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Comparison of Prospective and Retrospective Gated 4D Flow Cardiac MR Image Acquisitions in the Carotid Bifurcation

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Abstract

Purpose

To evaluate the agreement of 4D flow cMRI-derived bulk flow features and fluid (blood) velocities in the carotid bifurcation using prospective and retrospective gating techniques.

Methods

Prospective and retrospective ECG-gated three-dimensional (3D) cine phase-contrast cardiac MRI with three-direction velocity encoding (i.e., 4D flow cMRI) data were acquired in ten carotid bifurcations from men (n = 3) and women (n = 2) that were cardiovascular disease-free. MRI sequence parameters were held constant across all scans except temporal resolution values differed. Velocity data were extracted from the fluid domain and evaluated across the entire volume or at defined anatomic planes (common, internal, external carotid arteries). Qualitative agreement between gating techniques was performed by visualizing flow streamlines and topographical images, and statistical comparisons between gating techniques were performed across the fluid volume and defined anatomic regions.

Results

Agreement in the kinematic data (e.g., bulk flow features and velocity data) were observed in the prospectively and retrospectively gated acquisitions. Voxel differences in time-averaged, peak systolic, and diastolic-averaged velocity magnitudes between gating techniques across all volunteers were 2.7%, 1.2%, and 6.4%, respectively. No significant differences in velocity magnitudes or components (\({v}_{r}\), \({v}_{\theta }\), \({v}_{z}\)) were observed. Importantly, retrospective acquisitions captured increased retrograde flow in the internal carotid artery (i.e., carotid sinus) compared to prospective acquisitions (10.4 ± 6.3% vs. 4.6 ± 5.3%; \(p\) < 0.05).

Conclusion

Prospective and retrospective ECG-gated 4D flow cMRI acquisitions provide comparable evaluations of fluid velocities, including velocity vector components, in the carotid bifurcation. However, the increased temporal coverage of retrospective acquisitions depicts increased retrograde flow patterns (i.e., disturbed flow) not captured by the prospective gating technique.

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Acknowledgments

This study was supported with funding from the National Institutes of Health (R21 NS114602; JNO). This work utilized equipment that was purchased with funding from the National Institutes of Health (S10 D018482). Seg3D is an open-source software project that is supported by the National Institute of General Medical Sciences of the National Institutes of Health under grant number P41 GM103545 and R24 GM136986 (CRJ). The Authors thank Bea Hurd for assistance with illustrations.

Competing interest

The authors have no conflicts of interests or competing interests to declare.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

The authors affirm that human research participants provided informed consent for the publication of images in Fig. 1.

Ethical approval

Approval was obtained from the Institutional Review Boards at the University of Utah and Emory University. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Authors and Affiliations

  1. Department of Biomedical Engineering, University of Utah, 36 S. Wasatch Drive, Rm. 3100, Salt Lake City, UT, 84112, USA

    Elliott R. Hurd, Chris R. Johnson, Edward V. R. DiBella & Lucas H. Timmins

  2. School of Computing, University of Utah, Salt Lake City, UT, 84112, USA

    Mengjiao Han & Chris R. Johnson

  3. Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah, 84112, USA

    Mengjiao Han, Chris R. Johnson & Lucas H. Timmins

  4. Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, 84112, USA

    Jason K. Mendes, J. Rock Hadley & Edward V. R. DiBella

  5. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, 30322, USA

    John N. Oshinski

  6. Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA

    John N. Oshinski

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  1. Elliott R. Hurd
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Correspondence to Lucas H. Timmins.

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Associate Editor Keefe B. Manning oversaw the review of this article.

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Hurd, E.R., Han, M., Mendes, J.K. et al. Comparison of Prospective and Retrospective Gated 4D Flow Cardiac MR Image Acquisitions in the Carotid Bifurcation. Cardiovasc Eng Tech 14, 1–12 (2023). https://doi.org/10.1007/s13239-022-00630-6

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