8% (p < 0.001), overestimated average area by 13.6% (p < 0.001), and underestimated average flow by −7.4% (p < 0.001). Accuracy was significantly higher in the field of view centre compared to off-centre (p = 0.001). In vivo, stacked-2D-3dir-MRI underestimated average velocity (all three locations p < 0.001) and overestimated average area at all three locations (p = n.s./<0.001/<0.001). Average flow was significantly underestimated in the ascending aorta (p = 0.035), but tended to be overestimated in the aortic arch and descending aorta. In conclusion, stacked-2D-3dir-MRI tends to overestimate average aortic area and to underestimate average aortic velocity, resulting in significant underestimation of average flow in the ascending aorta.

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Acknowledgments

Fabian Rengier received a grant from the German Research Foundation within the “Research training group 1126: Intelligent Surgery—Development of new computer-based methods for the future workplace in surgery”. We would like to thank Michael Bock and Michael Markl, PhD, for reviewing the manuscript and giving very constructive suggestions for improvement. Finally, we highly appreciate support from Susanne Yubai in data analysis and Marianne Schwartmann in management of volunteer scans.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Fabian Rengier, Sebastian Ley, Matthias Müller-Eschner, Sasan Partovi, Hans-Ulrich Kauczor & Hendrik von Tengg-Kobligk

  2. Department of Radiology, German Cancer Research Center (DKFZ) Heidelberg, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany

    Fabian Rengier, Matthias Müller-Eschner & Hendrik von Tengg-Kobligk

  3. Department of Informatics, Institute for Anthropomatics, Karlsruhe Institute of Technology (KIT), Adenauerring 2, 76131, Karlsruhe, Germany

    Michael Delles, Roland Unterhinninghofen & Rüdiger Dillmann

  4. Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Philipp Geisbüsch

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  1. Fabian Rengier
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  2. Michael Delles
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  10. Hendrik von Tengg-Kobligk
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Correspondence to Fabian Rengier.

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Rengier, F., Delles, M., Unterhinninghofen, R. et al. In vivo and in vitro validation of aortic flow quantification by time-resolved three-dimensional velocity-encoded MRI. Int J Cardiovasc Imaging 28, 1999–2008 (2012). https://doi.org/10.1007/s10554-012-0027-3

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  • DOI: https://doi.org/10.1007/s10554-012-0027-3

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